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HCPF says >750,000 claims require adjustment after hospital rate changes; fiscal agent processing through January
Summary
HCPF told hospitals that outpatient rate updates effective July 1 and Oct. 1 prompted system timing that produced more than 750,000 claims needing adjustment; just under 400,000 had been processed at the time of the meeting and adjustments will continue through January.
Andrew Avalos, facility rate section manager at the Colorado Department of Health Care Policy & Financing, told participants the department implemented multiple outpatient hospital rate changes last year with effective dates of July 1 and Oct. 1. He said timing constraints required waiting for EAPG version and 340B pricing updates before performing hospital-specific base-rate updates.
Avalos…
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