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j_jtc_2017a_2017-10-11t10:04:47z1 Hearing Summary

Date: 10/11/2017

Location: RM 271


Medicaid Provider Perspective


Votes: View--> Action Taken:
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11:51 AM -- Medicaid Provider Perspective

Various members of the Medicaid provider community came to the table to discuss provider perspectives. They distributed a handout to the committee (Attachment C).

171011 AttachC.pdf171011 AttachC.pdf

Mr. Ryan Biehle, representing the Colorado Academy of Family Physicians, came to the table to discuss the claims and issues facing Medicaid providers in Colorado. He noted that providers are working with HCPF to find solutions, but that additional steps are needed in order to help providers.

11:59 AM

Ms. Sue Wiliamson, representing the Colorado Children’s Healthcare Access Plan and Colorado Chapter of the American Academy of Pediatrics, came to the table to discuss specific issues facing pediatric providers. She noted that providers have problems determining the source of their claim denial, whether it is the new system, user error, or a combination of both. She highlighted that many providers are experiencing serious financial problems due to claim payment delays. She also noted that the next big challenge is the amount of information coming from the department for financial accounting.

12:03 PM

Ms. Emma Hudson, representing Alliance, came to the table to discuss the specific issues the system is causing for persons with intellectual disabilities in Colorado. She noted that the community appreciates the targeted help from HCPF, but that Alliance's members have had $8.0 million in payment problems to date, of which $6.6 million is underpayment of claims. She stated that providers are having problems with uploading documents into the system.

12:10 PM

Mr. Josh Ewing, representing the Colorado Hospital Association, came to the table to discuss the issues facing hospital providers. He noted the panel offers three solutions items to the problem: a clear solutions plan, independent oversight for the solutions plan, and the creation of a new fund to help pay delayed and outstanding claims owed to providers across the state. He noted that the community is still facing numerous challenges, but grateful for the department's ability to work with hospital providers.

12:22 PM

In response to committee questions, Mr. Ewing noted that the solutions proposed by the panel are suggestions, but not specific asks for action. Mr. Biehle, in response to a committee question, noted that outside agencies have not been contacted by the Office of the State Auditor or other independent contractor verifications from the state. Committee discussion ensued regarding the proposed solutions suggested by the panel.