Final
Presentation by DHCPF
HIFA WAIVER COMMITTEE
Votes:
Action Taken:
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10:32 AM
Karen Reinertson, Executive Director of the Department of Health Care Policy and Financing, began the Department's discussion of the proposed Colorado Family Cares Program, a program that will be developed under a Health Insurance Flexibility and Accountability (HIFA) Medicaid waiver. Four handouts were distributed to the committee, including an outline of the presentation, a list of the individuals who comprised the Rose Community Foundation External Advisory Committee, a fact sheet, and commonly asked questions concerning the program (Attachments B through E). She discussed the differences between Medicaid and the Children's Basic Health Plan (CHP+) and described the population that will be served under the waiver program, specifically children and their families. She discussed how providers will contract to provide services under the program.
10:42 AM
Barbara Laydon, Department of Health Care Policy and Financing, continued the discussion of the waiver program. She gave an overview of materials that were previously provided to the committee, including the waiver application. She discussed federal requirements for HIFA waivers and described recent research completed by the Department on the population enrolled in CHP+ and Medicaid. She listed a number of benefits of the Colorado Family Care Program for providers including: a stable provider network, streamlined administrative requirements, adequate reimbursement, and a consistent benefit package. She further discussed advantages for participants of the Colorado Family Care Program including a medical home, continuity of coverage, stable provider networks, a benefit expansion for CHP+, and a co-payment structure that will not change.
10:58 AM
Ms. Laydon continued her discussion of the Colorado Family Care Program by describing the program's benefit package. Under the program, children and adults will receive a basic benefit package, known as Core benefits, that includes such services as routine physical examinations, immunizations, prescription drug coverage, and hospital care. Children with higher medical needs will receive an expanded benefit package, known as Core Plus, that includes expanded mental health services, extended physical and speech therapies, additional durable medical equipment, and additional oral health care. Ms. Laydon listed the overall benefits of the Colorado Family Care Program, including the expansion of eligibility of persons for CHP+ and Medicaid and creating a continuum of care with a medical home and a choice of primary care providers for participants. She gave a brief financial analysis of the program, stating that the program is not a block grant, but allows for normal anticipated growth in both mandatory and optional populations.
11:09 AM
Ms. Laydon and Ms. Reinertson responded to questions from the committee regarding the benefits offered under the program to adults and children, provider reimbursement rates, competitive bidding for providers, and the length of provider contracts. They further responded to questions from the committee regarding the design of the Core benefits package and the employer-sponsored insurance pilot program that will be implemented as part of the HIFA waiver. Ms. Laydon and Ms. Reinertson addressed committee questions regarding the competitive bidding process, Medicaid and CHP+ eligibility, budget neutrality, mental health benefits, community health centers, and the costs of the program.