The Home Health benefit for Health First Colorado (Colorado’s Medicaid Program) members provides services from a licensed and certified Home Health Agency (HHA) for members who need Intermittent Home Health Services.
There are two types of home health services:
- Acute Home Health: Skilled Home Health services provided to members who experience an acute health care need that necessitates skilled Home Health care. Acute Home Health services are allowed without prior authorization for up to 60 calendar days or until the acute condition is resolved, whichever comes first. (If the member is on a Health First Colorado Managed Care Program, prior authorization for acute Home Health may be required by the Managed Care Organization.)
- Long-term Home Health: Skilled Home Health services provided to members who require ongoing Home Health services beyond the Acute Home Health period. Prior authorization is required for Long-Term Home Health Services.
Health First Colorado Members who:
- Require Home Health Services for the treatment or amelioration of an illness, injury, or disability, which may include mental illness
- Are unable to perform the health care tasks for him or herself, and he or she has no Family Member/Caregiver who is willing and able to perform the skilled tasks
- Require services that cannot appropriately or effectively be received in an outpatient treatment office or clinic or for which the member’s residence is the most effective setting to accomplish the care required by the member’s medical condition
- The services meet medical necessity criteria and are provided in a manner consistent with professional practice
Benefits and Services
- Skilled Nursing (provided by a Registered Nurse or Licensed Practical Nurse)
- Certified Nurse Aide (CNA) services (may also be referred to as a Certified Nursing Assistant or Home Health Aide)
- Physical Therapy (PT)
- Occupational Therapy (OT)
- Speech/Language Pathology (SLP) services (or Speech Therapy)