Free through December '23! Join our members email list.
Join COMBINE today!
2023 dues are $99. COMBINE is a 501c4 nonprofit trade association and a registered nonpartisan nonprofit Small Donor Political Committee. Contributions not tax deductible.
An independent provider contracted with a RAE and feel frustrated and alone working within Colorado's Medicaid system?
If so, you're in the right place. You are not alone.
COMBINE brings together Coloradans concerned about the delivery of behavioral healthcare for the Medicaid population. COMBINE is a 501c4 trade association and a member driven nonpartisan registered Small Donor Political Committee advocating for a diverse, competent, and sustainable Medicaid behavioral healthcare workforce in Colorado.
Members are both professionals that provide Medicaid behavioral healthcare and the public. COMBINE offers mutual aid to members of the IPN and empowers members to advocate for a behavioral healthcare system that includes the IPN. Join us!
Providers are disadvantaged by the structure of managed care, where we cannot collectively bargain because we are contractors and we have no employee rights. Together we can offer experience and commitment when advocating for the maintenance and improvement of mental healthcare delivery for Colorado.
The world of public healthcare has history, tensions, and a future. COMBINE educates members about opportunities, rules, policy, and the actors in Colorado that determine our Medicaid behavioral healthcare future.
Medicaid is administered by both the federal and state governments, and managed by for-profit and non-profit corporations. State level legislators have influence over Medicaid policy. COMBINE vets and endorses candidates and scores their actions as legislators.
Outpatient clinics are a part of the essential safety net.
Attend online BHA workshops (10 AM, once a month) to learn safety net standards.
Oct 27, 2023, Nov 24, Dec 29, and Jan 26, 2024, Feb 23, March 29, April 26, May 31, and Jun 28
What are the Mental Health "Parity" laws all about?
"MHPAEA prohibits covered plans from imposing financial requirements and treatment limitations that are more restrictive for MH/SUD services when compared to medical/surgical."
Commissions: Medical (HCPF), Health (DHE), DOI bulletin drafts
Do you have a complaint for HCPF (Medicaid)?
If so, you can submit your complaint via the Health First Colorado Managed Care Provider Complaint Form.
Do you have a complaint for Colorado Division of Insurance (commercial payers)?
Here is the Complaint Form for Providers
September 2023 DOI advisory:
"The Division of Insurance strongly encourages providers to respond to its most recent bulletin and the associated website for Behavioral Health Providers. They need your complaint data. Pay close attention to the following directions to make your response as efficient and productive as possible.
1. All responses/complaints must be organized and individualized by insurance company, not issue. This helps DOI best process these as they process directly with each company, instead of having to cull through issue-focused emails to identify which payer is in violation on which issue(s).
Do not send a complaint about "supervisory billing" or "rates" or "credentialing" or "denied claims." Instead, organize your issues by insurance company and send an individual response or complaint for each insurance company. For example, you would have one complaint containing all of your Anthem issues, another one containing all of your United issues, etc.
2. All issues MUST be addressed in one of the following two contexts:
- Evidence of a parity violation between behavioral health and physical health OR
- Evidence of a contradiction between what an insurance company self-attested to the DOI and what a provider or member actually experienced. This second reason is why the DOI made the self-attestations public, so that providers and members can report things that directly violate that which the insurance companies self-attested.
Note: The Division of Insurance does not have the authority to interfere with carrier-provider disputes. It would take a legislative directive to make changes to the DOI's authority. At this time, the DOI's authority exists in two places: (1) Enforcing parity between behavioral health and physical health policies and procedures, and (2) Protecting consumers by pursuing resolutions to complaints made that validate an insurance company is committing a parity or self-attestation violation. This means that they cannot directly address rates, credentialing, auditing, contracting, claims issues, or any other single issue or topic with an insurance company unless it relates to a parity violation or self-attestation violation.
If so, you can submit your complaint via https://doi.colorado.gov/for-consumers/file-a-complaint
Oct 4, 2022: HCPF promotes free education for health services workers. CLICK HERE.
Care Forward Colorado is revitalizing Colorado’s healthcare workforce through zero-cost, short-term training programs at community and technical colleges. In a year or less, trainees can learn skills to become a certified nursing assistant, emergency services professional, and many more professions that are desperately needed in Colorado’s healthcare facilities.
Have you seen HCPF's Independent Provider Network Forum webpage yet?
September 30, 2022: UPDATE: For non-BHE Medicaid clinics training university interns and pre-licensure externs, HCPF/RAEs have agreed to use DORA's standard for supervision (3 years post-graduation experience plus supervision classes) and also will review providers with DORA stipulations "case by case". This is a win for COMBINE's advocacy.
August 19, 2022 HCPF released their narrative regarding huge disparity in rates received by the independent provider network compared to CMHC rates. The report is neither "independent" as required by law, nor complete. Read their report. Read COMBINE's response.
COMBINE analyzed the recommendations in the Blueprint to seek common priorities with the task force. The spreadsheet for tracking progress is public and displays comments and suggestions.