This bill aims to streamline the reenrollment and eligibility verification process for Colorado’s state medical assistance program, particularly for individuals with fixed incomes and those in need of long-term services and supports (LTSS).
Key Provisions:
Extended Reenrollment Timeline for Fixed-Income Members
The state would seek federal authorization to extend the period before members need to reapply if their income comes solely from fixed sources (e.g., Social Security, pensions).
Simplified Verification of Income & Need
The bill allows the state to verify income and need for services simultaneously to reduce administrative burdens.
Easier Verification for Long-Term Services & Supports (LTSS)
All licensed medical professionals with a bona fide physician-patient relationship could verify a member’s need for LTSS.
Reduces the number of questions asked to medical professionals, making it easier for patients to get approved.
No New Documentation for Care Transitions
Members transitioning between institutional care (e.g., nursing homes) and home-based services would not have to resubmit documentation, reducing delays in care.
Potential Benefits:
Reduces bureaucratic hurdles for fixed-income individuals.
Speeds up approvals for long-term care services.
Helps prevent gaps in coverage during care transitions.
Would you like to explore how this bill compares to similar policies in other states?
Summary
The bill authorizes the department of health care policy and
financing (state department) to seek federal authorization to:
•
Extend the timeline for member reenrollment in the state medical assistance program based on the financial eligibility for a member whose income is based solely on a fixed income source; and •
Verify a member's eligibility for reenrollment based on income and need at the same time.
The bill requires the state department to modify the questions
asked to medical professionals when verifying a member's need for long-term services and supports and allows any licensed medical professional who has a bona fide physician-patient relationship with a member to complete the documentation necessary to verify a member's need for long-term services and supports.
The bill prohibits the state department from requiring new
documentation for a member who transitions from receiving services in an institutional setting to receiving services in a home- and community-based setting and vice versa.
