HCPF Agenda Template Style Sheet

March 31, 2015

The Honorable Wayne W. Williams

Secretary of State

1560 Broadway, 2nd Floor

Denver, Colorado 80203

Dear Mr. Williams:

Attached is the Notice of Proposed Rules concerning Medical Assistance rules to be considered for final adoption at the May 2015 meeting of the Medical Services Board of the Department of Health Care Policy and Financing. The meeting will be held on Friday, May8, 2015, beginning at 9:00 A.M., in the seventh floor conference room at 303 East 17th Avenue, Denver, CO 80203.

This notice is submitted to you for publication, pursuant to § 24-4-103(3)(a) and (11)(a), C.R.S.

Respectfully,

Judi Carey,

Medical Services Board Coordinator

Department of Health Care Policy and Financing

April 10, 2015 Rule Notice

Page 3

NOTICE OF PROPOSED RULES

The Medical Services Board of the Colorado Department of Health Care Policy and Financing will hold a public meeting on Friday, May8, 2015, beginning at 9:00 a.m., in the seventh floor conference room at 303 East 17th Avenue, Denver, CO 80203. Reasonable accommodations will be provided upon request prior to the meeting, by contacting the Medical Services Board Coordinator at 303-866-4416.

A copy of the full text of these proposed rule changes is available for review from the Medical Services Board Office, 1570 Grant Street, Denver, Colorado 80203, (303) 866-4416, fax (303) 866-4411. Written comments may be submitted to the Medical Services Board Office on or before close of business the Wednesday prior to the meeting. Additionally, the full text of all proposed changes will be available approximately one week prior to the meeting on the Department’s website.

MSB 15-02-23-A,Revision to the Medical Assistance Eligibility Rules Concerning Removal of the Five Year Waiting Period Pursuant to Section 214 of the Children’s Health Insurance Program Reauthorization act of 2009 (CHIPRA) at section 8.100.4.G.2

Medical Assistance. The proposed rule amends 10 CCR 2505-10 § 8.100 to incorporate changes to the rule authorized by Section 214 of the Children’s Health Insurance Program Reauthorization act of 2009 (CHIPRA) which amends section 2107 of the Act granting states the option to provide benefits to children and pregnant women in both Medicaid and Child Health Plan Plus (CHP+), who are lawfully residing in the United States and who have not met the 5-year waiting period. This is also authorized through Colorado House Bill 09-1353.

The proposed rule will impact children eligible for Presumptive Eligibility and Medicaid who are lawfully residing and who have not met the 5-year waiting period. This rule will benefit these children by eliminating the 5-year waiting period and making them eligible for Presumptive Eligibility and Medicaid, as long as all other eligibility criteria are met. Changes to the Colorado Benefits Management System (CBMS) will be made to be in alignment with our federal and state regulations effective July 1, 2015.

The Department expects an increase in expenditure of $898,378 total funds in FFY 2014-15 and $4,056,176 in FFY 2015-16.This rule was authorized through House Bill 09-1353 and was partially implemented. Currently Colorado provides Presumptive Eligibility and Medicaid coverage to legally residing pregnant women that have not met the 5-year waiting period. This proposed rule change would complete the implementation of House Bill 09-1353. Inaction would leave Presumptive Eligibility and Medicaid eligible children who have been lawfully residing in the United States for less than 5 years without medical assistance.

The authority for this rule is contained Section 214 of the Children's Health Insurance Program Reauthorization act of 2009 ( CHIPRA) which amends section 2107 of the Act and House Bill 09-1353and sections 25.5-1-301 through 25.5-1-303, CRS (2014).

MSB 14-10-15-B, Revision to the Medical Assistance Health Programs Benefits Management Rule Concerning Family Planning, Section 8.730

Medical Assistance. This rule change will define the amount, scope and duration of the Family Planning Services benefit. In order to define amount, scope and duration, the Department is amending the existing Family Planning Services rule to reformat and clarify the rule language while removing abortion services and hysterectomy services to be placed in other rules.

The authority for this rule is contained in section 1905(a) of the Social Security Act, codified at 42 U.S.C. 1396d(a)(2); 42 CFR § 440.230 and in sections25.5-1-301 through 25.5-1-303, C.R.S (2014).

MSB 14-11-19-D, Revision to the Medical Assistance Health Programs Office Benefits and Operations Division Rule Concerning Women's Health Services, Section 8.731

Medical Assistance. This rule will define the amount, scope, and duration of the Women’s Health Services benefit. In order to define amount, scope, and duration, the Department is creating the Women’s Health Services rule to place all of the substantive content from the Benefit Coverage Standards into rule.

MSB 14-09-16-B, Revision to the Medical Assistance Health Programs Benefits and Operations Division Rule Concerning Family Planning Services Section 8.730.4 and 8.770 Abortion Services.

Medical Assistance. This rule change will define the amount, scope, and duration of the Abortion Services benefit. The Department is removing the substantive content for Abortion Services from the Family Planning rule under 10 CCR 2505-10 § 8.730.4 to a stand-alone rule under § 8.770.

MSB 15-01-26-A, Revision to the Medical Assistance Home and Community BasedServices for Elderly, Blind and Disabled Rule Concerning Respite Care, Section 8.492

Medical Assistance. The Medical Assistance Home and Community Based Services for Elderly, Blind, and Disabled Rule Concerning Respite Care C.C.R. 2505-10, Section 8.492 is being revised to provide clarification of policy and allow for potential rate increases.

The authority for this rule is contained in sections 25.5-6-303 through 25.5-1-307 and 25.5-1-301 through 25.5-1-303, C.R.S. (2014).

MSB 15-02-18-B, Revision to the Medical Assistance Health Information Office Rule Concerning Provider Screening Regulations, Section 8.125

Medical Assistance Health Information Office. Pursuant to the Affordable Care Act, the Department will submit a provider screening rule for implementation to comply with federal regulations. This rule applies to Medicaid and CHP+ providers.

The authority for this rule is contained in 42 CFR § 455 (b) and (e) and sections 25.5-1-301 through 25.5-1-303, C.R.S (2014).

MSB 15-02-18-C, Revision to the Medical Assistance Health Information Office Rule Concerning Enrollment Procedures, Section 8.013.1

Medical Assistance Health Information Office. Pursuant to the Affordable Care Act, the Department will submit changes to the out of state provider enrollment requirements found in 10 C.C.R. 2505-10, Section 8.013.1 to comply with federal regulations. Out of state providers are required to follow the same requirements as an in state provider.

The authority for this rule is contained in 42 CFR § 455 (b) and (e) and sections 25.5-1-301 through 25.5-1-303, C.R.S. (2014)