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FY 2023-24 Legislative Requests for Information Reports

HCPF, LRFI 1, Medical Services Premiums

The Department is requested to submit monthly Medicaid expenditure and caseload reports on the Medical Services Premiums, behavioral health capitation, and the intellectual and developmental disabilities line items to the Joint Budget Committee, by the fifteenth or first business day following the fifteenth of each month 

Legislative Request for Information #1

HCPF, LRFI 2, Prior Authorization Review (PARs)

The Department is requested to submit reports by June 15, 2023, and November 1, 2023, providing updates on prior authorization reviews (PARs) for private duty nursing, including data over time on approvals, partial denials, and full denials and on technical denials due to inadequate documentation. 

Legislative Request for Information #2- June 

Legislative Request for Information #2- November  

HCPF, LRFI 3, Regional Accountable Entity (RAE)

The Department is request to submit a report by November 1, 2022, discussing member utilization of capitate behavioral health services in FY 2020-21 and the Regional Accountable Entity (RAE) performance on network provider expansion, timeliness of processing provider claims within contract requirements, and timeliness of credentialing and contacting network providers. 

Legislative Request for Information #3

HCPF, LRFI 4, Specialty Drug Cost

 The Department is requested to submit a report by November 1, 2023, discussing specialty drug costs and reimbursements to providers. The report should include the percent of cost paid for specialty drugs, how the amounts were determined, and how they have changed over time. 

Legislative Request for Information #4

HCPF, LRFI 5, Children's Basic Health Plan

The Department is requested to submit a report by February 15, 2023 detailing the progress on all outstanding issues with administration of the Children's Basic Health Plan. The report should include a progress report on completing backlogged issues since the authorized additional FTE and a projection of when each backlogged issue will be completed and program authorities will become current and compliant. Finally, the report should include a recommendation on whether the administrative staffing level for CHP is sufficient to maintain effective operation into the future.

Legislative Request for Information #5

HCPF, LRFI 6, Case Management Redesign

The Department is requested to submit a report by November 1, 2023, detailing the progress on all outstanding issues with administration of the Case Management Redesign. The report should include a progress report on the number of CMAs who applied, and which ones were selected as part of the redesign, and a report on the populations served by each awarded contract. Finally, the report should include the Department’s plans for enforcing a case management ratio of 65 clients per case manager, as well as any stakeholder feedback on the 65:1 ratio.

Legislative Request for Information #6

HCPF, LRFI 7, School Health Services Program

The Department is requested to submit a report by November 1 of each year to the JBC on the services that receive reimbursement from the federal government under the SB 97-101 public school health services program. The report is requested to include information on the type of services, how those services meet the definition of medical necessity, and the total amount of federal dollars that were distributed to each school under the program. The report should also include information on how many children were served by the program.

Legislative Request for Information #7

Multi-Department, LRFI 1, Schedule 9 Report

All Departments are requested to provide by November 1 of each fiscal year Schedule 9 reports for every annually and continuously appropriated cash fund administered by the Department as part of the standard November 1 budget submission.  

Multi-Department Legislative Request for Information #1 

Multi-Department, LRFI, 5 HCPF and CUSOM

Joint LRFI between the University of Colorado and HCPF regarding the use of Anschutz Medical Campus Funds as the State contribution to the Upper Payment Limit. HCPF and the University of Colorado are requested to submit a report to the JBC about the program and its benefits by October 1 of each year.

Multi-Department Legislative Request for Information #5

Multi-Department, LRFI 6, Tobacco Master Settlement

Each Dept. is requested to provide the following information to the JBC by October 1, 2023 for each program funded with Tobacco Master Settlement Money: the name of the program, the amount of Tobacco Master Settlement Agreement money received and expended for the preceding fiscal year, a description of the program including the number of persons served and services provided and evaluation and effectiveness information.

Multi-Department Legislative Request for Information #6

Multi-Department, LRFI 7, HCPF and DHS Eligibility and Claims System

The departments are requested to provide the following updates regarding the implementation of the Non-Medicaid Behavioral Health Eligibility and Claims System by November 1, 2024: (1) the specific non-Medicaid programs that are utilizing the system for eligibility and/or claims purposes, including the specific uses for each program; (2) the number and percentage of clients and claims for which each program is using the system; (3) the number and percentage of providers that are using the system for each program; (4) the Departments’ plans to expand the utilization to other programs (including programs housed outside of the BHA) and other providers through FY 2024-25 and in subsequent years; and (5) any efficiencies or payment issues identified through the use of the system thus far. 

Multi-Department Legislative Request for Information #7