2020 Colorado Revised Statutes
Title 25.5 - Health Care Policy And Financing
Article 4. Colorado Medical Assistance Act - General Medical Assistance
Section 25.5-4-212. Medicaid client correspondence improvement process - legislative declaration - definition.

(1) (a) The general assembly finds and declares that:

1. Accurate, understandable, timely, informative, and clear correspondence from the state department is critical to the life and health of medicaid recipients, and, in some cases, is a matter of life and death for our most vulnerable populations;

2. Unclear, confusing, and late correspondence from the state department causes anincreased workload for the state, counties administering the medicaid program, and nonprofit advocacy groups assisting clients; and

3. Government should be a good steward of taxpayers' money, ensuring that it is spentin the most cost-effective manner.

(b) Therefore, the general assembly finds that improving medicaid client correspondence is critical to the health and safety of medicaid clients and will reduce unnecessary confusion that requires clients to call counties and the state department or file appeals.

2. As used in this section, unless the context otherwise requires, "client correspondence" means any communication, the purpose of which is to provide notice of an approval, denial, termination, or change to an individual's medicaid eligibility; to provide notice of the approval, denial, reduction, suspension, or termination of a medicaid benefit; or to request additional information that is relevant to determining an individual's medicaid eligibility or benefits. "Client correspondence" does not include communications regarding the state department's review of trusts or review of documents or records relating to trusts.

3. The state department shall improve medicaid client correspondence by ensuring thatclient correspondence revised or created after January 1, 2018:

1. Is written using person-first, plain language;

2. Is written in a format that includes the date of the correspondence and a client greeting;

3. Is consistent, using the same terms throughout to the extent practicable includingcommonly used program names;

4. Is accurately translated into the second most commonly spoken language in the stateif a client indicates that this is the client's written language of preference or as required by law;

5. Includes a statement translated into the top fifteen languages most commonly spokenby individuals in Colorado with limited English proficiency informing an applicant or client how to seek further assistance in understanding the content of the correspondence;

6. Clearly conveys the purpose of the client correspondence, the action or actions beingtaken by the state department or its designated entity, if any, and the specific action or actions that the client must or may take in response to the correspondence;

7. Includes a specific description of any necessary information or documents requestedfrom the applicant or client;

8. Includes contact information for client questions; and

9. Includes a specific and plain language explanation of the basis for the denial, reduction, suspension, or termination of the benefit if applicable.

4. Subject to the availability of sufficient appropriations and receipt of federal financialparticipation, on and after July 1, 2018, the state department shall make electronically available to a client specific and detailed information concerning the client's household composition, assets, income sources, and income amounts, if relevant to a determination for which client correspondence was issued. If implemented, the state department shall notify clients in the written correspondence of the option to access this information.

5. The state department is encouraged to promote the receipt of client correspondenceelectronically or through mobile applications for clients who choose those methods of delivery as allowed by law.

6. As part of its ongoing process to create and improve client correspondence, the statedepartment may engage with experts in written communication and plain language to test client correspondence against the criteria set forth in subsection (3) of this section with a geographically diverse and representative sample of medicaid clients relevant to the client correspondence being revised. The state department shall also develop a process to review and consider feedback from stakeholders including client advocates and counties prior to implementing significant changes to correspondence.

7. The state department shall ensure that client correspondence that may only affect asmall number of clients, but may, nonetheless, have a significant impact on the lives of those clients, is appropriately prioritized for revision.

8. As part of its annual presentation made to its legislative committee of reference pursuant to section 2-7-203, the state department shall present information concerning:

1. Its process for ongoing improvement of client correspondence;

2. Client correspondence revised pursuant to criteria set forth in subsection (3) of thissection during the prior year and client correspondence improvements that are planned for the upcoming year; and

3. A description of the results of testing of new or significantly revised client correspondence pursuant to subsection (6) of this section, including a description of the stakeholder feedback.

Source: L. 2017: Entire section added, (SB 17-121), ch. 303, p. 1651, § 1, effective August 9.