CO SB266

Directs the Department of Health Care Policy and Financing to pursue cost-control strategies, value-based payments, and other approaches to reduce Medicaid expenditure growth while dedicating permanent staff and resources to these efforts.

Requires the department to provide Medicaid expenditure and quality data to providers participating in the Accountable Care Collaborative and implement automatic claims review technology to identify and correct improper coding before payment.

Establishes an evidence-based hospital review program (subject to federal approval) including preadmission review, continued stay review, transfer planning, discharge planning, care coordination, and retrospective claims review consistent with 42 CFR 456.

Requires stakeholder consultation with recipients, hospitals, and providers before implementation; mandates testing with a limited group of hospitals prior to full rollout; and requires reports to the Joint Budget Committee by November 1, 2018, 2019, and 2020 detailing implementation status, cost savings, and health outcomes impact.

Appropriates $2,737,764 for the 2018-19 fiscal year ($2,007,911 from general fund, $729,853 from healthcare affordability and sustainability fee fund) and anticipates $5,200,263 in federal funds to implement the cost-control measures.