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Stakeholder Engagement

Funding Opportunities

LTSS Provisional Provider Payments (3Ps)

Long-Term Services and Supports (LTSS) providers are experiencing an increase in claim denials as a result of financial eligibility determination delays, and delays in functional eligibility assessments. The Department of Health Care Policy and Financing (HCPF) has been notified of these issues, as agencies and providers are unable to carry the unpaid claims balance within their existing resources. Some agencies have reported having to limit services, deny accepting new members, or even terminate staff to remain solvent.

HCPF wants to ensure our most vulnerable members continue receiving the support necessary within their communities by mitigating major financial stressors that some LTSS providers are experiencing, which are threatening their solvency or ability to provide service continuity. Therefore, HCPF will provide provisional payments in the form of short-term advances to providers that demonstrate the greatest need. HCPF is issuing the LTSS Provisional Provider Payments Request for Application (RFA) to solicit applications from eligible providers. 

Note: Providers receiving the provisional payment must continue to submit claims and rework denied claims, as normal. Providers that previously applied for the LTSS 3P’s payment, and received payment on February 5, 2024, can be considered for an additional payment. However, providers must be able to demonstrate and explain the need for additional funds.

Who is eligible the short-term advances:

  • The provisional payment must be less than 75% percent of the provider’s eligible denied claims balance;
  • Must be an LTSS provider and actively delivering services for a minimum of 1 year;
  • Must demonstrate within the application how they are facing insolvency or significant hardship;
  • Must describe the potential member impact if provisional payments are not received;
  • Must attest to repayment and also select a repayment plan.

Repayment:

The provider will be required to attest to repayment and select their repayment plan to be considered for this provisional payment. The provider may choose from the following options for repayment:

  • Check made out to the Department of Health Care Policy and Financing by July 1, 2024
  • Three quarterly installments made to the Department of Health Care Policy and Financing aligned with the fiscal year quarters (September 30, 2024; December 31, 2024; March 31, 2025)
  • Automatic deductions from the weekly claims payment starting July 1, 2024 through June 30, 2025

Timelines and Deadlines:

Applications will be made available to providers and agencies beginning February 23, 2024. There will be a two-week period allotted to providers to complete these applications. All applications must be received by 5:00 p.m. MT on March 8, 2024, to be under consideration.

Please submit questions about the application or program to Victoria Rodgers no later than 5:00 PM MST on March 4, 2024, to provide time for responses before the submission deadline. Responses will be posted to the materials folder as quickly as possible on a rolling basis. Questions submitted after 5:00 p.m. MT on March 4, 2024, may not receive a response.

Repayments will start July 1, 2024, as stipulated per the provider’s repayment plan of choice. 
 

How to Apply:

The following items must be submitted by 5:00 p.m. MT on March 8, 2024. Late and/or incomplete application packets will not be considered.

  • Online application including provider repayment attestation and payment plan selection
  • Email the following items to Victoria Rodgers with the subject line "3Ps Application Items - Your Agency Name".
    • Document showing accrued denied claims balance per month and calculation of request. View an example calculation
    • Cover letter signed by Executive Director or other authorized signatory.

Submission Considerations:

When submitting applications, please keep the following in mind: 

  • Application documentation requirements
  • The Department may not have sufficient funding to support all requests made and reserves the right to approve or deny applications based on funding limitations; providers are highly encouraged to be as concise and clear in describing the need in order to remain solvent
  • Payments will only be considered short-term. The provider/agency will be expected to repay the Department the full amount issued through these provisional payments. 

Exclusions:

The following will not be considered for the LTSS 3P’s Application:

  • All Non-Emergency Medical Transportation (NEMT) Providers

Materials:

Request for Application, Q and A Document, and example calculation materials can be found in the materials folder

Application and Supplemental Information Due Date: 

March 8, 2024 at 5 p.m. MT

Questions

Submit questions about the application or program to Victoria Rodgers no later than 5 p.m. MT on March 4, 2024. Questions and responses will be available in a Q and A document and updated regularly. Questions submitted after 5 p.m. MT on March 4, 2024 may not be responded to.
 

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HCPF_HCBS_Questions@state.co.us

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