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

Bill Ritter, Jr., Governor Joan Henneberry, Executive Director

March 31, 2009

The Honorable Bernie Buescher

Secretary of State

1560 Broadway, 2nd Floor

Denver, Colorado 80203

Dear Mr. Buescher:

Attached is the Notice of Proposed Rules concerning Medical Assistance rules to be considered for final adoption at the May 2009 meeting of the Medical Services Board of the Department of Health Care Policy and Financing. The meeting will be held on Friday, May 8, 2009, beginning at 9:00 A.M., in the sixth floor conference room at the Capitol Center, 225 East 16th 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 2009 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 8, 2009, beginning at 9:00 a.m., in the sixth floor conference room at the Capitol Center, 225 East 16th 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 are 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 http://www.chcpf.state.co.us/msb/agenda.

MSB# 09-01-15-A: Changes to Provider Reimbursement Rates for the Old Age Pension Health and Medical Care Program Changes provider reimbursement rates for the Old Age Pension Health and Medical Care Program under 10 C.C.R. 2505-10, Section 8.941.9. This rule also deletes language under 8.941.1(B) that limits inpatient hospital benefits for Old Age Pension Health and Medical Care Program recipients who receive inpatient hospital services from providers of the Colorado Indigent Care Program. In addition, this rule makes permanent, portions of a previous emergency rule, MSB # 08-11-21-B, authorizing the Executive Director of the Department of Health Care Policy and Financing to increase provider reimbursement rates under Section 8.941.1(E). The authority for this rule is contained in Sections 25.5-1-301 through 25.5-1-303 C.R.S. (2008).

MSB 06-10-20-A. Nursing Facilities. Pursuant to HB 08-1114 the nursing facility reimbursement methodology will change from a cost-based system to a hybrid model of reimbursement. Changes to the base rate will move the administrative and general cost component from a cost-based system to a price-based system. Changes to the health care component remove the 8% growth limitation to actual, allowable costs up to a maximum. The maximum rate is based on the median cost as determined by an array of all class I nursing facilities. The price is set at 105% of the median for facilities with 61 beds or more and 110% of the median for facilities with 60 beds or fewer. A rate add-on will provide additional reimbursement for facilities that develop, implement and sustain a Quality Improvement program to enhance the lives of nursing facility residents and the care provided to these residents. Additional reimbursement is provided for facilities that serve residents with major mental illness or developmental disabilities and/or cognitive loss, dementia or acquired traumatic brain injury. A provider fee is charged and collected from class I nursing facilities to fund the rate add-ons and to fund the base rate to the extent the base rate exceeds the statutory limit on annual growth in the general fund share of nursing facility per diem payments. Implementation of HB 08-1114 is contingent upon the Centers for Medicare and Medicaid Services approval of the provider fee. The authority for this rule is contained in 25.5-6-201 through 25.5-6-204, C.R.S. (2008).

MSB 08-05-22-A. Revision to the Pharmaceuticals Rule, Section 8.800. This rule revision serves to reorganize and update some language in the Pharmaceuticals rules. The authority for this rule revision is contained in Sections 25.5-1-301 through 25.5-1-303, C.R.S. (2008).

“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