July 2007 Rule Notice

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COLORADO DEPARTMENT OF HEALTH CARE POLICY & FINANCING

1570 Grant Street, Denver, CO 80203-1818 (303) 866-2993 (303) 866-4411 Fax (303) 866-3883 TTY

John Hickenlooper, Governor Susan E. Birch, MBA, BSN, RN, Executive Director

March 28, 2014

The Honorable Scott Gessler

Secretary of State

1560 Broadway, 2nd Floor

Denver, Colorado 80203

Dear Mr. Gessler:

Attached is the Notice of Proposed Rules concerning Medical Assistance rules to be considered for final adoption at the May 2014 meeting of the Medical Services Board of the Department of Health Care Policy and Financing. The meeting will be held on Friday, May 9, 2014, beginning at 9:00 A.M., in the seventh floor conference room at the 303 East 17th Avenue, Denver, CO 80203.

This notice is submitted to you for publication, pursuant to § 24-4-103(3)(a) and (11)(a), C.R.S.

Sincerely,

Judi Carey,

Coordinator

Medical Services Board

attachments

“The mission of the Department of Health Care Policy & Financing is to purchase cost-effective health care for qualified, low-income Coloradans.”

http://www.chcpf.state.co.us

May 9, 2014 Rule Notice

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NOTICE OF PROPOSED RULES

The Medical Services Board of the Colorado Department of Health Care Policy and Financing will hold a public meeting on Friday, May 9, 2014, beginning at 9:00 a.m., in the seventh floor conference room at the 303 East 17th Avenue, Denver, CO 80203. Reasonable accommodations will be provided upon request prior to the meeting, by contacting the Medical Services Board Coordinator at 303-866-4416.

A copy of the full text of these proposed rule changes is available for review from the Medical Services Board Office, 1570 Grant Street, Denver, Colorado 80203, tel. (303) 866-4416, fax (303) 866-4411. Written comments may be submitted to the Medical Services Board Office on or before close of business the Wednesday prior to the meeting. Additionally, the full text of all proposed changes will be available approximately one week prior to the meeting on the internet at HCPF:+Meeting Schedule.

MSB 14-02-26-A. Revision to the Medical Assistance Rule Concerning Home and Community Based Services Pediatric Hospice Waiver (HCBS-PHW), Section 8.504

Medical Assistance. The proposed rule amends the current Home and Community Based Services Pediatric Hospice Waiver (HCBS-PHW) rule to update the service definitions and provider qualifications. In addition, the rule amends the title of the waiver from Pediatric Hospice Waiver (PHW) to Children with Life Limiting Illness Waiver (CLLI). The authority for this rule is contained in 25.5-6-804, et. Seq. CRS (2013).

MSB 14-02-25-F. Revision to the Medical Assistance Home and Community-Based Services Rule Concerning Persons with Spinal Cord Injury (HCBS-SCI). Rule 10 C.C.R. 2505-10, Sections 8.517.5, 8.517.6

Medical Assistance. The rules providing guidance for the waiting list for the Home and Community-Based Services for persons with Spinal Cord Injury (HCBS-SCI) waiver pilot program are broad. Therefore, the 10 C.C.R. 2505-10, Sections 8.517.5 and 8.517.6, are being amended to provide specific criteria and processes for managing the waiting list. This amendment moves the waiting list procedure from subsection Section 8.517.5.G. to its own section number 8.517.6. The amended Section 8.517.6 requires individuals to meet all waiver eligibility requirements before being added to the waiting list, as well as the processes the Department will use for managing the waiting list. The current Section 8.517.6 will be moved down in numerical order and the subsequent sections will be renumbered accordingly. The authority for this rule is contained in 25.5-1-301 through 25.5-1-303, C.R.S. (2013).

MSB 14-02-25-A. Revision to the Medical Assistance Home and Community Based Services Brain Injury (HCBS-BI) Waiver Rule Concerning the Transitional Living Program, Section 8.516.30

Medical Assistance. Brain Injury Waiver Rule Change for Transitional Living. The rules set forth at 10 CCR 2505-10 Section 8.516.30 are being revised to incorporate the definition of services provided to HCBS-BI waiver clients effective June 30, 2014. Proposed changes to this rule expand the definitions of the transitional living program to provide more inclusive therapeutic services to clients. Additionally, the rule change expands the definition of a medically stable client, consequently expanding access to the HCBS-BI waiver. The authority for this rule is contained in 25.5-1-301 through 25.5-1-303, C.R.S. (2013).

MSB 14-02-25-B. Revision to the Medical Assistance Home and Community Based Services for Person with Brain Injury (HCBS-BI) Rule Counseling, Section 8.516.50

Medical Assistance. Revision to the Home and Community Based Services for Persons with Brain Injury Rule concerning Counseling, Section 8.516.5. The rules set forth at 10 CCR 2505-10 Section 8.516.5 are being altered to expand eligibility for the HCBS-BI waiver. Prior to these proposed changes, the HCBS-BI client was required to be present for all family training/counseling services. The new revisions eliminate this requirement and correct minor typographical errors from previous revisions. The authority for this rule is contained in 25.5-1-301 through 25.5-1-303, C.R.S. (2013).

MSB 14-02-25-C. Revision to the Medical Assistance Home and Community Based Services for Persons with Brain Injury Rule Respite Care, Section 8.516.70

Medical Assistance. Brain Injury Waiver Rule Change for Respite Care. The rules set forth at 10 CCR 2505-10 Section 8.516.70 are being revised to incorporate the definition of services provided to HCBS-BI waiver clients effective June 30, 2014. Prior to this proposed rule change, respite care services were provided to clients under the HCBS-BI waiver only as stipulated by the HCBS-Elderly, Blind, and Disabled Waiver. The primary changes to the BI rules involve amending the rule to add the definition, inclusion, restrictions, and certification standards and procedures for respite care (10 CCR 2505-10 Section 8.516.70). The authority for this rule is contained in 25.5-1-301 through 25.5-1-303, C.R.S. (2013).

MSB 14-02-25-D. Revisions to the Medical Assistance Home and Community Based Services for Persons with Brain Injury Rule Substance Abuse Counseling, Section 8.516.60

Medical Assistance. Revision to the Home and Community Based Services for Persons with Brain Injury Rule concerning Substance Abuse Counseling, Section 8.516.6. The rules set forth at 10 CCR 2505-10 Section 8.516.6 are being altered to expand the pool of providers capable of offering this service under the HCBS-BI waiver. The new revisions accomplish the provider expansion by changing the certification level of Certified Addiction Counselors. Revisions also correct minor typographical errors from previous revisions. The authority for this rule is contained in 25.5-1-301 through 25.5-1-303, C.R.S. (2013).

MSB 14-02-25-E. Revisions to the Medical Assistance Home and Community Based Services for Persons with Brain Injury Rule Eligible Persons, Section 8.515.50

Medical Assistance. Revision to the Home and Community Based Services for Persons with Brain Injury Rule Concerning Eligible Persons, Section 8.515.5. The rules set forth at 10 CCR 2505-10 Section 8.515.5 are being altered to expand eligibility for the HCBS-BI Waiver. Prior to these proposed changes, individuals were required to enroll in the HCBS-BI Waiver within six months of the brain injury. The proposed revisions remove this time restriction and enable individuals who receive brain injuries under the age of 16 to be eligible for the Waiver upon turning 16. The authority for this rule is contained in 25.5-1-301 through 25.5-1-303, C.R.S. (2013).

MSB 14-02-28-A. Revision to the Medical Assistance Pharmacy Section Rule Concerning Application to Participate in the Medical Assistance Pharmacy Program Repeal of Form Med-11E

Medical Assistance. Pharmacy Section. The statute authorizing the application to participate in the medical assistance pharmacy program, Form MED-11E. was repealed. Therefore, the rules implementing the program, Form MED-11E, are being deleted. The authority for this rule is contained in 25.5-1-301 through 25.5-1-303, C.R.S. (2013).

MSB 13-12-20-A. Revision to the Medical Assistance Health Programs Service and Support Rule Concerning the Program of All-Inclusive Care for the Elderly, Section 8.497

Medical Assistance. The statute authorizing the Program of All-Inclusive Care for the Elderly (PACE), Section 25.5-5-412, C.R.S. was modified pursuant to SB 12-023. Therefore, rules implementing aspects of the program, have been added to account for those changes.

This rule change adds two provisions:

1) To allow Medicaid clients that are eligible for PACE but enrolled in a managed care organization, RCCO, or other risk based entity to disenroll and enroll in PACE (if a client chooses to do so); and

2) To allow PACE organizations to contract with an enrollment broker to include information on PACE in the enrollment broker's marketing materials to eligible long-term care clients. The authority for this rule is contained in 25.5-1-301 through 25.5-1-303, C.R.S. (2013).

“The mission of the Department of Health Care Policy & Financing is to purchase cost-effective health care for qualified, low-income Coloradans.”

http://www.chcpf.state.co.us