HCPF: CMS has asked for more info on state plan amendments; agency seeks feedback on VNS reimbursement and will publish IME fact sheet

Andrew Avalos reported that multiple state plan amendments related to hospital rates — including across-the-board increases, a 340B-related adjustment and the 07/01/2025 rate rebasing amendment — are currently in 'request for additional information' status with the Centers for Medicare & Medicaid Services and are not yet approved.

He said the Medical Services Board received a rule presentation in November regarding modification of hospital rate-setting authority (to allow rate reductions related to executive order) and that the rule was adopted. Avalos also said the department plans a housekeeping rule change to correct references and does not expect operational or rate impacts from that clarification.

On VNS device reimbursement, Avalos reminded attendees that Senate Bill (read aloud in the meeting as) "Senate Bill 20 five-one 121" was postponed during the prior legislative session and that the department continues to seek hospital feedback on whether current reimbursement levels are causing access-to-care concerns.

Kevin JD Wilson of Children's Hospital Colorado asked technical questions about the department's budget filing and a proposed cut to the indirect medical education (IME) adjustment. Avalos said the department is preparing a shareable fact sheet that should address many of those questions, encouraged providers to submit batched questions, and said he would include Kevin Martin and Diane (contacts on the slides) in follow-up communications.

The department did not provide statutory citations or a rule number during the meeting; attendees were asked to email the contacts listed on the slides for more detail.