Background
Senate Bill 18-266 requires Health First Colorado (Colorado’s Medicaid program) to implement an evidence-based hospital review program to ensure appropriate utilization of hospital services. The hospital review program created by SB 18-266 is the Inpatient Hospital Review Program (IHRP).
The implementation of Step 1 (inpatient pre-admission review) of the Inpatient Hospital Review Program (IHRP) 2.0 has been deferred until further notice in response to provider feedback.
IHRP 2.0 post-admission reviews performed on hospital inpatient day 6 (Step 2) and days 30, 60 and 90 and every 30 days thereafter (Step 3) have been required since May 1, 2023. Post-admission reviews do not impact claims payment and allow providers to ask the member’s Regional Accountable Entity (RAE) for assistance in care coordination. Post-admission reviews have been incorporated into the new Inpatient Hospital Transitions (IHT). Protected Health Information (PHI) should not be included in emails.
IHRP Joint Operating Committee (JOC)
The IHRP Joint Operating Committee (JOC) will continue to meet monthly to discuss questions, issues, results and best practices. Upcoming meetings include:
- July 11, 2024 from 1:00-2:00 p.m.
- August 15 and 29, 2024 from 1:00-2:00 p.m
- September 5 and the first Thursday of the month for the remainder of 2024 from 1:00-2:00 p.m.
To be added to the JOC Meeting calendar invite, please send your name, facility name and your email address to hcpf_um@state.co.us.
Contact either the ColoradoPAR Program Utilization Management (UM) Team at hcpf_um@state.co.us or Acentra® (formerly Kepro) Provider Relations at COproviderissue@acentra.com with questions or for additional assistance.
Training Opportunities
Acentra is working to complete all required training; check back here for modules as they are completed.
Resources
- Recorded Webinars From Completed Trainings
- Introduction to IHRP And Atrezzo - The Intro to IHRP 2.0 and Portal Registration training will give a brief introduction to Acentra, discuss the background of IHRP and introduce the new version and its requirements. It will also introduce Atrezzo and demonstrate how to create an account, add users, and register NPI numbers.
- System Overview - The System Overview training will demonstrate how to login to the portal, create a case and submit a PAR request.
- Add-a-Baby Emergent Request Form
- How to Create Temp Consumer User Guide
Contact Information
Colorado PAR Program UM Team: hcpf_um@state.co.us
Acentra Provider Relations: coproviderissue@acetra.com