What is the difference between CFMC and ACS?
Colorado Foundation for Medical Care (CFMC) is the Quality Improvement Organization for the state of Colorado, and has a contract with CDHCPF (CO Medicaid) to review Prior Authorization Requests (PARs) for medical necessity. CFMC provides this review for the following: Certain surgical procedures, including transplants Certain durable medical equipment (DME), including power wheelchairs and scooters, augmentative communication devices, respiratory devices, and certain prosthetic and orthotic equipment Physical and occupational therapy Substance use disorder and mental health treatment Certain non-emergency transportation services EPSDT home health services Out-of-state elective hospital admissions Affiliated Computer Services (ACS) is the fiscal agent for Colorado Medicaid. ACS performs the following, among other services: Long Term Home Health PARS for clients age 18 and over should be sent to the Single Entry Point (SEP) agency in the client’s county of residence.
