Coming soon

Remote Application Assistance During the COVID-19 Public Health Emergency

January 6, 2021

During the COVID-19 Public Health Emergency (PHE), enrollment professionals at County Human/Social Services, Medical Assistance Sites, Eligibility Application Partner Sites, Presumptive Eligibility Sites, and Certified Application Assistance Sites can help applicants apply for Medical Assistance remotely. Assisters should complete an Acknowledgement of Receipt of Verbal Consent form and attach it to the application This form states that the assister has authorization to apply on the client’s behalf.

HCPF PM 21-001

Acknowledgement of Verbal Consent

Acknowledgement of Verbal Consent (Spanish)

Connect for Health Colorado Re-Opens Enrollment Period

January 28, 2021

Connect for Health Colorado re-opened enrollment for a special enrollment period (SEP) for Coloradans without health insurance. The SEP is scheduled for February 8 – May 15, 2021.

Connect for Health Colorado Statement

Changes to Fraud Investigations during the COVID-19 PHE

February 2, 2021 (going back to March 18, 2020)

Instructed that Health First Colorado (Colorado’s Medicaid Program) and Child Health Plan Plus (CHP+) members cannot be terminated due to fraud during the lock-into coverage during the COVID-19 Public Health Emergency and other instructions for fraud investigations.

PM 21-002

OM 21-029

Reduction to the Reasonable Opportunity Period

February 19, 2021

Reduced the Reasonable Opportunity Period (ROP) for income discrepancies from 90 to 30 days. The ROP is the period of time a Health First Colorado or CHP+ member has to submit verification of their income or an explanation if their income is not reasonably compatible with the electronic information. This became effective February 13, 2021.

OM 21-019

MSB 20-09-21-A

Health First Colorado Buy-In Programs Income Guidelines

March 5, 2021

Updated income guidelines for Health First Colorado Children with Disabilities and Working Adults with Disabilities programs.

Health First Colorado Children with Disabilities with Buy-In

Health First Colorado Buy-In for Working Adults with Disabilities

Updated Disability Determination Application

March 12, 2021

Updated the Disability Determination Application to align with Social Security Administration Disability Determination and automated processing within the Colorado Benefits Management System.

OM 21-028

Connect for Health Colorado Enrollment Period Extended

March 24, 2021

Connect for Health Colorado extended the existing enrollment period through at least August 15, 2021, for all Coloradans regardless of insurance status, following a federal decision to extend the federal open enrollment period.

Connect for Health Colorado Statement

Health First Colorado and CHP+ Income Guidelines

April 1, 2021

Adjusted income guidelines for MAGI programs.

OM 21-021

Health First Colorado Income Chart

CHP+ Income Chart

Health First Colorado Buy-In Programs Income and Premiums

April 1, 2021

Updated income chart and premium guide for Children with Disabilities Buy-in and Working Adults with Disabilities programs.

OM 21-026

OM 21-023

Codify COVID-19 Federal Regulations

April 11, 2021

Aligned state regulations with the Coronavirus Aid, Relief and Economic Security Act and the Families First Coronavirus Response Act and Maintenance of Effort provisions. Changes included allowing for self-attestation for verifiable information and maintaining eligibility for all members.

MSB 21-03-30-A

Expanded Care Locations for Emergency Medical Transportation and Non-Emergent Medical Transportation

April 11, 2021

Allowed for transports to a wider range of locations for Medicaid Emergency Medical Transportation and Non-Emergent Medical Transportation.

MSB 21-03-24-B

MSB 21-03-24-C

Enhanced Tax Credits from Connect for Health Colorado

April 15, 2021

Expanded Connect for Health Colorado tax credits due to the changes from the American Rescue Plan Act, including decreasing the cap for costs for all income group and opening zero-dollar benchmark plans for people with unemployment benefits in 2021.

Connect for Health Colorado news announcement

COVID-19 Stimulus Payments

April 28, 2021

Clarified that the economic stimulus checks from the American Rescue Plan Act are not considered countable income for MAGI Health First Colorado and CHP+ eligibility and non-MAGI Health First Colorado eligibility. Payments are not a countable resource for 12 months for Non-MAGI programs that include a resource test.

PM 21-003

CHP+ State Managed Care Network Transition

April 28, 2021

Beginning on July 1, 2021, all CHP+ members will be automatically enrolled into a CHP+ Managed Care Organization (MCO) upon enrolling. Members were previously enrolled in the State Managed Care Network.  Members will be transitioned into a CHP+ MCO on July 1, 2021.

IM 21-030

Changes to MAGI Income Methodologies

June 4, 2021 (going back to March 1, 2021)

Informed about changes for how alimony or spousal support, moving expenses, tuition, student debt, and capital gains are considered for income and asset tests.

OM 21-043

Income Interfaces for Medical Assistance

June 16, 2021

Notified of two new income interfaces, the Federal Data Services Hub and Equifax The Work Number, to verify income for Health First Colorado and Child Health Plan Plus. The two interfaces will be used in addition to the Income Eligibility Verification System through the Colorado Department of Labor.

HCPF OM 21-045

Affordable Care Act Upheld

June 17, 2021 

The U.S. Supreme Court upheld the Affordable Care Act (ACA) in California v. Texas., allowing Medicaid expansion and the ACA marketplaces, as well as all other current provisions from the ACA to stay in effect.

HCPF news announcement

Medical Assistance Denial Prior to CICP Benefits

July 15, 2021

Clarified that individuals must receive a denial for Health First Colorado or Child Health Plan Plus before receiving Colorado Indigent Care Program (CICP) benefits.

HCPF OM 21-051

Changes to Non-Emergent Medical Transportation

July 26, 2021

Informed that IntelliRide will reduce its service area to Non-Emergent Medical Transportation (NEMT) to nine counties (Adams, Arapahoe, Boulder, Broomfield, Denver, Douglas, Jefferson, Larimer, and Weld Counties) effective August 1, 2021. Local transportation providers will administer services to all other counties.

HCPF OM 21-055

Emergency Medicaid

July 29, 2021 

Informed about Emergency Medicaid eligibility, benefits, and the application process as well as the removal of the requirement to submit  physician statement, or life or limb threatening statement, to receive benefits.

HCPF OM 21-056

Compact of Free Association (COFA) Migrants

August 10, 2021 

Informed about new Health First Colorado eligibility for Compact of Free Association (COFA) migrants, which includes people from the Federated States of Micronesia, the Republic of the Marshall Islands, and the Republic of Palau. Eligibility is effective December 27, 2020.

HCPF OM 21-058

Advance Child Tax Credit

August 10, 2021 

Clarified that the expanded Advance Child Tax Credit from the American Rescue Plan Act are not considered countable income for MAGI Health First Colorado and CHP+ eligibility and non-MAGI Health First Colorado eligibility. Payments are not a countable resource for 12 months for Non-MAGI programs that include a resource test.

HCPF PM 21-006

Afghan Humanitarian Parolee Medicaid Eligibility

December 8, 2021 

Informed about expanded eligibility for Health First Colorado, CHP+, and Refugee Medical Assistance for Afghan Humanitarian Parolees.

HCPF OM 21-085

County Program Accuracy and Performance Compliance

Outlined new incentive eligibility quality assurance and performance compliance program for counties, including performance measures and incentive payments.

HCPF OM 21-079

HCPF OM 21-080

Increased Resource Limits

Informed about increased resource limits for Qualified Medicare Beneficiaries (QMB), Specified Low Income Medicare Beneficiaries (SLMB), Qualified Individuals (QI-1), and Low-Income Subsidy (LIS).

OM 21-093

Public Charge

Final rule announced August 14, 2019. While it was set to go into effect on October 15, 2019, lawsuits blocked implementation until February 24, 2020.

The definition of public charge, and corresponding public charge test was announced by U.S. Citizenship and Immigration Services, part of the U.S. Department of Homeland Security.

Public charge information and resources.

Special Enrollment Period Created for COVID-19

March 19, 2020

Created a special enrollment period for uninsured Coloradans to enroll in health insurance through Connect for Health Colorado from March 20 – April 3, 2020.

Emergency Regulation 20-E-02

Health First Colorado and CHP+ Income Guidelines

April 1, 2020

Adjusted income guidelines for MAGI programs.

Operational Memo

Health First Colorado Income Guidelines

CHP+ Income Guidelines

Special Enrollment Period for COVID-19 Extended

April 3, 2020

The Colorado Division of Insurance extended the special enrollment period for uninsured Coloradans to enroll in health insurance through Connect for Health Colorado from April 4 – April 30.

Emergency Regulation 20-E-06

Codify COVID-19 Federal Rules for Health First Colorado and CHP+

May 8, 2020

Codified rules from the Coronavirus Aid, Relief, and Economic Security Act and the Families First Coronavirus Response Act, including maintaining continuous enrollment, for the duration of the COVID-19 Public Health Emergency.

                                                                                                                        CHP 20-04-29-B

MSB 20-04-29-A

NEMT Services Expansion

June 10, 2020

Expanded the list of allowable non-emergency medical transportation destinations to include alternative care sites that are not covered places of service.

                                                                                                                        MSB 20-06-10-A

Directives for COVID-19 Continuous Eligibility

June 15, 2020

Communicated Continuous Enrollment policies established by the Families First Coronavirus Response Act, effective March 18, 2020.

                                                                                                                        HCPF PM 20-004

Self-Attestation of Information During COVID-19

July 14, 2020

Individuals applying during the public health emergency can self-attest to income, Social Security Number, and resources, as well as previous aspects, such as age, state residency, and household composition. After the public health emergency, members will be required to submit documentation or verifications for self-attested items. Members who do not return redeterminations during the public health emergency will be force-passed until the end of the PHE period.

                                                                                                                        HCPF OM 20-071

Health First Colorado and CHP+ Income Guidelines

April 1, 2019 Adjusted income guidelines for MAGI programs.

Operational Memo

Health First Colorado Income Guidelines

CHP+ Income Guidelines

Updates to CICP SSN Requirements

June 30, 2019

Waives the social security number (SSN) requirement for individuals who are not eligible to receive a SSN or refuse to obtain a SSN due to religious beliefs, allowing individuals who otherwise eligible for CICP to receive services.

MSB 19-01-31-A

Increase to Adult Dental Annual Limit

July 1, 2019

Increased the Health First Colorado annual adult dental limit from $1,000 to $1,500.

MSB 19-05-29-A

Public Charge

Final rule announced August 14, 2019. While it was set to go into effect on October 15, 2019, lawsuits blocked implementation until February 24, 2020.

The definition of public charge, and corresponding public charge test was announced by U.S. Citizenship and Immigration Services, part of the U.S. Department of Homeland Security.

Public charge information and resources.

CHIP Reauthorization

January 22, 2018 (retroactive to October 1, 2017), and February 9, 2018.

A six-year funding extension was passed on January 22, and an additional four years were added on February 9, 2018.

Health First Colorado and CHP + Income Guidelines

April 1, 2018

Adjusted income guidelines for MAGI programs.

Agency Letter

Updates to Returned Mail Policy

April 13, 2018

Updated eligibility sites’ outreach process for returned mail. Actions must be taken after one piece of return mail, rather than the previous practice of three pieces of returned mail. This supersedes previous guidance from April 23, 2015.

Agency Letter

Updates to Citizenship and Identity Verification

May 31, 2018

Allows copies of citizenship and identity documents to be accepted for Medical Assistance applications, in addition to the original documents.

MSB 18-10-16-A

Apply Reasonable Compatibility Standard to Non-MAGI Eligibility Verification

June 30, 2018

Updates were made to apply the reasonable compatibility methodology to eligibility verification for non-MAGI groups. This methodology permits a certain difference between self-attested income and what is available through electronic data sources. This practice was already applied to MAGI groups.

MSB 18-02-12-A

Children with Autism Waiver sunset

June 30, 2018

The Children with Autism Waiver sunset; the therapies provided under the waiver are available through EPSDT.

Children with Autism Waiver website

Limited Medicaid Benefits Available for Incarcerated Persons

October 16, 2018 (going back to March 1, 2017)

Allows incarcerated individuals who are eligible for certain Medical Assistance categories to maintain limited benefits from Health First Colorado during incarceration.

Policy Memo

Clarification of Reasonable Opportunity Period for Health First Colorado and CHP+

October 30, 2018

Clarifies that members receiving continuous eligibility have a 90-day reasonable opportunity period to verify their income if their self-attested income is not reasonably compatible with electronic records during the first income check.

MSB 18-06-12-A

MSB 18-05-15-B

Health First Colorado and CHP+ Income Guidelines

April 1, 2017

Adjusted income guidelines for MAGI programs.

2017 CHP+ Income Chart

2017 Health First Colorado Income Chart

Updates to citizenship eligibility

September 30, 2017

Updates were made to rule to include eligibility for children who have a pending Special Immigrant Juvenile status. Work quarters were also removed for CHP+ eligibility.

MSB 17-05-22-A

CHP+ enrollment date adjustment

October 30, 2017

Enrollment begin date in a CHP+ MCO changed from the first day of the month following eligibility determination that occurs on or before the 21st of the month, to a determination that happens on or before the 16th of the month.

MSB 17-06-08-A

Asset Verification Program

December 17, 2017

For non-MAGI categories, assets can now be verified electronically.

Agency Letter

FAQs

MSB 17-08-21-B

Retro closing and exceptions to 10-day noticing

March 20, 2016

Changes were made to the policy and logic in the Colorado Benefits Management System for retroactive, or retro-closing, and noticing for ongoing cases and redeterminations. Clients with the following circumstances will be terminated without 10-day noticing: not requesting assistance, not in the home, not a Colorado resident, or whereabouts unknown.

FAQ

Income guidelines updated

April 1, 2016

Income guidelines for program eligibility were updated.

Medicaid

Medicaid coverage extended to people residing in Community Corrections facilities (half-way homes)

June 1, 2016

Medicaid-covered services became available to residents of Community Corrections facilities (half-way homes) who would otherwise be Medicaid eligible, including individuals who reside at the facility involuntarily.

Policy Statement

Colorado’s Medicaid program name updated to Health First Colorado

June 27, 2016

Medicaid, Colorado’s public health insurance program for low-income Coloradans who qualify, is now called “Health First Colorado.”

Resources

Annualized Income

July 1, 2016

As of July 1, 2016, the Colorado Benefits Management System is programmed to use an applicant’s annualized income for Health First Colorado and Child Health Plan Plus (CHP+) eligibility determinations when the person has income from self-employment, commission-based employment, and/or seasonal employment, and is found financially ineligible for all Modified Adjusted Gross Income (MAGI) Medicaid Assistance programs based upon their current monthly income.

FAQ

Additional updates to the removal of the five-year bar for children and pregnant women

July 1, 2016

The removal of the five-year bar was extended to all Health First Colorado children eligible for non-MAGI programs, and some immigration codes were added.

FAQ

Health First Colorado and CHP+ eligibility appeal timeline extended to 60 days

September 1, 2016

Health First Colorado applicants and members now have 60 days, as opposed to the previous 30 days, after the eligibility determination date on the Notice of Action to file an eligibility appeal with the Office of Administrative Courts.

Agency Letter

HB 16-1277

Connect for Health Colorado eligibility appeal timeline extended to 60 days

October 1, 2016

Connect for Health Colorado extended the time limit for a customer to file an appeal from 30 days to 60 days to align with the changes to HCPF’s appeals process (listed above).

Appeals Information

Minimum Essential Coverage for Dependent Children of Parents and Caretaker Relatives

October 1, 2016

Parents and caretaker relatives who have incomes between 69 and 133 percent of the Federal Poverty Level are required to attest that any dependent children who live with them, under the age of 19, are enrolled in Minimum Essential Coverage in order to be eligible for the Health First Colorado MAGI-Adult category.

FAQ

Eligibility for refugees and other immigrants

December 30, 2016 (going back to September 2015)

Under the revised policy, individuals who are refugees will no longer be found ineligible for Health First Colorado and CHP+ based upon individuals not changing their status after seven years. Although the rule is effective December 30, 2016, the policy will be applied to applicants who lost coverage going back to September 2015.

Agency Letter

MSB 16-07-05-A

Medicaid eligibility income change for Parent and Caretaker Relatives

April 1, 2015

To align with federal requirements and to fully implement the Modified Adjusted Gross Income (MAGI) income conversion for this population, MAGI Parent/Caretaker income threshold was reduced from 107% of the Federal Poverty Level (FPL) to 68% FPL. Parents with incomes above 68% FPL were transitioned to the Adult MAGI Medicaid category.

MSB 15-02-06-A

Parent/Caretaker Relative Federal Poverty Level Changes Frequently Asked Questions (HCPF)

Elimination of the five year waiting for lawfully present children and pregnant women applying for Medicaid and Child Health Plan Plus (CHP+)

July 1, 2015

Colorado eliminated the five year waiting period for lawfully present children otherwise eligible for MAGI Medicaid and CHP+, and for lawfully present regnant women otherwise eligible for CHP+ in July 2015. State legislation authorizing the elimination of the five year bar was passed in 2009, and funding to fully implement the bill was provided in July 2014. Systems changes were implemented July 2015.

MSB 15-02-23-A

House Bill 09-1353

Elimination of Five-Year Bar for Lawfully Residing Pregnant Women and Children Frequently Asked Questions(HCPF)

Did you know you might now qualify for Medicaid or CHP+? (CKF Fact Sheet for Clients – English)

¿Sabía que ahora podría calificar para el Medicaid o CHP+? (CKF Fact Sheet for Clients – Spanish)

1115 Demonstration Waiver Extension for Prenatal Medicaid Coverage

August 1, 2015 – July 31, 2020

Colorado requested to maintain its existing authority under a 1115 demonstration waiver to provide Medicaid coverage using title XXI funding for uninsured pregnant women with income above 141 percent through 195 percent of the Federal Poverty Level (FPL). The renewal period will be effective from August 1, 2015 until July 31, 2020.

Centers for Medicare & Medicaid Services Approval Letter

12-month Continuous Eligibility extended to children’s non-MAGI Medicaid programs

October 18, 2015

12-month continuous eligibility was expanded to children enrolled in non-MAGI programs including children eligible for Supplemental Security Income (SSI) mandatory, Pickle, Disabled Adult Child (DAC), Medicaid Buy-In Program for Children with Disabilities and children in Long-Term Care programs such as Children’s Home and Community Based Services (HCBS) waiver and the Children with Autism Waiver (CWA). Continuous eligibility also applies to children under the age of 19 who are no longer eligible for Foster Care Medicaid.

MSB 15-05-27-D

Continuous Eligibility: Frequently Asked Questions (HCPF)

Medicaid eligibility rule review and updates

November 1, 2015

Several updates were made to the Medicaid eligibility regulations set forth in section 8.100.4 to align rule with federal regulations. These updates were made as part of a five-year rule review process. Clarifications were made to rules concerning verifications, MAGI methodology for income calculation, income disregard, household composition, presumptive eligibility, needy newborns, and transitional Medicaid.

MSB 15-07-08-B

Medicaid expansion for adults

January 1, 2014

Medicaid eligibility threshold expanded to 133% of the Federal Poverty Level (FPL) for Adults without Dependent Children, and for Parents and Caretaker relatives.

Senate Bill (SB) 13-200

Parent/Caretaker Relative Federal Poverty Level Changes Frequently Asked Questions (HCPF)

Implementation of 12-month continuous eligibility for kids in MAGI programs

March 1, 2014

Children ages 0-18 will remain eligible and enrolled in one program (either MAGI Medicaid or CHP+) for 12 continuous months regardless of changes to family size or income.

House Bill 09-1293

Adult dental Medicaid benefit added

April 1, 2014

Medicaid clients ages 21 and older (including pregnant women) gained access to limited dental benefits in April 2014. Full dental benefits, including restorative procedures and services requiring prior authorization, became available on July 1, 2014.

Senate Bill 13-242

Extension of reasonable opportunity period to 90 Days

May 1, 2014

The state responded to federal guidance by defining and aligning the reasonable opportunity period for citizens and non-citizen applicants to 90 days.

CHP+ children’s dental benefit expanded

July 1, 2014

The state responded to federal guidance by expanding benefits to include periodontic care, orthodontic care, prosthodontic care, and an increased annual maximum per member from $600 to $1,000.

Removal of Medicaid “stair step” for kids

January 1, 2013

Children between six and 18 with family incomes at or below 133 percent FPL gained Medicaid eligibility.

Senate Bill 11-008

MSB 12-07-03-A

Increase in Medicaid eligibility for pregnant women

January 1, 2013

Increased the Medicaid eligibility threshold for pregnant women to 185 percent FPL allowing them to access dental benefits and lower cost sharing.

Senate Bill 11-250

MSB 12-07-03-A

CHP+ expanded to dependents of state employees

January 1, 2013

CHP+ became a health coverage option for dependents of state employees, making their dependents eligible for CHP+ benefits, lower enrollment fees, and fewer out-of-pocket costs.

Implementation of CHP+ health plan automatic enrollment

January 1, 2013

Health Maintenance Organization selection for new CHP+ enrollees is automated to streamline enrollment. CKF continues to recommend that further changes be made to protect family choice.

CHP+ “opt in” options for children of families who have submitted food stamps or a Colorado Works application.

April 30, 2013

MSB 13-01-08-A

Express lane eligibility for children who have submitted an Free/Reduced Lunch application will have the option to “opt-in” for Medical Assistance eligibility determination at participating school districts

March 3, 2013

MSB 12-07-27-A

Removal of CHP+ three-month waiting period

May 1, 2013

Eliminates the three-month waiting period that required children who were covered by health insurance to wait three months before applying for CHP+ if the insurance was through an employer who contributed at least 50% of the premium cost.

Senate Bill 13-008

MSB 13-04-04-A

Funding Colorado Health Benefit Exchange

Eliminates the three-month waiting period that required children who were covered by health insurance to wait three months before applying for CHP+ if the insurance was through an employer who contributed at least 50% of the premium cost.

House Bill 13-1245

Transfer Developmental Disabilities to HCPF

House Bill 13-1314

CHP+ Enrollment Fee

January 1, 2012

CHP+ Enrollment Fee increased for families between 205-250% FPL.

MSB 11-08-30-A

CHP+ Co-pay increases

July 1, 2012

MSB 11-08-30-A

Medicaid Buy-In Program for Working Adults with Disabilities (Adult Buy-In)

March 1, 2012

House Bill 09-1293

Electronic Identity Verification

Feb. 27, 2012

Department of Motor Vehicles Electronic Interface with the Colorado Benefits Management System for Identity Verifications.

MSB 11-12-09-C

Adults without Dependent Children (AwDC)

April 1, 2012

Medicaid Expansion to Adults without Dependent Children under 10% of FPL.

House Bill 09-1293

Medicaid Buy-In Program for Children with Disabilities (Children’s Buy-In)

July 1, 2012

Families earning up to 300 percent of the Federal Poverty Level (FPL) can “buy-in” to Medicaid benefits for disabled children via a monthly premium.

Colorado Benefits Management System Project

House Bill 12-1339

Medicaid Payment Reform and Innovation Pilot Program

House Bill 12-1281