MSB 12-04-09-A Revision to the Medical Assistance Rule Concerning Colorado Choice Transitions

FEBRUARY 2013 EMERGENCY JUSTIFICATION FOR MEDICAL ASSISTANCE RULES ADOPTED AT THE FEBRUARY 8, 2013 MEDICAL SERVICES BOARD MEETING

MSB 12-04-09-A Revision to the Medical Assistance Rule Concerning Colorado Choice Transitions, A Money Follows The Person Demonstration, 8.500

To comply with state or federal law or federal regulation and/or for the preservation of public health, safety and welfare.

The Colorado Health Care Affordability Act [25.5-4-402.3, C.R.S. (2012)] instructs the Department to charge hospital provider fees and obtain federal Medicaid matching funds. The hospital provider fee is the source of funding for supplemental Medicaid payments to hospitals and payments associated with the Colorado Indigent Care Program (CICP). It is also the source of funding for the expansion of eligibility for Medicaid Parents from 60% to 100% of the federal poverty level (FPL) and the expansion of the Child Health Plan Plus (CHP+) from 205% to 250% FPL implemented in May 2010, and the expansions in 2012 of a Medicaid Buy-In Program for people with disabilities up to 450% of the federal poverty level and health coverage for Adults without Dependent Children.

The Department must immediately assess increased fees on hospital providers to fund expenditures resulting from increased caseload for Medicaid and CHP+ expansion populations, and to fund the payments to hospitals as approved by the Hospital Provider Fee Oversight and Advisory Board to be effective October 2012, including the implementation of the Hospital Quality Incentive Payment.

The proposed rule revisions will allow the Department to collect sufficient fees from hospitals to fund the health coverage expansions, hospital payments, and General Fund relief for the Medicaid program to comply with state statute and the Medicaid State Plan agreement with the Centers for Medicare and Medicaid Services. The proposed rule revisions ensure continuing health care coverage for the Medicaid and CHP+ expansions funded by hospital provider fees and access to discounted health care services for CICP clients.