PAR Updates

PARs Pause Extended Through March 2024 for Series of Services and Therapies

In January, the Department of Health Care Policy and Financing (the Department) temporarily paused prior authorizations request (PAR) requirements for a series of pediatric long-term home health services and home health therapies until June 1, 2022. Those included PARs for pediatric long-term home health Certified Nursing Assistant (CNA) services, and home health physical therapy, occupational therapy, and speech language pathology therapy services.  

Effective Feb. 28, 2022, the pause on the requirement to submit a PAR will extend through March 2024 and will now include

  • Pediatric long-term home health CNA services 

  • Pediatric long-term home health therapies: occupational therapy, physical therapy, and speech-language pathology therapy 

  • Pediatric long-term home health intermittent skilled nursing 

The two-year pause allows the Department and partners time to robustly engage with stakeholders, train providers on operational changes, evaluate benefit policy, and notify Health First Colorado (Colorado’s Medicaid program) members before the pause is lifted. This also gives the Department time to ensure full compliance with federal and state policy while keeping Health First Colorado members and their needs front and center. 

The Department is now collaborating with our utilization management vendor, Kepro, to implement operational changes supporting the extended pause. We will communicate and issue policy changes to Health First Colorado members, providers and other stakeholders over the coming days. The Department appreciates the engagement from Health First Colorado providers and members while we work on this important process during the next two years. Watch the recording of the CNA PARs session that was held on Friday, March 4. Read the frequently asked questions and the updated Operational Memo for more information. Continue visiting http://hcpf.colorado.gov/par-updates for more information and updates. 

Provider Sessions RE: To Update PAR Submission Process Challenges

The Department also recently hosted sessions with providers to discuss the issues and technical challenges they may experience when submitting a PAR. The Department will use the feedback to evaluate the situation and work with its utilization management vendor, Kepro, to address trending issues. In the meantime, providers can send PAR submission questions to the PAR inbox at hcpf_um@state.co.us. (Inquiries should include the member’s name, Medicaid identification, and PAR identification/case number.) Home health and private duty nursing policy and reimbursement questions can be sent to homehealth@state.co.us. Policy and reimbursement questions for benefits unrelated to home health can be sent to HCPF_benefitsupport@state.co.us.