HCPF Agenda Template Style Sheet



November 30, 2014

The Honorable Scott Gessler

Secretary of State

1560 Broadway, 2nd Floor

Denver, Colorado 80203

Dear Mr. Gessler:

Attached is the Notice of Proposed Rules concerning Medical Assistance rules to be considered for final adoption at the January 2015 meeting of the Medical Services Board of the Department of Health Care Policy and Financing. The meeting will be held on Friday, January 9, 2014, 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

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, January 9, 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 14-10-28-A. Revision to the Medical Assistance Eligibility Rule Concerning Allowable Deductions, Section 8.100.4.C.1.d

Medical Assistance. The proposed rule changes amend 10 CCR 2505-10 § 8.100.4.C.1.d to incorporate changes to the rule mandated by the Patient Protection and Affordable Care Act of 2010 (ACA) as they pertain to Modified Adjusted Gross Income (MAGI)-based methodologies. Among these changes: revision to the current policy regarding allowable deductions to calculate Adjusted Gross Income. Currently, when determining the Adjusted Gross Income under 8.100.4.C.1.d. the allowable deductions identified in the policy are not all applicable to determine Adjusted Gross Income. The proposed change will define what deductions are allowable as defined under title 26 U.S.C 62 to get the Adjusted Gross Income to determine eligibility for MAGI-Medical Assistance.

The proposed rule will impact applicants who have countable income applying for MAGI-Medical Assistance. The benefit of allowable deductions is to help lower an applicants Adjusted Gross Income when determining eligibility. Currently the rule is not in compliance with federal regulations and is giving individuals incorrect determinations based on the allowable deductions identified and cited in our current rule. Based on further clarification and research the rule will be updated to be in compliance with federal regulations for allowable deductions to calculate Adjusted Gross Income and determine correct eligibility for individuals applying for Medical Assistance. Updating this policy will also ensure federal matching dollars are appropriately spent.

Additional allowable deductions will be added to the Colorado Benefits Management System (CBMS) to calculate the adjusted gross income, which is likely to result in an increase in state expenditure via an increase in caseload. Because the Department does not currently deduct specific allowable deductions, the impact is ambiguous. However, given the nature of the deductions and the fact that some deductions are replacing others, the Department does not anticipate that the net impact will be significant.  The Department will monitor the federally mandated change and will make adjustments to the budget if necessary through the normal budget process.

The authority for this rule is contained in 42 CRF 435.603(e) and 25.5-1-301 through 25.5-1-303, C.R.S. (2014).

MSB 14-10-31-A, Revision to the Medical Assistance Eligibility Rule Concerning a Rule Citation Correction, Section 8.100.7.B.1.c and 8.100.7.B.2.c

Medical Assistance Home and Community Based Services for Working Adults with Disabilities Buy-in.

This is a technical correction to the rule citation in 10 CCR 2505-10 § 8.100.7.B that refers to Working Adults with Disabilities at 10 CCR 2505-10 § 8.100.6.O when it should be § 8.100.6.P.

The authority for this rule is contained in 25.5-1-301 through 25.5-1-303, C.R.S. (2014) and 25.5-5-201(1)(o) and 25.5-6-1401 through 1406 C.R.S. (2014).

MSB 14-07-28-A, Revision to the Medical Assistance Health Programs Benefits and Operations Physician Services Rule Concerning Podiatry Services, Section 8.200.3.A.8 (8.200.3.D)

Medical Assistance. This rule change will define the amount, scope and duration of the podiatry benefit. In order to define amount, scope and duration, the Department is amending the existing podiatry rule to place all of the substantive content from the Benefit Coverage Standards into rule. The Department has gone through a detailed analysis to ensure that the rule amendment does not change any of the substantive content of the original Benefit Coverage Standard. In addition, the rule will be moved within 10 CCR 2505-10 to make the rule easier to locate and understand.

The authority for this rule is contained in §1905(a)(18) of the Social Security Act and the Colorado Revised Statutes, sections 25.5-1-301 through 25.5-1-303 C.R.S. (2014).

MSB 14-07-15-B, Revision to the Medical Assistance Community Living Benefit Rule Concerning In-Home Support Services, Section 8.552

Medical Assistance. In Home Support Services. The proposed revisions to 10 CCR 2505-10 Section 8.552 in the Medical Assistance Home and Community Based Services rules regarding In Home Support Services implement programmatic changes mandated by HB 14-1357. The changes include 1) allowing IHSS to be provided in the community; 2) adding spouses as an eligible family member who may act as an attendant providing IHSS; 3) clarifying that the eligible client or the eligible client's authorized representative is responsible for directing the provision of IHSS, including scheduling, managing, and supervising attendants 4) allowing clients or the client's authorized representative to determine the amount of oversight needed in conjunction with the IHSS agency; 5) removing the 444 hour per year family member reimbursement limit on personal care and establishing a new 40 hour per week family reimbursement limit on personal care for individuals accessing IHSS through HCBS-EBD and HCBS-SCI Waivers; and 6) expanding IHSS to persons receiving services under the Spinal Cord Injury waiver pilot program. In addition to the mandated changes, the proposed revisions incorporate stakeholder feedback by allowing willing and able IHSS agencies to provide the support necessary for a client who does not have an AR to participate in IHSS. The proposed revisions also provide more explicit definitions of health maintenance, homemaker, and personal care activates and specify that the daily allotted scope and duration of each IHSS service must be documented in the IHSS plan.

The authority for this rule is contained in 42 U.S.C Section 1396n; 25.5-6-1201 through 15.5-6-1205 C.R.S. (2014) and in 25.5-1-301 through 25.5-1-303, C.R.S. (2014).

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1570 Grant Street, Denver, CO 80203-1818 P 303.866.2993 F 303.866.4411 hcpf

1570 Grant Street, Denver, CO 80203-1818 P 303.866.2993 F 303.866.4411 hcpf

 P 303.866.2993 F 303.866.4411 hcpf

1570 Grant Street, Denver, CO 80203-1818 P 303.866.2993 F 303.866.4411 hcpf

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