J_JTC_2017A 10/11/2017 10:04:47 AM Committee Summary

Senator Martinez Humenik called the meeting to order. A quorum was present. Representative Young joined the committee.



10:04 AM -- Presentation and Discussion with Colorado Department of Health Care Policy and Financing regarding the Colorado interChange and Medicaid Management Information System



Mr. Tom Massey, representing the Colorado Department of Health Care Financing and Policy (HCPF), came to the table to discuss the department's Colorado interchange and Medicaid Management Information System (MMIS). Mr. Massey distributed a packet of information to the committee (Attachment A). The committee also received a memorandum on MMIS (Attachment B).



171011 AttachA.pdf171011 AttachB.pdf



Mr. Chris Underwood, representing HCPF, came to the table to give the committee an overview and update on the Colorado Medicaid Management Innovation and Transportation (COMMIT) project, an update on Colorado interchange, an overview of payment issues, the actions the department and the vendor (DXC) are taking to help providers with the transition, and the department's plans for returning to normal operations.











10:25 AM



Mr. Underwood continued by discussing the modernizations implemented through the project. He also highlighted data comparing Colorado weekly paid claims percentages with data from other states. He continued by discussing provider enrollments in the medicaid program. Mr. Underwood noted that the call center wait times have been unacceptable and that the department worked with DXC to achieve wait times of 10 minutes or less. Mr. Underwood continued by discussing how the department plans to resolve problems and manage issues.



10:44 AM



In response to a committee question, Mr. Underwood discussed the system and its handling of prior authorizations. He continued by noting the steps the department and DXC is taking to help users during the transition. Mr. Underwood also discussed the delay of the implementation from October to March and the challenges of identifying providers. Responding to a committee question regarding notices, Mr. Underwood highlighted the department's outreach during the transition. Mr. Massey noted the communications issues encountered during the project and described the site visits the department undertakes. Mr. Stu Bailey, representing DXC, noted that the legacy system was paper-based and that the transition to computer-based systems provides training challenges.



11:11 AM



Mr. Underwood continued by discussing the how the department is using the claim denial rate data to fix system issues. Mr. Bailey noted the system refinement process DXC is conducting. In response to a committee question, Mr. Underwood noted that the department reviewed systems from Wisconsin and Delaware before implementation and that there were numerous failures of updated systems across the nation. He stated that the department is working with the State of Nevada and HCPF's federal partners to help implement the project. Mr. Massey noted that communication issues are hard to solve and that he encourages any providers to reach out to him.



11:33 AM



In response to a committee question, Mr. Underwood discussed the magnitude of the code and programming changes and how the department works with their vendors. He also highlighted the project's IV&V vendor and stated that HCPF works with them on a monthly basis. Mr. Underwood continued to respond to committee questions regarding the provider claims process.



11:43 AM



In response to a committee question, Mr. Underwood discussed the testing of the system before production and noted that the problems currently seem to involve small providers. Mr. Bailey, in response to a committee question, noted that other states have run into issues with the new Medicaid claim systems due to the complex nature of Medicaid. He stated that in comparison to other states, Colorado is doing well with this transition even though there are issues with providers.



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.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.





12:35 PM -- Public Testimony about interChange



Ms. Maureen Welch, representing herself, came to the table to discuss her personal experiences with MMIS. She suggested more targeted training for specific niche providers.



12:49 PM



Mr. Underwood returned to the table to discuss various questions raised during public testimony. Mr. Massey noted that the he will include the committee on the department's 30 day report for further updates and was open to the suggestions from the provider panel. Mr. Underwood and Mr. Massey responded to additional committee questions.















01:17 PM -- Introduction to FirstNet



Kevin Niemond, Joint Budget Committee Staff, presented an overview of the federal First Responder Network Authority (FirstNet). Committee members received a memorandum from Mr. Niemond (Attachment D).



171011 AttachD.pdf



01:26 PM -- FirstNet: Partner Presentation



Mr. Justin Shore, representing FirstNet, presented a background on FirstNet, including funding for FirstNet. He described the process of the opting-in and out of the FirstNet network. He noted that there is no mandate for first responders to utilize the FirstNet network. In response to committee questions, Mr. Shore noted that the network provides priority and preemption for data and voice for first responders.



01:43 PM



Mr. Shore clarified that AT&T is required to comply with all federal communications law and that cybersecurity mandates are included in the FirstNet public-private partnership contract. He continued by discussing interoperability between opt-out and opt-in states. Mr. Shore stated, in response to a committee question, that FirsNet is complementary to state digital trunked radio systems, but does not replace them. He also noted that Congress did not mandate the use of FirstNet in order to provide competition that results in lower prices. In response to a committee question, Mr. Shore explained that the business model of a public-private partnership allows AT&T to lease the spectrum to commercial users.



02:02 PM



Professor Ronald Rizzuto and Mr. Larry Satkowiak came to the table to discuss their white paper about FirstNet (Attachment E). Prof. Rizzuto noted the white paper illustrates the capital costs that go into building a network as well as ongoing network costs. The white paper, which was funded by AT&T, estimates that an opt-out decision would obligate Colorado to at least a $1.0 billion investment over the next ten years, after considering the potential $70.8 million to $88.5 million National Telecommunications and Information Administration construction grant. Mr. Satkowiak continued by noting that the paper recommends Colorado opt-in to FirstNet to due to liability issues and the difficulty planning for future technology.



171011 AttachE.pdf



02:29 PM -- FirstNet: Governor's Office of Information Technology Presentation



Mr. Brian Shepherd, representing the Governor's Office of Information Technology (OIT), came to table to discuss Colorado's FirstNet governance and process. He distributed a copy of his presentation to the committee (Attachment F). He noted several discrepancies in the white paper presented in Attachment E. He stated that the law requires each state to set up a governing body and that Colorado's includes various first responder representatives. He highlighted the opt-in decision timeline, noting the final decision for the state to opt-in is in December 2017. He noted that Colorado's governing body is considering several key factors in its decision: short versus long term objectives of the overall technology transition; coverage, pricing, and scalability planning for growth; and whether the public-private FirstNet/AT&T model fits Colorado. He continued by discussing the opt-out options for Colorado.









02:51 PM



In response to a committee questions, Mr. Shepherd noted that FirstNet was exempt from certain open records laws and that Colorado would not have access to the AT&T/FirstNet contract due to proprietary information. Mr. Shepherd continued by noting that Colorado's governing body has not yet reached a decision on whether to opt-in or out to AT&T's FirstNet system. In response to a committee question, Mr. Shepherd noted that the state did conduct a cost-benefit analysis and that it is currently under review by the Attorney General's Office.



171011 AttachF.pdf



03:11 PM -- Public Testimony regarding FirstNet



03:12 PM -- Mr. Chris Riley, representing FirstNet, came to the table to provide information why the state should opt-in to the FirstNet network.



03:17 PM -- Mr. Ryan Fields Spack, representing AT&T, came to the table to discuss the Aurora Fire Department's response to the Aurora theater shooting.



03:22 PM -- Mr. Nick Coglazier, representing the Colorado Competitive Council, came to the table to support Colorado opting-in to the FirstNet network.



03:24 PM -- Ms. Emily Ibach, representing the Colorado Farm Bureau, came to the table to support Colorado opting-in to the FirstNet network.



03:26 PM -- Ms. Lisa Gregg, representing the Colorado Business Roundtable, came to the table to support Colorado opting-in to the FirstNet network.



03:30 PM



Committee discussion regarding FirstNet ensued.



03:39 PM



The committee adjourned.