Colorado Department of Healthcare Policy & Finance Notice of Rule Changes

November 29, 2018

The Department of Health Care Policy and Financing - Medical Services will be holding a rulemaking hearing on Friday, January 11th, 2019, 9:00 am on rules regarding Timely Filing. The hearing will be held at: 303 East 17th Avenue, 11th Floor, Denver CO 80203.

The purpose of this rulemaking is: 

 

The proposed Timely Filing Rule is to update the restriction placed on how quickly providers must submit health care claims to Health First Colorado. Prior to the implementation of the Colorado interChange, timely filing was set at 120 days. Some providers experienced billing difficulties during the implementation, so the Department issued a temporary extension of the time frame. Initially, the timely period was extended to 240 days, and then further increased to 365 days, which is the maximum allowed under federal regulations. The Department has reassessed the policy and decided to make this temporary extension a permanent change to assist providers in health care claims submissions and to align with federal regulations.

If you believe there will be a significant negative impact on small business, job creation or economic competitiveness, you may request that the Department of Regulatory Agencies require the rulemaking agency to prepare a cost-benefit analysis of a proposed rule or amendment. This request must be made to the Department of Regulatory Agencies by Saturday, December 15th, 2018.

You may also submit comments directly to the rulemaking agency for the agency's consideration during the upcoming rulemaking hearing.

 

The Department of Health Care Policy and Financing - Medical Services will be holding a rulemaking hearing on Friday, January 11th, 2019, 9:00 am on rules regarding School Health Services Program. The hearing will be held at: 303 East 17th Avenue, 11th Floor, Denver CO 80203.

The purpose of this rulemaking is: 

 

The proposed changes to the SHS rules are to maintain the 120 days for timely filing and not have the SHS Program go with the new update to 365 days to submit claims. Changing to 365 days would have a negative impact on the school districts because it would delay payments to the school districts. In addition if we do not update the SHS rules the SHS state plan amendment would have to be updated as the two would be contradicting each other.

If you believe there will be a significant negative impact on small business, job creation or economic competitiveness, you may request that the Department of Regulatory Agencies require the rulemaking agency to prepare a cost-benefit analysis of a proposed rule or amendment. This request must be made to the Department of Regulatory Agencies by Saturday, December 15th, 2018.

You may also submit comments directly to the rulemaking agency for the agency's consideration during the upcoming rulemaking hearing.

 

The Department of Health Care Policy and Financing - Medical Services will be holding a rulemaking hearing on Friday, January 11th, 2019, 9:00 am on rules regarding Psychiatric Residential Treatment Facili. The hearing will be held at: 303 East 17th Avenue, 11th Floor, Denver CO 80203.

The purpose of this rulemaking is: 

 

The Psychiatric Residential Treatment Facility (PRTF) and Residential Child Care Facility (RCCF) rule section at 10 C.C.R. 2505-10, Section 8.765, requires an update to reflect the most current diagnostic manual, agency names, statutory references, State Plan Amendments, assessment tools, and federal requirements concerning restraint and seclusion. To align the rule with current practice, the update also identifies the Colorado Department of Human Services' (CDHS) Office of Behavioral Health (OBH) as the agency responsible for designating and licensing RCCFs and the requirement that PRTFs be certified by CDHS has been removed. Finally, the update includes a provision concerning RCCFs' ability to enroll as a separate provider type to render medically necessary services not included in the RCCF benefit. While this has always been the case, it is not specified in the current rule.

If you believe there will be a significant negative impact on small business, job creation or economic competitiveness, you may request that the Department of Regulatory Agencies require the rulemaking agency to prepare a cost-benefit analysis of a proposed rule or amendment. This request must be made to the Department of Regulatory Agencies by Saturday, December 15th, 2018.

You may also submit comments directly to the rulemaking agency for the agency's consideration during the upcoming rulemaking hearing.

We hope this information is helpful to you. Thank you for taking the time to participate in the rulemaking process.