Presentation of Legislative Recommendations by CCDC and CCLP
COMMUNICATION BETWEEN HCPF AND MEDICAID CLIENTS
|Votes: View-->||Action Taken:|
01:40 PM -- Presentation of Legislative Recommendations by CCDC and CCLP
Elisabeth Arenales, Colorado Center on Law & Policy (CCLP), discussed the challenges of addressing client correspondence issues. She noted that clients have communication issues and notice issues with programs other than Medicaid. Jack Regenbogen, CCLP, distributed a handout to the committee (Attachment B) with a summary of recommendations to the committee. He discussed a proposal for a more detailed adverse action notice to clients. He discussed including client household information in notices.
Representative Primavera asked about housing, and eligibility of households. Mr. Regenbogen explained how households members are counted. The committee discussed the cost of the recommendations related to information technology changes. Representative Primavera discussed vague notices. Ms. Arenales explained that the focus of CCLP's recommendations is on the client experience, rather than making changes within state agencies. Representative Lundberg expressed concern about testing notices with clients to check their understanding. He discussed a possible bill idea to require proof of client understanding for new notices. Committee discussion ensued. Ms. Arenales mentioned that the Department of Health Care Policy and Financing (HCPF) has been working on the issue of client understanding.
Mr. Regenbogen discussed a proposal to regularly audit client communication with state agencies and bring in a third party to inspect the legal sufficiency of the notices. Representative Primavera explained that the State Auditor's Office is receptive to undertaking the audit. Senator Newell discussed the need for regular internal audits by HCPF. Ms. Arenales described aspects of a possible audit.
Mr. Regenbogen explained a recommendation to enable a process for reviewing the sufficiency of notices. He explained that a review process would ease administration burdens of appeal hearings and enable clients to continue receiving benefits while they appeal a ruling. He suggested allowing an administrative law judge to review notices before appeal hearings. Representative Primavera discussed having an Ombudsman undertake the review notices. Mr Regenbogen explained that a checklist of items that would render a notice insufficient would be helpful. Mr. Regenbogen offered a final suggestion to the committee to request a report on technical glitches that result in errors in client communication from HCPF. He gave examples of technical glitches. Representative Primavera commented on excessive notices to clients, and suggested an information technology fix.
Josh Winkler, Colorado Cross-Disability Coalition (CCDC), provided handouts to the committee (Attachment C) and presented recommendations to the committee. Mr. Winkler discussed an example of a notice that he received that contained errors. He explained that HCPF should prioritize the disabled community's Medicaid programs because that community cannot function without Mediad. Mr. Winkler discussed a recommendation to move determination of eligibility for Medicaid buy-in programs to the state. He suggested that 'person-centered' be defined in statute, and that on-line appeal forms allow for special requests to be made. Mr. Winkler responded to a question regarding accommodations for appeal hearings, and the difficulties in scheduling hearings. He proposed that clients be allowed to send an e-mail as a response to a notice. Mr. Winkler explained HCPF's response to that suggestion. Representative Primavera asked about the dates and deadlines included in the notices.
Mr. Winkler responded to a question regarding nontraditional Medicaid clients and problems with Prior Authorization Requests (PAR) and 803 notices. He discussed the difference between long-term care and other Medicaid clients. Ms. Arenales explained the difficulty with determining eligibility for the buy-in and the challenges clients have with PAR.
Representative Primavera suggested continued work on client communication and HCPF beyond the interim. Senator Newell expressed support for ongoing conversation on the issue. Ms. Arenales and Mr. Winkler discussed the time frame for legislative recommendations.