C.R.S. § 25.5-4-431 — CO Code / Title 25.5 / Article 4 / Part 4 / Section 25.5-4-431
25.5-4-431. Preauthorization for treatment - request to share with insurance carrier
Status: in_force

25.5-4-431. Preauthorization for treatment - request to share with insurance carrier. [Editor's note: This section is effective January 1, 2025.] Subject to state and federal laws relating to the confidentiality of medical records, at the request and with the consent of an enrollee in the medical assistance program, the state department shall provide a copy of the enrollee's preauthorization for treatment to the enrollee's new insurance carrier within ten days after receipt of the request if the enrollee is no longer enrolled in the medical assistance program.
C.R.S. § 25.5-6-409 — CO Code / Title 25.5 / Article 6 / Part 4 / Section 25.5-6-409
25.5-6-409. Services for persons with intellectual and developmental disabilities
Status: repealed

25.5-6-409. Services for persons with intellectual and developmental disabilities. (1) A program to provide home- and community-based services to persons with intellectual and developmental disabilities who are in need of the level of care available in an intermediate care facility for individuals with intellectual disabilities is hereby established pursuant to the federal "Social Security Act", as amended. This program shall provide for the social, habilitative, remedial, residential, health, and other needs of persons with intellectual and developmental disabilities to avoid placement in an intermediate care facility for individuals with intellectual disabilities.

(2) Services for persons with intellectual and developmental disabilities provided through this program must be delivered under the provisions of a statewide services plan, in the form of home- and community-based services waivers or model waivers, developed by the state department and the department of human services and approved by the federal centers for medicare and medicaid services, or any successor agency. This plan must include the specific services to be offered, a plan for the delivery of such services through case management agencies or other service agencies approved pursuant to this article 6 or article 10.5 of title 27 utilizing where appropriate the provision of in-home services, the expected costs of such services, the expected benefits of providing those services, and the administrative provisions which shall govern the implementation of the plan. The plan must provide for all necessary safeguards to ensure the health and welfare of any eligible persons. The average per capita expenditure for services under this plan must not exceed the average per capita expenditure the department of human services or the state department would have made for services otherwise available without this plan.

(3) The plan shall utilize existing community-based services programs to the maximum extent possible and shall coordinate all available forms of assistance for the eligible person.

(4) Repealed.

(5) (a) No later than January 2024, the state department shall submit a report to the senate health and human services committee, the house of representatives public and behavioral health and human services committee, and the house of representatives health and insurance committee, or any successor committees, as part of its "State Measurement for Accountable, Responsive, and Transparent (SMART) Government Act" presentation required by section 2-7-203. At a minimum, the report must identify:

(I) A reimbursement system with a goal to incentivize and increase transportation provider participation;

(II) How the state department will ensure compliance with applicable federal laws and waiver requirements;

(III) A system of common reporting to ensure a member does not exceed the medicaid benefit in a multi-provider scenario; and

(IV) Best practices based on what other states have done to allow transportation network companies to provide nonmedical transportation services for individuals receiving services, including but not limited to, reimbursement rates; driver compensation; and integration with programs that provide nonmedical transportation services.

(b) In developing the report, the state department shall engage in a stakeholder process that includes individuals with intellectual and developmental disabilities and their families, individuals with disabilities, and transportation network companies. The report may be developed in conjunction with the reporting requirement in sections 25.5-6-307 (6), 25.5-6-606 (9), 25.5-6-704 (8), and 25.5-6-1303 (9).

(c) (I) Upon completion of the report described in subsection (5)(a) of this section, the state department shall analyze and review each operational transportation network company, as defined in section 40-10.1-602 (3). The state department shall verify each transportation network company's viability to ensure the health, safety, welfare, cost effectiveness, and capability in expanding nonmedical transportation services for individuals receiving services pursuant to this section and comply with all rules promulgated pursuant to subsection (5)(e)(I) of this section.

(II) No later than July 1, 2024, the state department shall authorize verified transportation network companies to provide nonmedical transportation services if the state department finds the transportation network company viable under federal requirements and within budgetary constraints.

(III) For the purposes of this subsection (5)(c), "verify" means a transportation network company meets all requirements resulting from the report described in subsection (5)(a) of this section.

(d) The state department may seek any necessary federal authorization for the implementation of this subsection (5).

(e) (I) The state department shall promulgate any necessary rules to ensure transportation network companies comply with federal and state oversight requirements and shall include all relevant stakeholders, including medicaid members, transportation network companies, current providers and drivers for nonmedical transportation services, and other parties interested in developing the requirements.

(II) Pursuant to section 40-10.1-105 (1)(l), transportation network companies are not subject to regulation by the public utilities commission when providing nonmedical transportation services pursuant to this section and are instead subject to rules promulgated by the state department pursuant to this subsection (5)(e).

(f) This subsection (5) does not apply to a provider authorized to provide transportation services pursuant to part 8 of article 1 of title 25.5 prior to August 10, 2022.
C.R.S. § 25.5-3-202 — CO Code / Title 25.5 / Article 3 / Part 2 / Section 25.5-3-202
25.5-3-202. Legislative declaration
Status: repealed

25.5-3-202. Legislative declaration. (Repealed)
C.R.S. § 25.5-4-506 — CO Code / Title 25.5 / Article 4 / Part 5 / Section 25.5-4-506
25.5-4-506. Coverage for doula services - stakeholder process - federal authorization - scho
Status: repealed

25.5-4-506. Coverage for doula services - stakeholder process - federal authorization - scholarship program - training - report - definitions - repeal. (1) As used in this section, unless the context otherwise requires:

(a) "Doula" means a trained birth companion who provides personal, nonmedical support to pregnant and postpartum people and their families prior to childbirth, during labor and delivery, and during the postpartum period.

(b) "Maternity advisory committee" means the committee facilitated by the state department composed predominantly of Black, Indigenous, and other people of color with maternity care experience as members.

(2) No later than September 1, 2023, the state department shall initiate a stakeholder process to promote the expansion and utilization of doula services for pregnant and postpartum members in the state. In conducting the stakeholder process, the state department shall:

(a) Design an outreach strategy that includes best practices in community engagement, including, but not limited to:

(I) Engaging trusted community partners to support the work;

(II) Reimbursement of participation costs for individuals who are not otherwise paid to participate;

(III) Reimbursement of child care costs for individuals who participate; and

(IV) Translation services and meeting times that allow diverse and inclusive participation;

(b) Solicit feedback related to:

(I) An approved doula certification process that incorporates national and local training programs;

(II) A billing process for doula services;

(III) Ways to recruit doulas and integrate them into hospital deliveries;

(IV) Support needed to build and retain a doula workforce;

(V) Community outreach to determine how to best promote doula services; and

(VI) The doula scholarship program created in subsection (7) of this section.

(3) Stakeholders must be diverse with regard to race, ethnicity, immigration status, sexual orientation, and gender, and must represent other populations that experience greater health disparities and inequities. The state department may include the following in the stakeholder process:

(a) Doulas and potential doulas who may serve members who include, but are not limited to, Black, Indigenous, and other people of color, refugees, non-English speakers, people living in rural areas, and people who were recently incarcerated;

(b) Individuals indirectly involved in the delivery of doula services, including, but not limited to, clinical providers, hospitals, managed care entities, and state partners, including, but not limited to, the department of public health and environment, department of human services, department of early childhood, and department of regulatory agencies;

(c) Representatives from the division of insurance with subject matter expertise;

(d) Representatives from the maternity advisory committee;

(e) Consumer advocates; and

(f) Experts on perinatal care and quality.

(4) For state fiscal year 2024-25, the state department shall submit a report to the general assembly as part of the state department's "SMART Act" presentation required by section 2-7-203. The report must include findings and recommendations from the stakeholder process as described in subsection (2) of this section. The state department shall work with the maternity advisory committee to create the report.

(5) In carrying out the stakeholder process described in subsection (2) of this section, the state department is exempt from the "Procurement Code", articles 101 to 112 of title 24.

(6) Not later than July 1, 2024, the state department shall seek federal authorization to provide doula services for pregnant and postpartum people to improve health outcomes of pregnant and postpartum people who face a disproportionately greater risk of poor birth outcomes.

(7) (a) Not later than July 1, 2024, the state department shall create a doula scholarship program that grants funds to individuals without sufficient financial resources to complete doula training and certification programs necessary to provide doula services.

(b) In designing the doula scholarship program, the state department shall solicit input from groups identified in subsection (3) of this section.

(c) The state department shall define eligibility criteria for the doula scholarship program that includes, but is not limited to, the following:

(I) Proof of financial hardship;

(II) Proof of state residency; and

(III) A statement of intent to serve as a doula provider in Colorado for pregnant and postpartum members.

(d) The state department shall define criteria for organizations to conduct training and certification programs for doulas that include, but are not limited to:

(I) An approved certification process for doulas;

(II) An equitable approach to doula recruitment and training; and

(III) An approved budget to provide free training to attendees.

(e) The state department may require individuals who receive scholarship money pursuant to the doula scholarship program described in this subsection (7) to submit to the state department, not later than six months after the individual's completion of doula training or certification, documentation that the individual is serving as a doula for members or is working toward enrollment as a doula for members. If an individual does not complete the documentation, the state department may seek repayment of the funds awarded to the individual through the doula scholarship program.

(f) (I) Any money appropriated to the doula scholarship program and not expended prior to July 1, 2024, is further appropriated to the state department through June 30, 2025, to be used for the same purpose.

(II) This subsection (7)(f) is repealed, effective July 1, 2026.

(g) Notwithstanding section 24-1-136 (11)(a)(I), the state department shall report annually beginning in 2025 to the general assembly as part of the state department's "SMART Act" presentation, as required by section 2-7-203, on the utilization and outcomes of the doula scholarship program.
C.R.S. § 25.5-10-303 — CO Code / Title 25.5 / Article 10 / Part 3 / Section 25.5-10-303
25.5-10-303. Administration - duties of department
Status: in_force

25.5-10-303. Administration - duties of department. (1) Subject to annual appropriation by the general assembly, the state department shall administer the family support services program and shall coordinate family support services with other existing services provided to families and individuals. Family support services must be provided in a manner that develops comprehensive, responsive, and flexible support to families in their role as the primary care givers for a family member with an intellectual and developmental disability.

(2) The state department may contract with case management agencies or entities approved by the state department to provide family support services in accordance with this part 3. Programs developed shall be flexible in order to address individual family needs.

(3) In administering the family support services program, the state department shall have the following duties:

(a) To design the program;

(b) To pursue a family support model 200 waiver for approval by the federal centers for medicare and medicaid services in order to utilize medicaid funds for the provision of family support services, implemented subject to appropriation;

(c) To develop rules to be promulgated by the state board pursuant to section 25.5-10-306, with consultation from service agencies, including representatives of families of persons with intellectual and developmental disabilities;

(d) To allocate funds;

(e) To coordinate training and provide technical assistance to case management agencies or entities approved to provide family support services;

(f) To monitor and evaluate the program;

(g) To coordinate contracts, expenditures, and billing of the program; and

(h) To recommend changes in the program.

(4) Subject to annual appropriation by the general assembly, out of the appropriation to the state department for community programs in the general appropriation act, the state department is authorized to use up to seven percent of such appropriation allocated for family support services to pay for administrative costs within the state department and the service agency.

(5) The state department shall take any necessary action relating to the termination and wind up of the Colorado family support loan fund as created in section 25.5-10-402 prior to its repeal. The state department shall receive payments relating to outstanding loans made from the Colorado family support loan fund as created in section 25.5-10-402 prior to its repeal, which payments shall be transferred to the state treasurer and credited to the family support services fund created in section 25.5-10-303.5.
C.R.S. § 25.5-6-310 — CO Code / Title 25.5 / Article 6 / Part 3 / Section 25.5-6-310
25.5-6-310. Special provisions - personal care services provided by a family - repeal
Status: repealed

25.5-6-310. Special provisions - personal care services provided by a family - repeal. (1) A member of an eligible person's family, other than the person's spouse, may be employed to provide personal care services to such person.

(2) The maximum reimbursement for the services provided by a member of the person's family per year for each medicaid member must not exceed the equivalent of four hundred forty-four service units per year for a member of the eligible person's family.

(3) This section is repealed, effective July 1, 2025.
C.R.S. § 25.5-3-103 — CO Code / Title 25.5 / Article 3 / Part 1 / Section 25.5-3-103
25.5-3-103. Definitions
Status: in_force

25.5-3-103. Definitions. As used in this part 1, unless the context otherwise requires:

(1) "Emergency care" means treatment for conditions of an acute, severe nature which are life, limb, or disability threats requiring immediate attention, where any delay in treatment would, in the judgment of the responsible physician, threaten life or loss of function of a patient or viable fetus.

(2) "Executive director" means the executive director of the state department.

(3) "General provider" means a general hospital, birth center, or community health clinic licensed or certified by the department of public health and environment pursuant to section 25-1.5-103 (1)(a)(I) or (1)(a)(II); a federally qualified health center, as defined in the federal "Social Security Act", 42 U.S.C. sec. 1395x (aa)(4); a rural health clinic, as defined in the federal "Social Security Act", 42 U.S.C. sec. 1395x (aa)(2); a health maintenance organization issued a certificate of authority pursuant to section 10-16-402; and the health sciences center when acting pursuant to section 25.5-3-108 (5)(a)(I) or (5)(a)(II)(A). For the purposes of the program, "general provider" includes associated physicians.

(4) "Health sciences center" means the schools of medicine, dentistry, nursing, and pharmacy established by the regents of the university of Colorado under section 5 of article VIII of the Colorado constitution.

(5) "Program" means the program for the medically indigent established by section 25.5-3-104.

(6) "University hospital" means the university hospital operated pursuant to article 21 of title 23, C.R.S.
C.R.S. § 25.5-6-106 — CO Code / Title 25.5 / Article 6 / Part 1 / Section 25.5-6-106
25.5-6-106. Single entry point system - authorization - phases for implementation - services
Status: repealed

25.5-6-106. Single entry point system - authorization - phases for implementation - services provided - repeal. (Repealed)
C.R.S. § 25.5-5-104 — CO Code / Title 25.5 / Article 5 / Part 1 / Section 25.5-5-104
25.5-5-104. Qualified medicare beneficiaries
Status: in_force

25.5-5-104. Qualified medicare beneficiaries. Qualified medicare beneficiaries are medicare-eligible individuals with income and resources at a level which qualifies them as eligible under section 301 of Title III of the federal "Medicare Catastrophic Coverage Act of 1988", as amended, or subsequent amending federal legislation. For purposes of this article and articles 4 and 6 of this title, such individuals shall be referred to as "qualified medicare beneficiaries". The state department is hereby designated as the single state agency to administer benefits available to qualified medicare beneficiaries in accordance with Title XIX and this article and articles 4 and 6 of this title. Such benefits are limited to medicare cost-sharing expenses as determined by the federal government. Accordingly, the state department shall not be required to provide qualified medicare beneficiaries the entire range of services set forth in section 25.5-5-102.
C.R.S. § 25.5-6-307 — CO Code / Title 25.5 / Article 6 / Part 3 / Section 25.5-6-307
25.5-6-307. Services for the elderly, blind, and disabled
Status: repealed

25.5-6-307. Services for the elderly, blind, and disabled. (1) [Editor's note: This version of subsection (1) is effective until July 1, 2025.] Subject to the provisions of this part 3, home- and community-based services for the elderly, blind, and disabled include only the following services:

(a) Adult day care;

(b) Alternative care services;

(c) Electronic monitoring services;

(d) Home modification services;

(e) Homemaker services;

(f) Nonmedical transportation services;

(g) Personal care services;

(h) Respite care services;

(i) Repealed.

(j) Services provided under the consumer-directed care service model, part 11 of this article;

(k) In-home support services provided pursuant to part 12 of this article.

(1) [Editor's note: This version of subsection (1) is effective July 1, 2025.] Subject to the provisions of this part 3, home- and community-based services for the elderly, blind, and disabled include only the following services:

(a) Adult day care;

(b) Alternative care services;

(c) (Deleted by amendment, L. 2023.)

(d) Home modification services;

(e) (Deleted by amendment, L. 2023.)

(f) Nonmedical transportation services;

(g) (Deleted by amendment, L. 2023.)

(h) Respite care services;

(i) Repealed.

(j) (Deleted by amendment, L. 2023.)

(k) (Deleted by amendment, L. 2023.)

(2) All providers of home- and community-based services for the elderly, blind, and disabled may be separately certified to provide other services, if otherwise qualified.

(3) A case management agency may be certified to provide the services described in subsection (1) of this section, if otherwise qualified as a provider under the state medical assistance program.

(4) (a) The case management agency, in coordination with the eligible person, the person's family or guardian, and the person's physician, shall include in each case plan a process by which the eligible person may receive necessary care, which may include respite care, if the eligible person's family or service provider is unavailable due to an emergency situation or to unforeseen circumstances. The eligible person and the person's family or guardian shall be duly informed by the case management agency of these alternative care provisions at the time the case plan is initiated.

(b) The requirements of this subsection (4) shall not apply if the eligible person is residing in an alternative care facility.

(5) (a) No later than January 2024, the state department shall submit a report to the senate health and human services committee, the house of representatives public and behavioral health and human services committee, and the house of representatives health and insurance committee, or any successor committees, as part of its "State Measurement for Accountable, Responsive, and Transparent (SMART) Government Act" presentation required by section 2-7-203. At a minimum, the report must identify:

(I) A reimbursement system with a goal to incentivize and increase transportation provider participation;

(II) How the state department will ensure compliance with applicable federal laws and waiver requirements;

(III) A system of common reporting to ensure a member does not exceed the medicaid benefit in a multi-provider scenario; and

(IV) Best practices based on what other states have done to allow transportation network companies to provide nonmedical transportation services for individuals receiving services, including but not limited to, reimbursement rates; driver compensation; and integration with programs that provide nonmedical transportation services.

(b) In developing the report, the state department shall engage in a stakeholder process that includes individuals with intellectual and developmental disabilities and their families, individuals with disabilities, and transportation network companies. The report may be developed in conjunction with the reporting requirement in sections 25.5-6-409 (6), 25.5-6-606 (9), 25.5-6-704 (8), and 25.5-6-1303 (9).

(c) (I) Upon completion of the report described in subsection (5)(a) of this section, the state department shall analyze and review each operational transportation network company, as defined in section 40-10.1-602 (3). The state department shall verify each transportation network company's viability to ensure the health, safety, welfare, cost effectiveness, and capability in expanding nonmedical transportation services for individuals receiving services pursuant to this section and comply with all rules promulgated pursuant to subsection (5)(e)(I) of this section.

(II) No later than July 1, 2024, the state department shall authorize verified transportation network companies to provide nonmedical transportation services if the state department finds the transportation network company viable under federal requirements and within budgetary constraints.

(III) For the purposes of this subsection (5)(c), "verify" means a transportation network company meets all requirements resulting from the report described in subsection (5)(a) of this section.

(d) The state department may seek any necessary federal authorization for the implementation of this subsection (5).

(e) (I) The state department shall promulgate any necessary rules to ensure transportation network companies comply with federal and state oversight requirements and shall include all relevant stakeholders, including medicaid members, transportation network companies, current providers and drivers for nonmedical transportation services, and other parties interested in developing the requirements.

(II) Pursuant to section 40-10.1-105 (1)(l), transportation network companies are not subject to regulation by the public utilities commission when providing nonmedical transportation services pursuant to this section and are instead subject to rules promulgated by the state department pursuant to this subsection (5)(e).

(f) This subsection (5) does not apply to a provider authorized to provide transportation services pursuant to part 8 of article 1 of title 25.5 prior to August 10, 2022.
C.R.S. § 25.5-5-413 — CO Code / Title 25.5 / Article 5 / Part 4 / Section 25.5-5-413
25.5-5-413. Direct contracting with providers - legislative declaration
Status: repealed

25.5-5-413. Direct contracting with providers - legislative declaration. (Repealed)
C.R.S. § 25.5-1-202 — CO Code / Title 25.5 / Article 1 / Part 2 / Section 25.5-1-202
25.5-1-202. Advisory committee on covering all children in Colorado - reports - definitions
Status: repealed

25.5-1-202. Advisory committee on covering all children in Colorado - reports - definitions - repeal. (Repealed)
C.R.S. § 25.5-5-336 — CO Code / Title 25.5 / Article 5 / Part 3 / Section 25.5-5-336
25.5-5-336. Prohibition on using the body mass index or ideal body weight - medical necessit
Status: in_force

25.5-5-336. Prohibition on using the body mass index or ideal body weight - medical necessity criteria. (1) (a) Beginning July 1, 2023, the state medical assistance program shall not utilize the body mass index, ideal body weight, or any other standard requiring an achieved weight when determining medical necessity or the appropriate level of care for an individual diagnosed with an eating disorder, including but not limited to, bulimia nervosa, atypical anorexia nervosa, binge-eating disorder, avoidant restrictive food intake disorder, and other specified feeding and eating disorders as defined in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders.

(b) Subsection (1)(a) of this section does not apply when determining medical necessity or the appropriate level of care for an individual diagnosed with anorexia nervosa, restricting subtype; however, body mass index, ideal body weight, or any other standard requiring an achieved body weight must not be the determining factor when assessing medical necessity or the appropriate level of care for an individual diagnosed with anorexia nervosa, restricting subtype.

(2) The following factors, at a minimum, must be considered when determining medical necessity or the appropriate level of care for an individual diagnosed with an eating disorder:

(a) The individual's eating behaviors;

(b) The individual's need for supervised meals and support interventions;

(c) Laboratory results, including but not limited to, the individual's heart rate, renal or cardiovascular activity, and blood pressure;

(d) The recovery environment; and

(e) Co-occurring disorders the individual may have.
C.R.S. § 25.5-3-203 — CO Code / Title 25.5 / Article 3 / Part 2 / Section 25.5-3-203
25.5-3-203. Definitions
Status: repealed

25.5-3-203. Definitions. (Repealed)
C.R.S. § 25.5-5-510 — CO Code / Title 25.5 / Article 5 / Part 5 / Section 25.5-5-510
25.5-5-510. Pharmacy reimbursement - substance use disorder - injections
Status: in_force

25.5-5-510. Pharmacy reimbursement - substance use disorder - injections. A pharmacy administering injectable antagonist medication for medication-assisted treatment for substance use disorders shall receive an enhanced dispensing fee that aligns with the administration fee paid to a provider in a clinical setting.
C.R.S. § 25.5-5-501 — CO Code / Title 25.5 / Article 5 / Part 5 / Section 25.5-5-501
25.5-5-501. Providers - drug reimbursement
Status: in_force

25.5-5-501. Providers - drug reimbursement. (1) (a) As to drugs for which payment is made, the state board's rules for payment must include the requirement that the generic equivalent of a brand-name drug be prescribed if the generic equivalent is a therapeutic equivalent to the brand-name drug, except when reimbursement to the state for a brand-name drug makes the brand-name drug less expensive than the cost of the generic equivalent. The state department shall grant an exception to this requirement if the patient has been stabilized on a medication and the treating physician, or a pharmacist with the concurrence of the treating physician, is of the opinion that a transition to the generic equivalent of the brand-name drug would be unacceptably disruptive. The requirements of this subsection (1) do not apply to medications for the treatment of behavioral or mental health disorders, cancer, epilepsy, or human immunodeficiency virus and acquired immune deficiency syndrome.

(b) The provisions of this subsection (1) shall apply to fee-for-service and primary care physician program recipients.

(2) It is the general assembly's intent that requiring the use of a generic equivalent of a brand-name drug will produce savings within the state's medicaid program. The state department, therefore, is authorized to use savings in the medical services premiums appropriations to fund the administrative review process required by subsection (1) of this section.
C.R.S. § 25.5-6-115 — CO Code / Title 25.5 / Article 6 / Part 1 / Section 25.5-6-115
25.5-6-115. Notification of federal immigration consequences
Status: in_force

25.5-6-115. Notification of federal immigration consequences. The state department shall consult with stakeholders, including people with lived experience, immigrants rights advocates, health-care advocates, and immigration lawyers, to provide clear and accurate information and referrals regarding current public charge policies.
C.R.S. § 25.5-6-1803 — CO Code / Title 25.5 / Article 6 / Part 18 / Section 25.5-6-1803
25.5-6-1803. Development of spending plan
Status: in_force

25.5-6-1803. Development of spending plan. (1) In accordance with federal guidance issued by the federal centers for medicare and medicaid services regarding the implementation of section 9817 of the "American Rescue Plan Act", the state department shall develop a proposed spending plan using the enhanced funding, which plan may include but is not limited to the following components:

(a) Consideration of methods to maximize federal financial participation;

(b) Incorporation of feedback from medical assistance members, advocates, and providers for the services for which the "American Rescue Plan Act" provides additional federal financial participation;

(c) Expedition of the response and recovery for medical assistance members, providers, and other relevant organizations most significantly impacted by the COVID-19 pandemic. Response and recovery efforts may include but are not limited to:

(I) One-time provider rate increases to support organizations and the direct-care workers impacted by COVID-19;

(II) One-time payments to support infection control; and

(III) Tribal grants to increase access to and use of home- and community-based services on tribal lands;

(d) Advancement and acceleration of existing and newly identified system reform efforts. Advancement and acceleration efforts may include but are not limited to:

(I) Support for local organizations and stakeholders to plan and prepare for the implementation of case management redesign efforts;

(II) Analysis and development of recommendations to better stabilize existing rural providers and to expand provider access in rural communities;

(III) Analysis and development of recommendations for new models of care for investment and innovation;

(IV) Development of pay for performance programs;

(V) Improvement of provider certification oversight;

(VI) Development of acuity tools for long-term home health;

(VII) Development of training to align with 988 mobile dispatch;

(VIII) Analysis and development of recommendations for implementing behavioral health peer supports for day services serving people experiencing homelessness;

(IX) Development of transition support services for people with complex behavioral needs;

(X) Provider capacity-building to serve people with high-intensity needs;

(XI) Development of provider cultural and disability competency training; and

(XII) Home- and community-based services through the community first choice option, section 1915(k) of the "Social Security Act", 42 U.S.C. 1396n;

(e) Investment in infrastructure and technology innovation that has a long-term benefit to the system and the people of Colorado, including integration with other statewide and local efforts. Investments may include but are not limited to:

(I) Comprehensive training for case managers and providers;

(II) System enhancements to support streamlined eligibility;

(III) Member and family material on case management, care coordination, and home- and community-based services;

(IV) Expanding member access to technology and technology literacy training;

(V) Capital funding for IT infrastructure to purchase devices to support the implementation of the care and case management tool; and

(VI) Telemedicine and telehealth one-time payments to support equipment for service delivery; and

(f) Development and stabilization of the direct-care workforce. Efforts may include but are not limited to:

(I) The analysis of nationwide efforts to strengthen the direct-care workforce;

(II) Development of a strategic plan to stabilize the direct-care workforce, including plans for rural sustainability;

(III) Consideration of direct-care worker wage sustainability through increased rates and potential wage pass-through programs;

(IV) Development of training programs focusing on additional career pathways; and

(V) Creation of structure around recruitment, retention, and public awareness of direct-care work.

(2) The state department shall continue to engage stakeholders for input concerning prioritization of the use of the enhanced funding from the "American Rescue Plan Act".
C.R.S. § 25.5-6-304 — CO Code / Title 25.5 / Article 6 / Part 3 / Section 25.5-6-304
25.5-6-304. Administration
Status: in_force

25.5-6-304. Administration. The provisions of this part 3 shall be administered by the state department.
C.R.S. § 25.5-1-203 — CO Code / Title 25.5 / Article 1 / Part 2 / Section 25.5-1-203
25.5-1-203. Prescription drug information and technical assistance program - expansion
Status: in_force

25.5-1-203. Prescription drug information and technical assistance program - expansion. The state department may expand the prescription drug information and technical assistance program created in section 25.5-5-507 to include persons receiving drug benefits pursuant to any program that is administered by the state department.
C.R.S. § 25.5-1-117 — CO Code / Title 25.5 / Article 1 / Part 1 / Section 25.5-1-117
25.5-1-117. County departments - district departments
Status: in_force

25.5-1-117. County departments - district departments. (1) Except as provided in subsection (2) of this section, there is established in each county of the state a county department of human or social services that consists of a county board of human or social services, a county director of human or social services, and any additional employees as may be necessary for the efficient performance of public assistance, as defined in section 26-2-103 (7), and medical assistance.

(2) Case management agencies established pursuant to part 17 of article 6 of this title 25.5 may act as state designated agencies and are authorized to carry out functions as specified in part 17 of article 6 of this title 25.5 that are otherwise performed by county departments of human or social services.

(3) With the approval of the state department of human services, two or more counties may jointly establish a district department of human or social services. All duties and responsibilities for county departments of human or social services set forth in this title 25.5 also apply to district departments of human or social services.
C.R.S. § 25.5-5-203 — CO Code / Title 25.5 / Article 5 / Part 2 / Section 25.5-5-203
25.5-5-203. Optional programs with special state provisions - repeal
Status: repealed

25.5-5-203. Optional programs with special state provisions - repeal. (1) Subject to the provisions of subsection (2) of this section, this section specifies programs developed by Colorado to increase federal financial participation through selecting optional services or optional eligible groups. These programs include but are not limited to:

(a) Pharmaceutical services, as specified in section 25.5-5-504;

(b) The home- and community-based services program for the elderly, blind, and disabled, as specified in part 3 of article 6 of this title;

(c) The home- and community-based services program for the developmentally disabled, as specified in part 4 of article 6 of this title;

(d) Repealed.

(e) The home- and community-based services program for persons with major mental health disorders, as specified in part 6 of article 6 of this title 25.5;

(f) The home- and community-based services program for persons with brain injury, as specified in part 7 of article 6 of this title;

(g) Clinic services, as defined in sections 25.5-5-301 and 25.5-5-302;

(h) The program for private duty nursing, as specified in section 25.5-5-303;

(i) The disabled children care program, as specified in section 25.5-6-901;

(j) The program of all-inclusive care for the elderly, as specified in section 25.5-5-412;

(k) Hospice care, as specified in section 25.5-5-304;

(l) The treatment program for high-risk pregnant women, as specified in section 27-80-112, C.R.S., and sections 25.5-5-309, 25.5-5-310, and 25.5-5-311;

(m) The program for residential child health care, as specified in section 25.5-6-903;

(n) The children's personal assistance services and family support waiver program, as specified in section 25.5-6-902;

(o) (I) Home- and community-based services for children with autism, as specified in part 8 of article 6 of this title.

(II) This subsection (1)(o) is repealed, effective July 1, 2025.

(2) In order to keep expenditures within approved appropriations, the state board may, by rule, establish limits on a service provided pursuant to this section so long as the service provided is sufficient in the amount, duration, and scope to reasonably achieve the purpose of the service as required by federal law or regulation. When a rule is promulgated pursuant to this subsection (2), the state board shall provide a summary report of the limitations established by the rule and any fiscal impact of the rule to members of the health and human services committees of the senate and house of representatives, or any successor committees, and any other members of the general assembly who request the reports.
C.R.S. § 25.5-2.5-101 — CO Code / Title 25.5 / Article 2.5 / Part 1 / Section 25.5-2.5-101
25.5-2.5-101. Short title
Status: in_force

25.5-2.5-101. Short title. The short title of this part 1 is the "Colorado Cares Rx Act".
C.R.S. § 25.5-1-205 — CO Code / Title 25.5 / Article 1 / Part 2 / Section 25.5-1-205
25.5-1-205. Providing for the efficient provision of health care through state-supervised co
Status: in_force

25.5-1-205. Providing for the efficient provision of health care through state-supervised cooperative action - rules. (1) Cooperation among health-care payors, including both private sector entities and federal and state-administered health-care programs, has the potential to eliminate needless and costly complexity in the administration of the programs and to benefit patients, payors, and the government. Further, alignment of financial incentives among private and public entities may accelerate and reinforce improvements in health-care quality and patient outcomes.

(2) The executive director shall facilitate departmental oversight of collaboration among providers, medicaid members and advocates, and payers that is designed to improve health outcomes and patient satisfaction and support the financial sustainability of the medicaid program.

(3) The executive director may promulgate rules relating to the collaborative process set forth in this section.
C.R.S. § 25.5-2-104 — CO Code / Title 25.5 / Article 2 / Section 25.5-2-104
25.5-2-104. State-funded health and medical care
Status: in_force

25.5-2-104. State-funded health and medical care. (1) Beginning no later than January 1, 2025, there is created the state medical assistance program, referred to in this section as "state medical assistance". State medical assistance includes all benefits and services at the same cost to the beneficiary as are offered pursuant to the medical assistance program defined in section 25.5-4-103 (13), such that, to the maximum extent possible, eligible individuals must not be able to tell that the person is enrolled in a different program from medical assistance pursuant to section 25.5-4-103 (13).

(2) A child who is less than nineteen years of age is eligible to receive state medical assistance if the child would be eligible for medical assistance as defined in section 25.5-4-103 (13) but is not eligible due solely to the child's immigration status.

(3) A child who is less than nineteen years of age is presumptively eligible for state medical assistance and will receive services specified by state law only if a parent or legal guardian of the child declares all pertinent information relating to the criteria of income and assets of the child's family.

(4) State medical assistance must be funded by state funds only, except to the extent federal funds are made available through express written authorization through a federal waiver, state plan amendment, or otherwise, by the federal centers for medicare and medicaid services.

(5) The state department shall seek any necessary federal approvals to maximize any available federal financial participation in implementing this section.

(6) To the maximum extent allowable under federal law, the state department shall, using appropriate funding, use the same infrastructure and provider network to deliver state medical assistance as it does to deliver medical assistance as defined in section 25.5-4-103 (13).

(7) This section constitutes state authority within the meaning of 8 U.S.C. sec. 1621 (d), as that law existed on January 1, 2022.

(8) (a) During its 2024 presentation to the joint budget committee of the general assembly and in its presentation to the health and human services committee of the senate and the health and insurance committee of the house of representatives, or any successor committees, at the hearing held pursuant to section 2-7-203 (2)(a) of the "State Measurement for Accountable, Responsive, and Transparent (SMART) Government Act", the state department shall report on its plans and progress in implementing state medical assistance.

(b) Beginning January 1, 2026, and continuing every January thereafter, the state department, in its presentation to the joint budget committee of the general assembly and in its presentation to the health and human services committee of the senate and the health and insurance committee of the house of representatives, or any successor committees, at the hearing held pursuant to section 2-7-203 (2)(a) of the "State Measurement for Accountable, Responsive, and Transparent (SMART) Government Act", shall report on the cost savings and health improvements associated with state medical assistance.
C.R.S. § 25.5-5-328 — CO Code / Title 25.5 / Article 5 / Part 3 / Section 25.5-5-328
25.5-5-328. Secure transportation for behavioral health crises - benefit - funding
Status: in_force

25.5-5-328. Secure transportation for behavioral health crises - benefit - funding. (1) On or before January 1, 2023, the state department shall create a benefit for secure transportation services, as defined in section 25-3.5-103 (11.4). The state department shall research and create a plan to establish secure transportation services, which may include supplemental and coordinated community response services, to be implemented on or before July 1, 2023. The state department shall collaborate with the behavioral health administration in the department of human services in its research and planning efforts to determine how this benefit may align with co-responder, mobile crisis, and emergency crisis dispatch.

(2) The state department is authorized to seek, accept, and expend gifts, grants, and donations from public or private sources for the purpose of funding the urgent transportation needs within the existing nonemergency medical transportation benefit and secure transportation services benefit under the medical assistance program, as set forth in subsection (1) of this section and section 25.5-5-324 (1).
C.R.S. § 25.5-6-113 — CO Code / Title 25.5 / Article 6 / Part 1 / Section 25.5-6-113
25.5-6-113. Health home - integrated services - contracting - legislative declaration - defi
Status: in_force

25.5-6-113. Health home - integrated services - contracting - legislative declaration - definitions. (1) (a) The general assembly finds and declares that:

(I) The state demography office in the department of local affairs estimates that between 2005 and 2015, the portion of Colorado's population that is over sixty-five years of age will increase by more than twenty-three percent;

(II) This drastic increase in the population that is over sixty-five years of age is driven by the aging "baby boomer" generation and will result in a parallel increase in a demand for community long-term care services;

(III) Older adults, persons with disabilities, and their families need quality health-care coverage and choice and flexibility in accessing community long-term care services that support their independence and ability to live in the least restrictive environment;

(IV) Research has shown that older adults suffer from higher rates of depression, have a higher risk of suicide, and have an increased misuse of prescription and illicit drugs, making the need for behavioral health-care services essential to long-term care services;

(V) Coloradans deserve to have access to the proper level of health care;

(VI) The state needs a long-term care delivery system that addresses the needs of older adults, persons with disabilities, and their families, and health-care coverage and coordination should not be fragmented or difficult to access; instead, it should be integrated to meet the needs of older adults, persons with disabilities, and their families;

(VII) A community long-term care system should be integrated, person-centered, and provide maximum service delivery and make efficient use of available public funds; and

(VIII) The system must ensure a comprehensive approach to long-term care that addresses the different demographic and geographic challenges in the state and the various long-term care services and supports that members need.

(b) Therefore, the general assembly declares that a comprehensive approach to long-term care requires that programs and policies integrating and coordinating care under the medicaid program be flexible and allow for full participation by providers of long-term care services to ensure quality of care for members and efficient use of limited resources.

(2) As used in this section, unless the context otherwise requires:

(a) "Dually eligible person" means a person who is eligible for assistance or benefits under both medicaid and medicare.

(b) "Health home" means a provider or group of providers that operate in coordination with a team of health-care professionals that shall include primary care providers selected by an eligible individual with chronic conditions to provide health home services, as the term is defined in section 2703 of the federal "Patient Protection and Affordable Care Act", 42 U.S.C. sec. 1396w-4.

(3) (a) In determining the structure of health homes for chronic conditions for purposes of the federal "Patient Protection and Affordable Care Act", 42 U.S.C. sec. 1396w-4, and state plan amendments to the medicaid program, the state department shall include, to the extent permitted under federal law, provisions allowing providers of long-term care services and supports to participate as health homes or as part of a health home that provides:

(I) Comprehensive care management;

(II) Care coordination and health promotion;

(III) Comprehensive transitional care;

(IV) Patient and family support;

(V) Referral to community and social support services; and

(VI) The use of health information technology to link services, as is feasible and appropriate.

(b) The health home may consist of a multi-disciplinary team, including primary care management providers, behavioral health-care providers, case managers, and providers of long-term services and supports, including but not limited to case management agencies, as defined in section 25.5-6-1702, nursing homes, alternative care facilities, day programs for the elderly, home care agencies, community mental health centers, and hospice and palliative care centers.

(4) To the extent provided under federal law, in integrating dually eligible persons, persons with chronic conditions, or persons needing long-term care services and supports in an organization with which the state department contracts pursuant to part 4 of article 5 of this title, the state department shall permit providers of long-term services and supports to contract as health homes or to provide some or all of the services provided by the organization contracted with the state department, which services may include, but need not be limited to, navigation of primary, specialty, or long-term care supports.

(5) Dually eligible members may voluntarily elect to participate in a recognized medicare coordinated care system and may voluntarily elect to participate in the state department's medicaid coordinated care system.
C.R.S. § 25.5-5-206 — CO Code / Title 25.5 / Article 5 / Part 2 / Section 25.5-5-206
25.5-5-206. Medicaid buy-in program - disabled children - disabled adults - federal authoriz
Status: in_force

25.5-5-206. Medicaid buy-in program - disabled children - disabled adults - federal authorization - rules. (1) (a) Subject to available appropriations, the state department is authorized to seek federal authorization to and to establish a medicaid buy-in program or programs for:

(I) Disabled children; or

(II) Disabled adults who do not qualify for the medicaid buy-in program established pursuant to part 14 of article 6 of this title.

(b) The medicaid buy-in program or programs established pursuant to paragraph (a) of this subsection (1) may provide for premium and cost-sharing charges on a sliding fee scale based upon a family's income.

(2) The state board shall promulgate rules consistent with any federal authorization to implement and administer the medicaid buy-in program or programs established pursuant to paragraph (a) of subsection (1) of this section.
C.R.S. § 25.5-1-102 — CO Code / Title 25.5 / Article 1 / Part 1 / Section 25.5-1-102
25.5-1-102. Legislative declaration
Status: in_force

25.5-1-102. Legislative declaration. (1) The general assembly declares that state and local policymakers and health and human services administrators recognize that the management of and the delivery system for health and human services have become complex, fragmented, and costly and that the health and human services delivery system in this state should be restructured to adequately address the needs of Colorado citizens.

(2) The general assembly further finds and declares that a continuing budget crisis makes it unlikely that funding sources will keep pace with the increasing demands of health and human services.

(3) Therefore, the general assembly finds that it is appropriate to restructure principal departments responsible for overseeing the delivery of health and human services and to reform the state's health and human services administration and delivery system, using guiding principles and within the time frames set forth in article 1.7 of title 24, C.R.S., as said article existed prior to July 1, 1997. It is the general assembly's intent that the departments of public health and environment, health care policy and financing, and human services be operational, effective July 1, 1994.
C.R.S. § 25.5-5-304 — CO Code / Title 25.5 / Article 5 / Part 3 / Section 25.5-5-304
25.5-5-304. Hospice care
Status: repealed

25.5-5-304. Hospice care. (1) The medical assistance program in this state shall include hospice care. Except as otherwise provided in subsection (2) of this section, hospice care shall be provided for a period of up to two hundred ten days in accordance with rules adopted by the state board, which rules shall comply with 42 U.S.C. sec. 1396d, and shall include at least the following requirements:

(a) That a person shall obtain a certified medical prognosis indicating a life expectancy of nine months or less, which certification shall comply with rules adopted by the state board;

(b) That a person shall execute a waiver of other medical benefits available under this article and articles 4 and 6 of this title, which election shall be executed in accordance with rules adopted by the state board;

(c) That the service shall be reasonable and necessary for the palliation or management of the terminal illness and related conditions.

(2) Hospice care may be provided to a person beyond two hundred ten days if such person is recertified by a physician or hospice medical director as terminally ill in accordance with subsection (1) of this section.

(3) (a) Subject to the receipt of any necessary federal authorization, for a person who has executed the waiver described in paragraph (b) of subsection (1) of this section and who is a resident in a class I facility, as defined in section 25.5-6-201 (13), the class I facility shall bill the state department and the state department shall pay the class I facility for the room and board costs of the person.

(b) Subject to the receipt of any necessary federal authorization, the hospice care provided pursuant to this section may include room and board in a hospice inpatient facility licensed pursuant to section 25-3-101, C.R.S. The state department is authorized to establish the reimbursement rate for the costs for room and board at a licensed hospice inpatient facility for patients eligible for the routine level of hospice care.

(c) (I) If required, the state department shall seek the appropriate federal authorization, conditioned on the receipt of gifts, grants, or donations sufficient to provide for the state's administrative costs of preparing and submitting the request, to make the payment described in paragraph (a) of this subsection (3) and to include room and board at a licensed hospice inpatient facility as described in paragraph (b) of this subsection (3). On or before January 15, 2011, the state department shall submit a brief report to the members of the health and human services committees of the senate and house of representatives, or any successor committees, on the status of any request for authorization pursuant to this subparagraph (I). If federal authorization to implement the changes described in paragraphs (a) and (b) of this subsection (3) is obtained, the state department shall request, through the state budget process, that the changes be implemented during the fiscal year following the year in which the approval is obtained.

(II) The state department is authorized to seek and accept gifts, grants, or donations from private or public sources for the purpose of providing for the administrative costs of preparing and submitting the request for federal approval for the payments described in paragraphs (a) and (b) of this subsection (3). All such private and public funds received through gifts, grants, or donations shall be transmitted to the state treasurer, who shall credit the same to the hospice care account in the department of health care policy and financing cash fund created pursuant to section 25.5-1-109, which account is hereby created. Moneys in the account shall be subject to appropriation and shall only be used for the purposes described in this subparagraph (II).

(4) Repealed.
C.R.S. § 25.5-6-312 — CO Code / Title 25.5 / Article 6 / Part 3 / Section 25.5-6-312
25.5-6-312. Gifts - grants
Status: in_force

25.5-6-312. Gifts - grants. The state department, acting for and on behalf of the state, may receive and accept title to any grant or gift from any source, including the federal government, and all grants, grants-in-aid, and gifts shall be deposited with the state treasurer, who shall credit the same to the general fund, and such moneys shall be appropriated to the state department to carry out the purposes of this article and articles 4 and 5 of this title.
C.R.S. § 25.5-10-101 — CO Code / Title 25.5 / Article 10 / Part 1 / Section 25.5-10-101
25.5-10-101. Office of community living - creation - transfer of duties and functions - rules
Status: repealed

25.5-10-101. Office of community living - creation - transfer of duties and functions - rules - legislative declaration. (1) There is created in the state department the office of community living, referred to in this article 10 as the "office". The office is a type 2 entity, as defined in section 24-1-105. The head of the office is the director of community living appointed by the executive director in accordance with section 13 of article XII of the state constitution. The director of community living reports directly to the executive director.

(2) (a) On and after March 1, 2014, the powers, duties, and functions of the department of health care policy and financing include the powers, duties, and functions relating to the programs, services, and supports contained in this article 10 that were formerly vested in the department of human services. Such powers, duties, and functions are allocated to the division of intellectual and developmental disabilities of the office, which division is created in part 2 of this article 10.

(b) (I) By March 1, 2014, all positions of employment in the department of human services related to the administration of community-based long-term services and supports are transferred to the division of intellectual and developmental disabilities of the office and become employment positions therein.

(II) All employees in positions transferred to the division of intellectual and developmental disabilities are considered employees of the division of intellectual and developmental disabilities of the office. Such employees retain all rights under the state personnel system and to retirement benefits pursuant to the laws of this state, and their services shall be deemed to have been continuous.

(c) By March 1, 2014, all items of property, real and personal, including office furniture and fixtures, books, documents, and records of the department of human services related to the administration of community-based long-term services and supports are transferred to the division of intellectual and developmental disabilities of the office and become the property thereof.

(d) On and after March 1, 2014, whenever the executive director of the department of human services or the department of human services is referred to or designated by any contract or other document in connection with the powers, duties, and functions transferred to the department of health care policy and financing, the reference or designation shall be deemed to apply to the department of health care policy and financing. All contracts entered into by the executive director of the department of human services prior to March 1, 2014, in connection with the powers, duties, and functions transferred to the department of health care policy and financing are hereby validated, with the executive director of the department of health care policy and financing succeeding to all the rights and obligations of such contracts.

(3) All rules and orders of the department of human services, the executive director of the department of human services, and the state board of human services in connection with the programs transferred to the department of health care policy and financing shall continue to be effective until revised, amended, repealed, or nullified pursuant to law.

(4) Repealed.
C.R.S. § 25.5-8-109.5 — CO Code / Title 25.5 / Article 8 / Section 25.5-8-109.5
25.5-8-109.5. Telehealth - interim therapeutic restorations - reimbursement - definitions
Status: in_force

25.5-8-109.5. Telehealth - interim therapeutic restorations - reimbursement - definitions. (1) Subject to federal authorization and financial participation, on or after July 1, 2016, in-person contact between a health-care provider and an enrollee is not required under the children's basic health plan for the diagnosis, development of a treatment plan, instruction to perform an interim therapeutic restoration procedure, or supervision of a dental hygienist performing an interim therapeutic restoration procedure. A health-care provider may provide these services through telehealth, including store-and-forward transfer, and is entitled to reimbursement for the delivery of those services via telehealth to the extent the services are otherwise eligible for reimbursement under the plan. The services are subject to the reimbursement policies developed pursuant to the children's basic health plan.

(2) As used in this section:

(a) "Interim therapeutic restoration" has the same meaning as set forth in section 12-220-104 (10).

(b) "Store-and-forward transfer" means the asynchronous transmission of medical or dental information to be reviewed by a dentist at a later time at a distant site without the patient present in real time.
C.R.S. § 25.5-6-2001 — CO Code / Title 25.5 / Article 6 / Part 20 / Section 25.5-6-2001
25.5-6-2001. System of care for children and youth - federal authorization - leadership and i
Status: in_force

25.5-6-2001. System of care for children and youth - federal authorization - leadership and implementation team - report - rules - definition. (1) No later than July 1, 2024, the state department, in collaboration with the behavioral health administration, and the department of human services pursuant to article 64.5 of title 27, shall begin developing a system of care for children and youth who have complex behavioral health needs. At a minimum, the system of care must include:

(a) Implementation of a standardized assessment tool that:

(I) Expands upon and modifies the assessment tool described in section 19-1-115 (4)(e)(I);

(II) Makes recommendations regarding the appropriate level of care necessary to meet the child's or youth's treatment needs;

(III) Informs the child's or youth's treatment planning, including behavioral health programming and medical needs; and

(IV) Is administered to children and youth who are enrolled in the medical assistance program or any child or youth who meets the referral requirements established by the behavioral health administration pursuant to article 64.5 of title 27;

(b) Intensive-care coordination for children and youth enrolled in the medical assistance program;

(c) Expanded supportive services for children and youth pursuant to subsection (4) of this section; and

(d) Expanded access to treatment foster care, as defined in section 26-6-903, pursuant to subsection (5) of this section.

(2) (a) No later than November 1, 2024, the state department shall convene a leadership team that is responsible for the decision-making and oversight of the system of care for children and youth who have complex behavioral health needs.

(b) The leadership team consists of the following members:

(I) The executive director of the state department, or the executive director's designee;

(II) The executive director of the department of human services, or the executive director's designee;

(III) The commissioner of the behavioral health administration in the department of human services, or the commissioner's designee;

(IV) The executive director of the department of public health and environment, or the executive director's designee;

(V) The commissioner of the department of education, or the commissioner's designee;

(VI) The executive director of the department of early childhood, or the executive director's designee;

(VII) The commissioner of the division of insurance in the department of regulatory agencies, or the commissioner's designee;

(VIII) One county commissioner, or the county commissioner's designee, from the eastern region, the front range region, the mountain region, the southern region, and the western region, as designated by the statewide organization that represents county commissioners;

(IX) One county commissioner at large, or a county commissioner's designee;

(X) One director of a county department of human or social services at large, or the director's designee, as designated by the statewide organization that represents county department of human or social services directors;

(XI) One or more families or individuals with lived experience using children's or youth's behavioral health services, appointed by the commissioner of the behavioral health administration; and

(XII) One or more representatives from a consumer advocacy organization, appointed by the commissioner of the behavioral health administration.

(c) The leadership team has the following duties and responsibilities:

(I) To evaluate the performance and effectiveness of the state department in the development of the system of care for children and youth with complex behavioral health needs;

(II) To oversee and advise the strategic direction of the development of the system of care; and

(III) To provide fiscal oversight of the state department's development and oversight of the system of care.

(3) (a) No later than October 1, 2024, the state department shall convene an implementation team that shall create a plan to implement the system of care for children and youth who have complex behavioral health needs.

(b) The implementation team consists of the following members:

(I) The executive director of the state department, or the executive director's designee;

(II) The executive director of the department of human services, or the executive director's designee;

(III) The commissioner of the behavioral health administration in the department of human services, or the commissioner's designee;

(IV) The executive director of the department of public health and environment, or the executive director's designee;

(V) The commissioner of the department of education, or the commissioner's designee;

(VI) The executive director of the department of early childhood, or the executive director's designee;

(VII) The commissioner of the division of insurance in the department of regulatory agencies, or the commissioner's designee;

(VIII) One or more county commissioners, as designated by the statewide organization that represents county commissioners;

(IX) One or more directors of a county department of human or social services, or the director's designee, as designated by the statewide organization that represents county department of human or social services directors;

(X) One or more families or individuals with lived experience using children's or youth's behavioral health services, appointed by the commissioner of the behavioral health administration;

(XI) One or more representatives from a consumer advocacy organization, appointed by the commissioner of the behavioral health administration;

(XII) A representative of the statewide association that represents child welfare agencies, appointed by the director of the association;

(XIII) A representative of the statewide association that represents hospitals, appointed by the director of the association; and

(XIV) A representative of the statewide association that represents comprehensive behavioral health providers, appointed by the director of the association.

(4) No later than January 1, 2025, the state department shall seek federal authorization to expand the residential child health-care program established pursuant to section 25.5-6-903 to include children and youth who have a serious emotional disturbance that puts the child or youth at risk or in need of out-of-home placement.

(5) No later than January 1, 2025, the state department shall develop and implement a plan to increase access to treatment foster care, as defined in section 26-6-903, under the state medical assistance program.

(6) The state department may promulgate rules in consultation with the behavioral health administration and the department of human services for the administration and implementation of the system of care for children and youth.

(7) (a) No later than January 1, 2025, the department of health care policy and financing shall contract with a third-party vendor to complete an actuarial analysis in order to determine the appropriate medicaid reimbursement rate for psychiatric residential treatment facilities, as defined in section 25.5-4-103.

(b) Beginning January 2025, and each quarter thereafter, the state department shall report progress on the development and implementation of the system of care developed pursuant to this section to the joint budget committee.

(8) As used in this section, "child or youth" means an individual who is less than twenty-one years of age.
C.R.S. § 25.5-10-232 — CO Code / Title 25.5 / Article 10 / Part 2 / Section 25.5-10-232
25.5-10-232. Competency to give consent to sterilization
Status: in_force

25.5-10-232. Competency to give consent to sterilization. (1) If the competency of the person with an intellectual and developmental disability to give consent to sterilization is disputed by the intellectual and developmental disabilities professional, the psychiatrist or psychologist, or physician, said person may file a petition for declaration of competency to give consent to sterilization with the court. Upon the filing of a petition which shows that said person is over eighteen years of age and desires to give consent to sterilization, the court shall immediately set a hearing to determine the person's competency to give such consent. For the purpose of determining competency, the court shall appoint two or more independent professional persons with expertise in the field of intellectual and developmental disabilities who do not provide services and supports to said person to examine said person and to present their findings as to said person's competency to give consent to sterilization at the competency hearing.

(2) If the court determines that the person has given consent to sterilization and is competent to give such consent, the court may order that the sterilization be performed unless the person withdraws consent to sterilization prior to the sterilization being performed. If the court determines that the person is incompetent to give consent to sterilization, the court shall order that no sterilization be performed without further court proceedings pursuant to section 25.5-10-233.

(3) Determination of competency in these proceedings is specific to the ability to give consent to sterilization and does not determine legal competency for any other purpose.
C.R.S. § 25.5-5-303 — CO Code / Title 25.5 / Article 5 / Part 3 / Section 25.5-5-303
25.5-5-303. Private-duty nursing
Status: in_force

25.5-5-303. Private-duty nursing. (1) The medical assistance program in this state shall include private-duty nursing to persons who are technology dependent and otherwise eligible as provided under this section.

(2) A member is eligible for private-duty nursing services if the member:

(a) Is dependent on technology at least part of each day;

(b) Requires private-duty nursing care as determined in accordance with state department rules;

(c) Is able to be served safely under the limitations of the private-duty nursing benefit and within the availability of services; and

(d) Is not residing in a nursing facility or hospital at the time of the delivery of the private-duty nursing services.

(3) (a) The state board shall establish rules in accordance with this section that identify medical criteria for determining the circumstances under which private-duty nursing services will be delivered to assure that only persons who need the services receive them and only to the extent medically necessary.

(b) Private-duty nursing services shall not be provided as twenty-four-hour care except in special circumstances and for limited time periods as established by the state department pursuant to this section.

(c) The home health agency, in conjunction with the family or in-home caregiver and the attending physician, shall include in a care plan that includes private-duty nursing services a process by which the eligible person may receive necessary care, which may include respite care, if the family or in-home caregiver is unavailable due to an emergency situation or to unforeseen circumstances. The family or in-home caregiver shall be duly informed by the home health agency of these alternative care provisions at the time the care plan is initiated.

(4) As used in this section, unless the context otherwise requires, "private-duty nursing" means nursing care that is more individualized and continuous than both the nursing care available under the home health benefit and the nursing care routinely provided in a hospital or nursing facility.
C.R.S. § 25.5-5-305 — CO Code / Title 25.5 / Article 5 / Part 3 / Section 25.5-5-305
25.5-5-305. Pediatric hospice care - legislative declaration - federal authorization - rules
Status: in_force

25.5-5-305. Pediatric hospice care - legislative declaration - federal authorization - rules - fund. (1) Legislative declaration. (a) The general assembly finds and declares that:

(I) The death of a child has a devastating and enduring impact on the child's family;

(II) Too often, children with fatal conditions and their families fail to receive compassionate and consistent care that meets their physical, emotional, and spiritual needs;

(III) Better care is possible but current methods of organizing and financing palliative, end-of-life, and bereavement care impede the provision of services that are both more appropriate and more cost-efficient;

(IV) Current federal medicaid regulations contain inherent barriers to providing appropriate palliative and end-of-life care to pediatric patients. These barriers include requirements that preclude the pursuit of curative treatments, mandate a do-not-resuscitate order, and require physician certification that death is expected within six months.

(b) The general assembly declares that it is in the best interest of the state to investigate and implement hospice guidelines that provide appropriate, compassionate care to dying children and their families while proving to be cost-neutral or cost-saving to the state and federal medicaid programs.

(c) The general assembly further finds and declares that, while this direction immediately concerns federal approval for hospice care that recognizes the distinct circumstances of children facing life-threatening illnesses and their families, it is the intent of the general assembly that the information and data produced as a result of this act shall be used to improve the delivery of palliative and end-of-life services to persons of all ages when such improvements can be made in a manner that is cost-neutral or cost-saving to the state.

(2) Definitions. As used in this section, unless the context otherwise requires:

(a) "Eligible child" means a child who:

(I) Is less than nineteen years of age; and

(II) Is eligible for the state's medicaid program pursuant to section 25.5-5-101, 25.5-5-201, or 25.5-5-203;

(b) "Pediatric hospice care" means hospice care for eligible children as authorized in this section.

(3) Pediatric hospice care. (a) (I) The state department shall seek the appropriate federal authorization, conditioned on the receipt of gifts, grants, or donations sufficient to provide for the state's administrative costs of preparing and submitting the request, for pediatric hospice care that shall include but may not be limited to:

(A) Respite care;

(B) Expressive therapies, as defined in rule by the state board;

(C) Palliative care from the time of diagnosis of a potentially life-threatening illness; and

(D) A continuum of care through the coordination of services, which may include skilled, intermittent, and around-the-clock nursing care.

(II) The state department is authorized to seek federal approval for modifications to the provision of hospice care for adults who are eligible for the state's medicaid program.

(b) For the provision of pediatric hospice care, the state department shall seek an exemption from the following federal medicaid requirements for the eligibility of and election for hospice care:

(I) The mandatory do-not-resuscitate order;

(II) A physician's certification that a patient is expected to live less than six months; and

(III) The nonallowance of curative care therapies concurrent with palliative and hospice care.

(c) In any application for federal authorization pursuant to this section, the state department shall retain bereavement services to the extent available under federal law.

(d) Pediatric hospice care, as authorized pursuant to this section, shall meet aggregate federal waiver budget neutrality requirements.

(e) The state department shall implement the provision of pediatric hospice care to the extent authorized by the federal government.

(4) Review. The state department shall notify the joint budget committee of the general assembly of the extent to which the state department received federal authorization for pediatric hospice care services pursuant to this section in order for the joint budget committee to review the approved budget neutrality analysis for such services prior to the state department's implementation.

(5) Rules. The state department shall develop the service provisions for pediatric hospice care in consultation with medical professionals who have expertise in providing end-of-life and palliative care to pediatric patients and family members who have experienced the death of a child. The state board shall adopt rules necessary to implement and administer the provisions of this section.

(6) Fund. The state department is authorized to seek and accept gifts, grants, or donations from private or public sources for the purpose of providing for the administrative costs of preparing and submitting the request for federal approval for the provision of pediatric hospice care. All private and public funds received through gifts, grants, or donations shall be transmitted to the state treasurer, who shall credit the same to the pediatric hospice care cash fund, which fund is hereby created and referred to in this section as the "fund". The moneys in the fund shall be subject to annual appropriation by the general assembly for preparing and submitting the request for federal approval pursuant to this section. Any moneys in the fund not expended for the purpose of this section may be invested by the state treasurer as provided by law. All interest and income derived from the investment and deposit of moneys in the fund shall be credited to the fund. Any unexpended and unencumbered moneys remaining in the fund at the end of a fiscal year shall remain in the fund and shall not be credited or transferred or revert to the general fund or another fund.
C.R.S. § 25.5-5-416 — CO Code / Title 25.5 / Article 5 / Part 4 / Section 25.5-5-416
25.5-5-416. Report concerning efficient contracting in managed care - legislative declaratio
Status: repealed

25.5-5-416. Report concerning efficient contracting in managed care - legislative declaration - repeal. (Repealed)
C.R.S. § 25.5-4-503 — CO Code / Title 25.5 / Article 4 / Part 5 / Section 25.5-4-503
25.5-4-503. Waiver applications - authorization
Status: in_force

25.5-4-503. Waiver applications - authorization. (1) The state department is authorized to apply for health insurance flexibility and accountability waivers that will enable the state to add more flexibility to Colorado's medicaid program and that will result in a cost-effective method of providing health-care services to Coloradans.

(2) The state department shall pursue and, if approved, implement a demonstration waiver that authorizes the state to use federal medical assistance payments authorized pursuant to section 1903(v) of the federal "Social Security Act", as amended, in coordination with the division of insurance to enhance or expand a state-subsidized individual health coverage plan as defined in section 10-16-1203 (15) and, only if needed to maximize federal financial participation, for Coloradans receiving state medical assistance pursuant to section 25.5-2-104 or 25.5-5-201 (6). To the extent such federal funds are used to enhance or expand a state-subsidized individual health coverage plan, as defined in section 10-16-1203 (15), the health insurance affordability enterprise created pursuant to section 10-16-1204 must receive, deposit into the health insurance affordability cash fund created in section 10-16-1206, and allocate the federal share of the medical assistance payments pursuant to section 10-16-1205 (2), subject to any conditions set forth in the approval of the waiver.
C.R.S. § 25.5-6-702 — CO Code / Title 25.5 / Article 6 / Part 7 / Section 25.5-6-702
25.5-6-702. Legislative declaration - no entitlement created
Status: in_force

25.5-6-702. Legislative declaration - no entitlement created. (1) The general assembly hereby finds and declares that the purpose of this part 7 is to provide, under federal authorization and subject to available appropriations, home- and community-based services for persons with brain injury.

(2) Nothing in this part 7 shall be construed to establish that eligible persons as defined in section 25.5-6-703 (4) are entitled to receive services from the state department. The provision of any services pursuant to this part 7 shall be subject to federal waiver authorization and available appropriations.
C.R.S. § 25.5-10-401 — CO Code / Title 25.5 / Article 10 / Part 4 / Section 25.5-10-401
25.5-10-401. Legislative declaration
Status: repealed

25.5-10-401. Legislative declaration. (Repealed)
C.R.S. § 25.5-6-111 — CO Code / Title 25.5 / Article 6 / Part 1 / Section 25.5-6-111
25.5-6-111. Pilot program for coordinated care for people with a disability - fund - repeal
Status: repealed

25.5-6-111. Pilot program for coordinated care for people with a disability - fund - repeal. (Repealed)
C.R.S. § 25.5-5-414 — CO Code / Title 25.5 / Article 5 / Part 4 / Section 25.5-5-414
25.5-5-414. Telemedicine - legislative intent
Status: repealed

25.5-5-414. Telemedicine - legislative intent. (1) It is the intent of the general assembly to recognize the practice of telemedicine as a legitimate means by which an individual may receive medical services from a health-care provider without person-to-person contact with a provider.

(2) Repealed.

(3) On or after January 1, 2002, face-to-face contact between a health-care provider and a patient is not required under the statewide managed care system created in this part 4 for services appropriately provided through telemedicine, subject to reimbursement policies developed by the state department to compensate providers who provide health-care services covered by the program created in section 25.5-4-104. Telemedicine services may only be used in areas of the state where the technology necessary for the provision of telemedicine exists. The audio and visual telemedicine system used must, at a minimum, have the capability to meet the procedural definition of the most recent edition of the current procedural terminology that represents the service provided through telemedicine. The telecommunications equipment must be of a level of quality to adequately complete all necessary components to document the level of service for the current procedural terminology fourth edition codes that are billed. If a peripheral diagnostic scope is required to assess the patient, it must provide adequate resolution or audio quality for decision-making.

(4) Repealed.

(5) The statewide managed care system is not required to pay for consultation provided by a provider by telephone or facsimile machines.

(6) The state department may accept and expend gifts, grants, and donations from any source to conduct the valuation of the cost-effectiveness and quality of health care provided through telemedicine by those providers who are reimbursed for telemedicine services by the statewide managed care system.

(7) Nothing in this section shall be construed to:

(a) Alter the scope of practice of any health-care provider; or

(b) Authorize the delivery of health-care services in a setting or manner not otherwise authorized by law.
C.R.S. § 25.5-6-205 — CO Code / Title 25.5 / Article 6 / Part 2 / Section 25.5-6-205
25.5-6-205. Collection of penalties assessed against nursing facilities - creation of cash f
Status: in_force

25.5-6-205. Collection of penalties assessed against nursing facilities - creation of cash fund. (1) (a) The state department shall assess, enforce, and collect any civil penalties that are recommended by the department of public health and environment pursuant to the authority granted under section 25-1-107.5, C.R.S.

(b) Prior to the denial of medicaid payments or the assessment of a civil money penalty against a nursing facility, the nursing facility shall be offered by the state department an opportunity for a hearing in accordance with the provisions of section 24-4-105, C.R.S. Enforcement and collection of the denial of medicaid payments or civil money penalty shall occur following the decision reached at such hearing.

(2) In conjunction with the authority granted under subsection (1) of this section, the state board shall promulgate rules that:

(a) Provide any nursing facility assessed a civil penalty the opportunity to appeal such assessment;

(b) Govern the procedures for such appeals, including the right of a nursing facility to thirty days' notice prior to the collection of any civil money penalty; and

(c) Are otherwise necessary to implement this section.

(3) (a) Any civil penalties collected by the state department pursuant to this section shall be transmitted to the state treasurer, who shall credit the same to the nursing home penalty cash fund, which fund is hereby created.

(b) (I) On and after July 1, 2021, the money in the fund is subject to annual appropriation by the general assembly to the state department and the department of public health and environment for the purposes set forth in section 25-1-107.5. Pursuant to section 25-1-107.5 (4)(b)(II)(B), the money in the fund is continuously appropriated to the state department and the department of public health and environment for the purpose of emergency funding needs.

(II) Such moneys shall be used in the manner prescribed in section 25-1-107.5, C.R.S., and the rules promulgated thereunder.

(c) All interest derived from the deposit and investment of moneys in the fund shall be credited to the fund.

(d) At the end of any fiscal year, all unexpended and unencumbered moneys remaining in the fund shall remain therein and shall not be credited or transferred to the general fund or any other fund.
C.R.S. § 25.5-4-504 — CO Code / Title 25.5 / Article 4 / Part 5 / Section 25.5-4-504
25.5-4-504. Federal authorization - repeal
Status: repealed

25.5-4-504. Federal authorization - repeal. (Repealed)
C.R.S. § 25.5-4-303 — CO Code / Title 25.5 / Article 4 / Part 3 / Section 25.5-4-303
25.5-4-303. State income tax refund intercept - garnishment of earning - failure to provide
Status: in_force

25.5-4-303. State income tax refund intercept - garnishment of earning - failure to provide medical support for child. (1) (a) At any time prescribed by the department of revenue, but not less frequently than annually, the state department may certify to the department of revenue information regarding any person who:

(I) Is obligated to the state agency responsible for administering medical assistance in this state for medical support based on medical assistance provided to the obligor's dependent child; and

(II) Has received payment from a third party to cover the health-care costs of the child but has neither applied such payment to cover the child's health-care costs nor to reimburse the state department, the custodial parent of the child, or the provider of medical care.

(b) The information provided to the department of revenue shall include the name and the social security number of the person described in paragraph (a) of this subsection (1), the amount of medical assistance provided to the child during the period for which medical support was ordered but not provided as described in subparagraph (II) of paragraph (a) of this subsection (1), and any other identifying information required by the department of revenue.

(2) Prior to a final certification of the information described in subsection (1) of this section to the department of revenue, the state department shall notify the obligated person, in writing, that the state intends to refer the person's name to the department of revenue in an attempt to offset the person's medical support obligation against the person's state income tax refund. Such notification shall include information on the parent's right to object to the offset.

(3) Upon notification by the department of revenue of amounts deposited with the state treasurer pursuant to section 39-21-108 (3), C.R.S., the state department may recover the amount of the medical assistance described in paragraph (b) of subsection (1) of this section.

(4) The state department may garnish the wages and other earnings of a person described in paragraph (a) of subsection (1) of this section. The garnishment of wages and earning shall be in accordance with articles 54 and 54.5 of title 13, C.R.S.

(5) The state board shall adopt rules as are necessary for the implementation of this section.
C.R.S. § 25.5-2.5-103 — CO Code / Title 25.5 / Article 2.5 / Part 1 / Section 25.5-2.5-103
25.5-2.5-103. Lower-cost prescription drugs - information - research - reporting
Status: in_force

25.5-2.5-103. Lower-cost prescription drugs - information - research - reporting. (1) The state department shall make information available to the public concerning lower-cost prescription drug programs. The information shall include, but need not be limited to:

(a) Ways in which low-income, uninsured persons can obtain lower-cost prescription drugs; and

(b) Contact information concerning programs for lower-cost prescription drugs.

(2) The state department shall research cost-effective programs or mechanisms by which low-income, uninsured persons may purchase lower-cost prescription drugs.

(3) The state department shall report annually to the health and human services committees of the house of representatives and the senate, or any successor committees, concerning the provisions of this article.
C.R.S. § 25.5-5-500.3 — CO Code / Title 25.5 / Article 5 / Part 5 / Section 25.5-5-500.3
25.5-5-500.3. Authorization to bill third party
Status: in_force

25.5-5-500.3. Authorization to bill third party. As a condition of doing business in the state, each provider is deemed to authorize the state department, or an independent contractor retained by the state department, to bill a third party, as defined in section 25.5-4-209 (2)(g)(II), on behalf of the provider if the third party is determined to be liable to pay for care pursuant to sections 25.5-4-209 and 25.5-4-300.4.
C.R.S. § 25.5-3-110 — CO Code / Title 25.5 / Article 3 / Part 1 / Section 25.5-3-110
25.5-3-110. Effect of part 1
Status: in_force

25.5-3-110. Effect of part 1. This part 1 does not affect the responsibilities of the behavioral health administration in the department of human services for the provision of mental health care in accordance with article 66 of title 27, and this part 1 does not affect any provisions of article 22 of title 23 or any other provisions of law relating to the university of Colorado psychiatric hospital.
C.R.S. § 25.5-6-107 — CO Code / Title 25.5 / Article 6 / Part 1 / Section 25.5-6-107
25.5-6-107. Financing of single entry point system - repeal
Status: repealed

25.5-6-107. Financing of single entry point system - repeal. (Repealed)
C.R.S. § 25.5-6-1405 — CO Code / Title 25.5 / Article 6 / Part 14 / Section 25.5-6-1405
25.5-6-1405. Rule-making authority
Status: in_force

25.5-6-1405. Rule-making authority. (1) The state board shall promulgate rules necessary to implement and administer the medicaid buy-in program created in this part 14, including the establishment of appropriate premium and cost-sharing charges on a sliding-fee scale based on income. The premiums and cost-sharing charges shall be based upon an actuarial study of the disabled population in this state.

(2) Any rules adopted by the state board must be consistent with the federal "Ticket to Work and Work Incentives Improvement Act of 1999", Pub.L. 106-170, and the "Balanced Budget Act of 1997", Pub.L. 105-33, 111, as amended.
C.R.S. § 25.5-1-122 — CO Code / Title 25.5 / Article 1 / Part 1 / Section 25.5-1-122
25.5-1-122. County appropriation increases - limitations
Status: in_force

25.5-1-122. County appropriation increases - limitations. (1) Beginning in calendar fiscal year 1994 and for each calendar fiscal year thereafter to and including calendar fiscal year 1997, the board of county commissioners in each county of this state shall annually appropriate funds for the county share of the administrative costs of medical assistance in the county in an amount equal to the actual county share for the previous fiscal year adjusted by an amount equal to the actual county share for the previous fiscal year multiplied by the percentage of change in property tax revenue.

(2) For the purposes of this section:

(a) "County share" means the actual amount of the county share for the previous fiscal year. "County share" shall not include:

(I) The amount expended by the county from the county contingency fund or the county tax base relief fund pursuant to section 26-1-126, C.R.S.;

(II) The amount expended by the county for general assistance pursuant to part 1 of article 17 of title 30, C.R.S.; and

(III) The amount expended by the county for programs or services provided by the county on its own, without requirements or funding from any other governmental agency.

(b) "Percentage of change in property tax revenue" means the difference between the total property tax levied for the previous fiscal year less the amount levied for debt service for the previous fiscal year and the total property tax levied for the year for which the percentage of change in tax revenue is being calculated less the amount levied for debt service for the year in which the percentage of change in tax revenue is being calculated divided by the total property tax levied for the previous fiscal year less the amount levied for debt service for the previous fiscal year.

(3) Notwithstanding the provisions of section 25.5-1-121, a county in the state shall not be required to contribute more than the amount set forth in subsection (1) of this section in any fiscal year. Nothing in this section shall be construed to limit the ability of a county to establish programs or services provided by the county on its own, without requirements or funding from any other governmental agency.

(4) (Deleted by amendment, L. 2008, p. 1812, § 3, effective June 2, 2008.)

(5) Any amounts remaining in the county social services fund created in section 26-1-123, C.R.S., at the end of any fiscal year shall remain in the county fund for expenditure as determined by the board of county commissioners for administrative costs of public assistance, medical assistance, and food stamps, and program costs of public assistance and food stamps.

(6) The limitation set forth in this section on the increase in the county share of the administrative costs of medical assistance will result in increased costs to the state. By making state funds available, the state is encouraging counties not to exercise any right a county may have pursuant to section 20 (9) of article X of the Colorado constitution to reduce or end its share of the costs of medical assistance administration for the county for three fiscal years following the fiscal year in which the state funds are received. If a county accepts funds from the state based on the limitation provided in this section for any fiscal year, the county agrees not to exercise any rights the county may have to reduce or end its share of the costs of medical assistance administration for the fiscal year in which the funds are accepted. Nothing in this subsection (6) or any agreement pursuant to this subsection (6) shall be construed to affect the existence or status of any rights accruing to the state or any county pursuant to section 20 (9) of article X of the Colorado constitution.
C.R.S. § 25.5-10-231 — CO Code / Title 25.5 / Article 10 / Part 2 / Section 25.5-10-231
25.5-10-231. Sterilization rights
Status: in_force

25.5-10-231. Sterilization rights. (1) It is the intent of the general assembly that the procedures set forth in the following subsections be utilized when sterilization is being considered for the primary purpose of rendering the person incapable of reproduction.

(2) Any person with an intellectual and developmental disability over eighteen years of age who has given informed consent has the right to be sterilized, subject to the following:

(a) Prior to the procedure, competency to give informed consent and assurance that such consent is voluntarily and freely given shall be evaluated by the following:

(I) A psychiatrist, psychologist, or physician who does not provide services or supports to the person and who has consulted with and interviewed the person with an intellectual and developmental disability; and

(II) An intellectual and developmental disabilities professional who does not provide services or supports in which said person participates, and who has consulted with and interviewed the person with an intellectual and developmental disability.

(b) The professionals who conducted the evaluation pursuant to paragraph (a) of this subsection (2) shall consult with the physician who is to perform the operation concerning each professional's opinion in regard to the informed consent of the person requesting the sterilization.

(3) Any person with an intellectual and developmental disability whose capacity to give an informed consent is challenged by the intellectual and developmental disabilities professional or the physician may file a petition with the court to declare competency to give consent pursuant to the procedures set forth in section 25.5-10-232.

(4) No person with an intellectual and developmental disability who is over eighteen years of age and has the capacity to participate in the decision-making process regarding sterilization shall be sterilized in the absence of the person's informed consent. No minor may be sterilized without a court order pursuant to section 25.5-10-233.

(5) Sterilization conducted pursuant to this section shall be legal. Consent given by any person pursuant to subsection (2) of this section is not revocable after sterilization, and no person shall be liable for acting pursuant to such consent.
C.R.S. § 25.5-4-106 — CO Code / Title 25.5 / Article 4 / Part 1 / Section 25.5-4-106
25.5-4-106. Cooperation with federal government - grants-in-aid - cooperation with the state
Status: in_force

25.5-4-106. Cooperation with federal government - grants-in-aid - cooperation with the state department of human services in delivery of services. (1) The state department shall be the sole state agency for administering the state plans for health and medical assistance pursuant to this title, and any other state plan relating to medical assistance that requires state action which is not specifically the responsibility of some other state department, division, section, board, commission, or committee under the provisions of federal or state law.

(2) (a) The state department may accept on behalf of the state of Colorado the provisions and benefits of acts of congress designed to provide funds or other property for particular medical assistance within the state, which funds or other property are designated for such purposes within the function of the state department, and may accept on behalf of the state any offers which have been or may from time to time be made of funds or other property by any persons, agencies, or entities for particular medical assistance activities within the state, which funds or other property are designated for such purposes within the function of the state department; but, unless otherwise expressly provided by law, such acceptance shall not be manifested unless and until the state department has recommended such acceptance to and received the written approval of the governor and the attorney general. Such approval shall authorize the acceptance of the funds or property in accordance with the restrictions and conditions for the purpose for which funds or property are intended.

(b) The state treasurer is designated as ex officio custodian of all medical assistance funds received by the state from the federal government and from any other source, if the approval provided for in paragraph (a) of this subsection (2) has been obtained.

(c) The state treasurer shall hold each such fund separate and distinct from state funds and is authorized to make disbursements from such funds for the designated purpose or for administrative costs, which may be provided in such grants upon warrants issued by the state controller upon the voucher of the state department.

(3) The state department shall cooperate with the federal department of health and human services and other federal agencies in any reasonable manner, in conformity with the laws of this state, which may be necessary to qualify for federal financial participation, including the preparation of state plans, the making of reports in such form and containing such information as any federal agency may from time to time require, and the compliance with such provisions as the federal government may from time to time find necessary to assure the correctness and verification of the reports.

(4) The rules of the state department may include provisions to accommodate requirements of contracts entered into between the state department and the federal department of health and human services, or any successor agency, for studies of guaranteed annual income or other forms of income maintenance research projects; and for such purpose, the requirements of this title as to eligibility for medical assistance shall not apply for the term of and in accordance with the contract for such purpose.

(5) The state department is responsible for administering the delivery of medical assistance by county departments of human or social services or any other public or private entities participating in the delivery of medical assistance pursuant to this article 4 and articles 5 and 6 of this title 25.5.
C.R.S. § 25.5-5-102 — CO Code / Title 25.5 / Article 5 / Part 1 / Section 25.5-5-102
25.5-5-102. Basic services for the categorically needy - mandated services
Status: in_force

25.5-5-102. Basic services for the categorically needy - mandated services. (1) Subject to the provisions of subsection (2) of this section and section 25.5-4-104, the program for the categorically needy must include the following services as mandated and defined by federal law:

(a) Inpatient hospital services;

(b) Outpatient hospital services;

(c) Other laboratory and X-ray services;

(d) Physicians' services, wherever furnished;

(e) Nursing facility services;

(f) Home health services;

(g) Early and periodic screening, diagnosis, and treatment, as required by federal law;

(h) Family planning, including a one-year supply of any federal food and drug administration-approved contraceptive drug, device, or product, unless the member requests a supply covering a shorter period of time;

(i) Rural health services;

(j) Advanced practice registered nurse services;

(k) and (l) (Deleted by amendment, L. 2008, p. 138, § 2, effective July 1, 2008.)

(m) Federally qualified health centers.

(2) In order to keep expenditures within approved appropriations, the state board may, by rule, establish limits on a service provided pursuant to this section so long as the service provided is sufficient in the amount, duration, and scope to reasonably achieve the purpose of the service as required by federal law or regulation. When a rule is promulgated pursuant to this subsection (2), the state board shall provide a summary report of the limitations established by the rule and any fiscal impact of the rule to members of the health and human services committees of the senate and house of representatives, or any successor committees, and any other members of the general assembly who request the reports.
C.R.S. § 25.5-5-508 — CO Code / Title 25.5 / Article 5 / Part 5 / Section 25.5-5-508
25.5-5-508. Electronic prescriptions - study - report - repeal
Status: repealed

25.5-5-508. Electronic prescriptions - study - report - repeal. (Repealed)
C.R.S. § 25.5-5-804 — CO Code / Title 25.5 / Article 5 / Part 8 / Section 25.5-5-804
25.5-5-804. Integrated funding pilot
Status: in_force

25.5-5-804. Integrated funding pilot. Subject to available appropriations, the state department, in conjunction with the behavioral health administration in the department of human services, counties, and other relevant departments, shall design and recommend a child and youth behavioral health delivery system pilot program that addresses the challenges of fragmentation and duplication of behavioral health services. The pilot program shall integrate funding for behavioral health intervention and treatment services across the state to serve children and youth with behavioral health disorders. To implement the provisions of this section, the state department shall collaborate with the behavioral health administration in the department of human services and other relevant stakeholders, including counties, managed care entities, and families.
C.R.S. § 25.5-5-316 — CO Code / Title 25.5 / Article 5 / Part 3 / Section 25.5-5-316
25.5-5-316. Legislative declaration - state department - disease management programs authori
Status: in_force

25.5-5-316. Legislative declaration - state department - disease management programs authorization - report. (1) The general assembly finds that, because Colorado is faced with rising health-care costs and limited resources, it is necessary to seek new ways to ensure the availability of high-quality, cost-efficient care for medicaid members. The general assembly further finds that disease management is a patient-focused, integrated approach to providing all components of care with attention to both quality of care and total cost. In addition, the general assembly finds that this approach may include coordination of physician care with pharmaceutical and institutional care. The general assembly further finds that disease management also addresses the various aspects of a disease state, including meeting the needs of persons who have multiple chronic illnesses. The general assembly declares that the improved coordination in disease management helps to provide chronically ill patients with access to the latest advances in treatment and teaches them how to be active participants in their health care through health education, thus reducing total health-care costs.

(2) The state department, in consultation with the department of public health and environment, is authorized to develop and implement disease management programs, for fee-for-service and primary care physician program recipients, that are designed to address over- or under-utilization or the inappropriate use of services or prescription drugs and that may affect the total cost of health-care utilization by a particular medicaid member with a particular disease or combination of diseases. The disease management programs shall target medicaid members who are receiving prescription drugs or services in an amount that exceeds guidelines outlined by the state department. The state department shall not restrict a medicaid member's access to the most cost-effective and medically appropriate prescription drugs or services. The state department may contract on a contingency basis for the development or implementation of the disease management programs authorized in this subsection (2).

(3) If the state department implements any disease management programs authorized in subsection (2) of this section, the state department shall report to the joint budget committee of the general assembly an estimate of the fiscal implications generated by the implementation of the disease management programs. Such report shall be made on or before February 1 of the year following the implementation of a disease management program and on or before each February 1 thereafter in which such program is in place.
C.R.S. § 25.5-5-514 — CO Code / Title 25.5 / Article 5 / Part 5 / Section 25.5-5-514
25.5-5-514. Prescription drugs used for treatment or prevention of HIV - prohibition on util
Status: in_force

25.5-5-514. Prescription drugs used for treatment or prevention of HIV - prohibition on utilization management - definition. (1) As used in this section, "HIV" means human immunodeficiency virus.

(2) (a) Before July 1, 2027, the state department shall not restrict by prior authorization or step therapy requirements any prescription drug approved by the federal food and drug administration that is used for the treatment or prevention of HIV if a prescribing practitioner licensed pursuant to title 12 has determined the prescription drug to be medically necessary for the treatment or prevention of HIV for a member. Prescription drugs used for the treatment or prevention of HIV include protease inhibitors, non-nucleoside reverse transcriptase inhibitors, nucleoside reverse transcriptase inhibitors, antivirals, integrase inhibitors, long-acting medications, and fusion inhibitors.

(b) Nothing in this subsection (2) prevents the state department from performing drug utilization review that may be necessary for patient safety or for ensuring the prescribed use is for a medically accepted indication, as required by section 1927 of the federal "Social Security Act of 1935".
C.R.S. § 25.5-6-1601 — CO Code / Title 25.5 / Article 6 / Part 16 / Section 25.5-6-1601
25.5-6-1601. Definitions
Status: in_force

25.5-6-1601. Definitions. As used in this part 16, unless the context otherwise requires:

(1) "Compensation" has the meaning set forth in section 25.5-6-406 (2)(b)(I).

(2) [Editor's note: This version of subsection (2) is effective until July 1, 2025.] "Health maintenance activities" has the meaning set forth in section 25.5-6-1202 (4).

(2) [Editor's note: This version of subsection (2) is effective July 1, 2025.] "Health maintenance activities" has the meaning set forth in section 25.5-6-1901 (2).

(3) "Home care agency" has the meaning set forth in section 25-27.5-102 (3).

(4) [Editor's note: This version of subsection (4) is effective until July 1, 2025.] "Homemaker services" has the meaning set forth in section 25.5-6-303 (11).

(4) [Editor's note: This version of subsection (4) is effective July 1, 2025.] "Homemaker services" has the meaning as set forth in section 25.5-6-1901 (3).

(5) "In-home support service agency" has the meaning set forth in section 25.5-6-1202 (5).

(6) "In-home support services" has the meaning set forth in section 25.5-6-1202 (6); except that the term does not include health maintenance activities.

(7) "Personal care services" has the meaning set forth in section 25-27.5-102 (6).
C.R.S. § 25.5-10-304 — CO Code / Title 25.5 / Article 10 / Part 3 / Section 25.5-10-304
25.5-10-304. Family support councils
Status: in_force

25.5-10-304. Family support councils. (1) The state department shall ensure that each case management agency or service agency approved to provide family support services establishes a family support council in each defined service area. The family support councils must consist of professionals, interested citizens, family members of persons with an intellectual and developmental disability, and persons with an intellectual and developmental disability with a majority of the council being made up of family members.

(2) The family support council shall:

(a) Provide direction and assistance to the case management agency in the development of a family support plan for the defined service area;

(b) Make recommendations regarding other family supports or services not specifically listed in this part 3;

(c) Monitor the implementation of the supports or services provided pursuant to the plan; and

(d) Provide a written report to the state department of its involvement in the duties specified in this subsection (2).
C.R.S. § 25.5-5-513 — CO Code / Title 25.5 / Article 5 / Part 5 / Section 25.5-5-513
25.5-5-513. Pharmacy benefits - prescription drugs - rebates - analysis
Status: in_force

25.5-5-513. Pharmacy benefits - prescription drugs - rebates - analysis. (1) Beginning in 2023, the state department shall, in collaboration with the administrator of the all-payer health claims database described in section 25.5-1-204, conduct an annual analysis of the prescription drug rebates received in the previous calendar year, by health insurance carrier and prescription drug tier. The analysis, using data from the all-payer health claims database and other sources, must be completed on or before May 1 of each year.

(2) The state department shall make the analysis conducted in subsection (1) of this section available to the public on an annual basis.
C.R.S. § 25.5-5-315 — CO Code / Title 25.5 / Article 5 / Part 3 / Section 25.5-5-315
25.5-5-315. Acceptance of gifts, grants, and donations - Native American substance abuse tre
Status: repealed

25.5-5-315. Acceptance of gifts, grants, and donations - Native American substance abuse treatment cash fund. (1) The executive director may accept and expend money from gifts, grants, and donations for purposes of providing for the administrative costs of preparing and submitting the request for federal approval to provide substance use disorder treatment and recovery services to Native Americans as provided for in section 25.5-5-314. All such gifts, grants, and donations must be transmitted to the state treasurer who shall credit the same to the Native American substance abuse treatment cash fund, which fund is created and referred to in this section as the "fund". The money in the fund is subject to annual appropriation by the general assembly. All investment earnings derived from the deposit and investment of money in the fund remains in the fund and shall not be transferred or revert to the general fund of the state at the end of any fiscal year.

(2) Repealed.
C.R.S. § 25.5-4-303.3 — CO Code / Title 25.5 / Article 4 / Part 3 / Section 25.5-4-303.3
25.5-4-303.3. Provider fraud - attorney general report
Status: in_force

25.5-4-303.3. Provider fraud - attorney general report. (1) No later than October 1, 2017, and no later than October 1 each year thereafter, the attorney general shall submit a written report to the state department for inclusion in a single, comprehensive report to the general assembly concerning medicaid fraud pursuant to section 25.5-1-115.5. The attorney general shall provide information relating to medicaid provider fraud including, at a minimum:

(a) Investigations of provider fraud during the year;

(b) Criminal complaints requested, cases dismissed, cases acquitted, convictions, and confessions of judgment;

(c) Recoveries, including fines and penalties, restitution ordered, and restitution collected;

(d) Civil claims;

(e) Trends in methods used to commit provider fraud, excluding law enforcement-sensitive information; and

(f) An estimate of the total savings, total cost, and net cost-effectiveness of fraud detection and recovery efforts.
C.R.S. § 25.5-6-411 — CO Code / Title 25.5 / Article 6 / Part 4 / Section 25.5-6-411
25.5-6-411. Personal needs trust fund required
Status: in_force

25.5-6-411. Personal needs trust fund required. All personal needs funds must be held in trust by a residential facility authorized to provide services pursuant to this part 4, or the residential facility's designated trustee, separate and apart from any other funds of the facility, in a checking account or savings account or any combination established to protect and separate the personal needs funds of the members. At all times, the principal and all income derived from the principal in the personal needs trust fund must remain the property of the participating members, and the residential facility or the facility's designated trustee is bound by all of the duties imposed by law upon fiduciaries in handling the fund including accounting for all expenditures from the fund.
C.R.S. § 25.5-10-238 — CO Code / Title 25.5 / Article 10 / Part 2 / Section 25.5-10-238
25.5-10-238. Federal funds
Status: in_force

25.5-10-238. Federal funds. The state department is authorized to accept, on behalf of the state, any grants of federal funds made available for any purposes consistent with the provisions of this article. The executive director of the state department, with the approval of the governor, shall have power to direct the disposition of any such grants so accepted in conformity with the terms and conditions under which they are given.
C.R.S. § 25.5-10-210 — CO Code / Title 25.5 / Article 10 / Part 2 / Section 25.5-10-210
25.5-10-210. Revocation of designation - repeal
Status: repealed

25.5-10-210. Revocation of designation - repeal. (Repealed)
C.R.S. § 25.5-10-306 — CO Code / Title 25.5 / Article 10 / Part 3 / Section 25.5-10-306
25.5-10-306. Rules
Status: in_force

25.5-10-306. Rules. (1) The state board shall develop rules concerning:

(a) Further definition of services and supports to be provided by the family support services program described in this part 3;

(b) The requirements for eligibility for services and supports;

(c) The manner of providing services and supports; and

(d) The size, makeup, and duties of family support councils.
C.R.S. § 25.5-1-115.5 — CO Code / Title 25.5 / Article 1 / Part 1 / Section 25.5-1-115.5
25.5-1-115.5. Medical assistance fraud - report
Status: in_force

25.5-1-115.5. Medical assistance fraud - report. (1) Notwithstanding section 24-1-136 (11)(a)(I), on or before November 1, 2017, and each November 1 thereafter, the state department shall submit a written report to the joint budget committee; to the house of representatives judiciary committee and the house of representatives public and behavioral health and human services committee, or their successor committees; and to the senate judiciary committee and the senate health and human services committee, or their successor committees, concerning fraud in the medicaid program. The state department shall compile a single, comprehensive report that includes the information described in this subsection (1), as well as information that the attorney general provides to the state department pursuant to section 25.5-4-303.3. The state department shall report to the general assembly concerning the fraudulent receipt of medicaid benefits, including, at a minimum:

(a) Investigations of member fraud during the year;

(b) Termination of member medicaid benefits due to fraud;

(c) District attorney action, including, at a minimum, criminal complaints requested, cases dismissed, cases acquitted, convictions, and confessions of judgment;

(d) Recoveries, including fines and penalties, restitution ordered, and restitution collected;

(e) Trends in methods used to commit member fraud, excluding law enforcement-sensitive information; and

(f) An estimate of the total savings, total cost, and net cost-effectiveness of fraud detection and recovery efforts.
C.R.S. § 25.5-10-209.5 — CO Code / Title 25.5 / Article 10 / Part 2 / Section 25.5-10-209.5
25.5-10-209.5. Case management agencies - certification - purchase of services and supports - r
Status: repealed

25.5-10-209.5. Case management agencies - certification - purchase of services and supports - rules - repeal. (Repealed)
C.R.S. § 25.5-4-101 — CO Code / Title 25.5 / Article 4 / Part 1 / Section 25.5-4-101
25.5-4-101. Short title
Status: in_force

25.5-4-101. Short title. This article and articles 5 and 6 of this title shall be known and may be cited as the "Colorado Medical Assistance Act".
C.R.S. § 25.5-6-407 — CO Code / Title 25.5 / Article 6 / Part 4 / Section 25.5-6-407
25.5-6-407. Gifts - grants
Status: in_force

25.5-6-407. Gifts - grants. The state department and the department of human services, acting on behalf of the state, may receive and accept title to gifts or grants from any source, including the federal government. Both departments shall deposit all grants, grants-in-aid, and gifts with the state treasurer, who shall credit them to the general fund. These moneys shall remain available for appropriation to either department to carry out the purposes of this part 4.
C.R.S. § 25.5-6-1207 — CO Code / Title 25.5 / Article 6 / Part 12 / Section 25.5-6-1207
25.5-6-1207. Repeal of part
Status: repealed

25.5-6-1207. Repeal of part. This part 12 is repealed, effective September 1, 2028. Prior to such repeal, in-home support services established under this part 12 shall be reviewed as provided for in section 24-34-104.
C.R.S. § 25.5-6-706 — CO Code / Title 25.5 / Article 6 / Part 7 / Section 25.5-6-706
25.5-6-706. Rate structure - rules - quality assurance
Status: in_force

25.5-6-706. Rate structure - rules - quality assurance. (1) (a) The state board, by rule, shall set tiered per diem rates for services provided on a supportive care campus under this part 7. When structuring the tiered per diem rates, the state board shall consider the medical and cognitive needs of eligible persons being served on the supportive care campus.

(b) The maximum per diem rate for the services provided on a supportive care campus shall not exceed the total per diem cost of comparable populations either in institutions or in other community-based settings.

(2) The state board shall adopt rules necessary for quality assurance, which shall include certification of supportive care campuses.
C.R.S. § 25.5-3-403 — CO Code / Title 25.5 / Article 3 / Part 4 / Section 25.5-3-403
25.5-3-403. Definitions
Status: in_force

25.5-3-403. Definitions. As used in this part 4, unless the context otherwise requires:

(1) "Advisory committee" means the senior dental advisory committee created in section 25.5-3-406.

(2) "Covered dental care services" are to be defined by rules of the medical services board pursuant to section 25.5-3-404 and include but are not limited to diagnostic, preventive, and restorative care.

(3) "Dental health-care services grant" means a grant awarded to a qualified grantee pursuant to section 25.5-3-404.

(4) "Eligible senior" means an adult who is sixty years of age or older and who is economically disadvantaged as specified by rule of the medical services board.

(5) "Program" means the Colorado dental health care program for low-income seniors created pursuant to section 25.5-3-404.

(6) "Qualified grantee" means an entity that can demonstrate that it can provide or arrange for the provision of comprehensive dental and oral care services and may include but is not limited to:

(a) An area agency on aging, as defined in section 26-11-203, C.R.S.;

(b) A community-based organization or foundation;

(c) A federally qualified health center, as defined in the federal "Social Security Act", 42 U.S.C. sec. 1395x (aa)(4); safety-net clinic; or health district;

(d) A local public health agency; or

(e) A private dental practice.

(7) "Qualified provider" means any person who is licensed to practice dentistry in Colorado or who employs a dentist licensed in Colorado and who is willing to accept reimbursement for covered dental services pursuant to this program.
C.R.S. § 25.5-1-125 — CO Code / Title 25.5 / Article 1 / Part 1 / Section 25.5-1-125
25.5-1-125. Centennial care choices - value benefit plans - request for information - reques
Status: repealed

25.5-1-125. Centennial care choices - value benefit plans - request for information - request for proposals - report to general assembly - definitions - legislative declaration. (Repealed)
C.R.S. § 25.5-10-230 — CO Code / Title 25.5 / Article 10 / Part 2 / Section 25.5-10-230
25.5-10-230. Discrimination
Status: in_force

25.5-10-230. Discrimination. No person who has received services or supports under any provision of this article shall be discriminated against because of such status. For purposes of this section, "discrimination" means the giving of any unfavorable weight to the fact that a person has received such services or supports.
C.R.S. § 25.5-5-509 — CO Code / Title 25.5 / Article 5 / Part 5 / Section 25.5-5-509
25.5-5-509. Substance use disorder - prescription drugs - opioid antagonist - definition
Status: in_force

25.5-5-509. Substance use disorder - prescription drugs - opioid antagonist - definition. (1) Notwithstanding any provisions of this part 5 to the contrary, for the treatment of a substance use disorder, in promulgating rules, and subject to any necessary federal authorization, the state board shall authorize reimbursement for at least one federal food and drug administration-approved ready-to-use opioid overdose reversal drug without prior authorization.

(2) (a) As used in this subsection (2), unless the context otherwise requires, "opioid antagonist" has the same meaning as set forth in section 12-30-110 (7)(d).

(b) A hospital or emergency department shall receive reimbursement under the medical assistance program for the cost of an opioid antagonist if, in accordance with section 12-30-110, a prescriber, as defined in section 12-30-110 (7)(h), dispenses an opioid antagonist upon discharge to a medical assistance member who is at risk of experiencing an opioid-related drug overdose event or to a family member, friend, or other person in a position to assist a medical assistance member who is at risk of experiencing an opioid-related drug overdose event.

(c) The state department shall seek federal financial participation for the cost of reimbursement for the opioid antagonist but shall provide reimbursement to the hospital or emergency department for the opioid antagonist using state money until federal financial participation is available.
C.R.S. § 25.5-1-130 — CO Code / Title 25.5 / Article 1 / Part 1 / Section 25.5-1-130
25.5-1-130. Improving access to behavioral health services for individuals at risk of enteri
Status: in_force

25.5-1-130. Improving access to behavioral health services for individuals at risk of entering the criminal or juvenile justice system - duties of the state department. (1) On or before March 1, 2020, the state department shall develop measurable outcomes to monitor efforts to prevent medicaid members from becoming involved in the criminal or juvenile justice system.

(2) On or before July 1, 2021, the state department shall work collaboratively with managed care entities to create incentives for behavioral health providers to accept medicaid members with severe behavioral health disorders. The incentives may include, but need not be limited to, higher reimbursement rates, quality payments to managed care entities for adequate networks, establishing performance measures and performance improvement plans related to network expansion, transportation solutions to incentivize medicaid members to attend health-care appointments, and incentivizing providers to conduct outreach to medicaid members to ensure that they are engaged in needed behavioral health services, including technical assistance with billing procedures. The state department may seek any federal authorization necessary to create the incentives described in this subsection (2).
C.R.S. § 25.5-5-332 — CO Code / Title 25.5 / Article 5 / Part 3 / Section 25.5-5-332
25.5-5-332. Therapy using equine movement - federal authorization - definition
Status: in_force

25.5-5-332. Therapy using equine movement - federal authorization - definition. (1) Subject to federal authorization and federal financial participation, on or after July 1, 2024, therapy using equine movement may be provided by a physical therapist licensed pursuant to article 285 of title 12, an occupational therapist licensed pursuant to article 270 of title 12, or a speech-language pathologist certified pursuant to article 305 of title 12.

(2) As used in this section, unless the context otherwise requires, "therapy using equine movement" means therapeutic activities that leverage horse-human interactions to facilitate progression toward meeting therapeutic goals.
C.R.S. § 25.5-6-1406 — CO Code / Title 25.5 / Article 6 / Part 14 / Section 25.5-6-1406
25.5-6-1406. Availability of federal financial assistance under medical assistance
Status: in_force

25.5-6-1406. Availability of federal financial assistance under medical assistance. Notwithstanding any other provision of law, this part 14 shall be implemented only if, and to the extent that, the state department determines that federal financial participation is available under the medicaid program.
C.R.S. § 25.5-5-404 — CO Code / Title 25.5 / Article 5 / Part 4 / Section 25.5-5-404
25.5-5-404. Selection of managed care entities
Status: repealed

25.5-5-404. Selection of managed care entities. (Repealed)
C.R.S. § 25.5-3-302 — CO Code / Title 25.5 / Article 3 / Part 3 / Section 25.5-3-302
25.5-3-302. Annual allocation - primary care services - qualified provider - rules
Status: in_force

25.5-3-302. Annual allocation - primary care services - qualified provider - rules. (1) The state department shall annually allocate the moneys appropriated by the general assembly to the primary care fund created in section 24-22-117 (2)(b), C.R.S., to all eligible qualified providers in the state who comply with the requirements of subsection (2) of this section. The state department shall allocate the moneys in amounts proportionate to the number of uninsured or medically indigent patients served by the qualified provider. For a qualified provider to be eligible for an allocation pursuant to this section, the qualified provider shall meet either of the following criteria:

(a) The qualified provider is a community health center, as defined in section 330 of the federal "Public Health Service Act", 42 U.S.C. sec. 254b; or

(b) At least fifty percent of the patients served by the qualified provider are uninsured or medically indigent patients, or patients who are enrolled in the medical assistance program, articles 4, 5, and 6 of this title, or the children's basic health plan, article 8 of this title, or any combination thereof.

(2) [Editor's note: This version of subsection (2) is effective until July 1, 2025.] A qualified provider shall annually submit to the state department information sufficient to establish the provider's eligibility status. A qualified provider, except for a provider specified in paragraph (a) of subsection (1) of this section, shall provide an annual report that includes the total number of patients served, the number of uninsured or medically indigent patients served, and the number of patients served who are enrolled in the medical assistance program, articles 4, 5, and 6 of this title, or the children's basic health plan, article 8 of this title. A community health center specified in paragraph (a) of subsection (1) of this section shall annually provide to the state department the number of uninsured or medically indigent patients served. Each eligible qualified provider shall annually develop and submit to the state department documentation regarding the quality assurance program in place at the provider's facility to ensure that quality comprehensive primary care services are being provided. All qualified providers shall submit to the state department the information required under this section, as specified in rule by the state board. The data regarding the number of patients served shall be verified by an outside entity. For purposes of this part 3, the number of patients served is the number of unduplicated users of health-care services and is not the number of visits by a patient.

(2) [Editor's note: This version of subsection (2) is effective July 1, 2025.] (a) A qualified provider shall annually submit to the state department information sufficient to establish the provider's eligibility status as specified in rule by the state board. A qualified provider shall submit an annual application for money that includes the total number of patients served, the number of uninsured or medically indigent patients served who have an annual household income at or below two hundred percent of the federal poverty guideline, and the number of patients served who are enrolled in the medical assistance program, articles 4, 5, and 6 of this title 25.5, or the children's basic health plan, article 8 of this title 25.5.

(b) Each qualified provider shall annually develop and submit to the state department documentation regarding the quality assurance program in place at the provider's facility to ensure that quality comprehensive primary care services are being provided. The state department may, through state board rule, exempt a community health center from the reporting requirements described in this subsection (2)(b).

(c) The data regarding the number of patients served must be verified by an outside entity. For purposes of this part 3, the number of patients served is the number of unduplicated users of health-care services and is not the number of visits by a patient.

(3) [Editor's note: This version of subsection (3) is effective until July 1, 2025.] The state department shall make annual direct allocations of the total amount of money annually appropriated by the general assembly to the primary care fund pursuant to section 24-22-117 (2)(b), C.R.S., minus three percent for the administrative costs of the program, to all eligible qualified providers. An eligible qualified provider's allocation shall be based on the number of uninsured or medically indigent patients served by the provider in proportion to the total number of uninsured or medically indigent patients served by all eligible qualified providers in the previous calendar year. The state department shall establish a schedule for allocating the moneys in the primary care fund for eligible qualified providers. The disbursement of moneys in the primary care fund to eligible qualified providers under this part 3 are exempt from the provisions of the "Procurement Code", articles 101 to 112 of title 24, C.R.S.

(3) [Editor's note: This version of subsection (3) is effective July 1, 2025.] (a) The state department shall make annual direct allocations of the total amount of money annually appropriated by the general assembly to the primary care fund pursuant to section 24-22-117 (2)(b), minus three percent for the administrative costs of the program, to all qualified providers.

(b) A qualified provider's allocation is based on the number of uninsured or medically indigent patients served by the provider in proportion to the total number of uninsured or medically indigent patients served by all qualified providers in the previous calendar year.

(c) The state department shall establish a schedule for allocating the money in the primary care fund for qualified providers. The disbursement of money in the primary care fund to qualified providers pursuant to this part 3 is exempt from the provisions of the "Procurement Code", articles 101 to 112 of title 24.

(4) Beginning in the 2021-22 state fiscal year, and to the extent available and permitted by the federal government and section 21 of article X of the state constitution, the state department shall maximize federal funds for payment to qualified providers pursuant to this section by aligning payments with the "Colorado Medical Assistance Act", articles 4, 5, and 6 of this title 25.5.

(5) The state board shall adopt any rules necessary for the administration and implementation of this part 3.
C.R.S. § 25.5-5-331 — CO Code / Title 25.5 / Article 5 / Part 3 / Section 25.5-5-331
25.5-5-331. Federally qualified health center - clinical pharmacy services - reimbursement -
Status: in_force

25.5-5-331. Federally qualified health center - clinical pharmacy services - reimbursement - rules. (1) Costs associated with services provided by clinical pharmacists through a federally qualified health center, as defined in the federal "Social Security Act", 42 U.S.C. sec. 1395x (aa)(4), are considered allowable costs for the purpose of a federally qualified health center's cost report and must be included in the calculation of the reimbursement rate for a patient visit at a federally qualified health center.

(2) The state department shall promulgate rules to implement the provisions of this section.
C.R.S. § 25.5-6-108 — CO Code / Title 25.5 / Article 6 / Part 1 / Section 25.5-6-108
25.5-6-108. Legislative declaration - advisory committee - long-term care - report - repeal
Status: repealed

25.5-6-108. Legislative declaration - advisory committee - long-term care - report - repeal. (Repealed)
C.R.S. § 25.5-5-301 — CO Code / Title 25.5 / Article 5 / Part 3 / Section 25.5-5-301
25.5-5-301. Clinic services
Status: in_force

25.5-5-301. Clinic services. (1) As used in this article and articles 4 and 6 of this title, unless the context otherwise requires, "clinic services" means preventive, diagnostic, therapeutic, rehabilitative, or palliative items or services furnished to outpatients.

(2) Under the federal option for clinic services, Colorado has selected clinic services provided by the following:

(a) Community mental health centers or clinics;

(b) Case management agencies;

(c) Birthing centers;

(d) Ambulatory surgery facilities;

(e) Freestanding dialysis clinics.

(3) "Clinic services" also means preventive, therapeutic, or palliative items or services that are furnished to patients by county or district public health agencies or county or district boards of health established pursuant to part 5 of article 1 of title 25, C.R.S., that are recommended for certification by the department of public health and environment as qualified to receive payments pursuant to this article and articles 4 and 6 of this title.

(4) "Clinic services" also means preventive, diagnostic, therapeutic, rehabilitative, or palliative items or services furnished to a pregnant woman who is enrolled or eligible for services pursuant to section 25.5-5-101 (1)(c) or 25.5-5-201 (1)(m.5) in a facility that is not a part of a hospital but is organized and operated as a freestanding substance use disorder treatment program approved and licensed by the behavioral health administration in the department of human services pursuant to section 27-80-108 (1)(c).

(5) "Clinic services" also means preventive, diagnostic, therapeutic, rehabilitative, or palliative items or services that are furnished to children up to age twenty-one or to high-risk pregnant women in a facility which is not a part of a hospital but is organized and operated as a school-based clinic.

(6) "Clinic services" also means preventive, diagnostic, therapeutic, rehabilitative, or palliative items or services that are furnished to students by a school district, board of cooperative services, or state educational institution within the scope of the "Colorado Medical Assistance Act" pursuant to the provisions of section 25.5-5-318.
C.R.S. § 25.5-10-226 — CO Code / Title 25.5 / Article 10 / Part 2 / Section 25.5-10-226
25.5-10-226. Records and confidentiality of information pertaining to eligible persons or the
Status: repealed

25.5-10-226. Records and confidentiality of information pertaining to eligible persons or their families - repeal. (Repealed)
C.R.S. § 25.5-4-205.5 — CO Code / Title 25.5 / Article 4 / Part 2 / Section 25.5-4-205.5
25.5-4-205.5. Confined persons - suspension of benefits
Status: in_force

25.5-4-205.5. Confined persons - suspension of benefits. (1) For purposes of this section, unless the context otherwise requires, "confined person" means a person who is:

(a) An inmate confined to a correctional institution operated by or under contract with the department of corrections;

(b) Confined in a jail;

(c) Committed to a juvenile commitment facility;

(d) Committed to a department of human services facility pursuant to part 1 of article 8 of title 16, C.R.S.; or

(e) A patient placed in a department of human services facility pursuant to court order or certification.

(2) Notwithstanding any other provision of law, a person who, immediately prior to becoming a confined person, was a member of medical assistance pursuant to this article 4 or article 5 or 6 of this title 25.5, remains eligible for medical assistance while a confined person; except that medical assistance may not be furnished pursuant to this article 4 or article 5 or 6 of this title 25.5 while the person is a confined person unless federal financial participation is available for the cost of the assistance, including, but not limited to, juveniles held in a facility operated by or under contract to the division of youth services established pursuant to section 19-2.5-1501 or the department of human services. Once a person is no longer a confined person, the person is eligible for receipt of medical assistance pursuant to this article 4 or article 5 or 6 of this title 25.5 until the person is determined to be ineligible for the receipt of the assistance. To the extent permitted by federal law, the time during which a person is a confined person is not included in any calculation of when the person must renew the person's eligibility for medical assistance pursuant to this article 4 or article 5 or 6 of this title 25.5.
C.R.S. § 25.5-5-321.5 — CO Code / Title 25.5 / Article 5 / Part 3 / Section 25.5-5-321.5
25.5-5-321.5. Telehealth - interim therapeutic restorations - reimbursement - definitions
Status: in_force

25.5-5-321.5. Telehealth - interim therapeutic restorations - reimbursement - definitions. (1) Subject to federal authorization and federal financial participation, on or after July 1, 2016, in-person contact between a health-care provider and a member is not required under the state's medical assistance program for the diagnosis, development of a treatment plan, instruction to perform an interim therapeutic restoration procedure, or supervision of a dental hygienist performing an interim therapeutic restoration procedure. A health-care provider may provide these services through telehealth, including store-and-forward transfer, and is entitled to reimbursement for the delivery of those services via telehealth to the extent the services are otherwise eligible for reimbursement under the program when provided in person. The services are subject to the reimbursement policies developed pursuant to the state medical assistance program.

(2) As used in this section:

(a) "Interim therapeutic restoration" has the same meaning as set forth in section 12-220-104 (10).

(b) "Store-and-forward transfer" means the asynchronous transmission of medical or dental information to be reviewed by a dentist at a later time at a distant site without the patient present in real time.
C.R.S. § 25.5-6-309 — CO Code / Title 25.5 / Article 6 / Part 3 / Section 25.5-6-309
25.5-6-309. Special provisions - post-eligibility treatment of income
Status: in_force

25.5-6-309. Special provisions - post-eligibility treatment of income. Persons who receive services under this part 3 shall pay to the state department, or designated agent or provider, all income remaining after application of federally allowed maintenance and medical deductions or shall pay the cost of home- and community-based services rendered, whichever is less.
C.R.S. § 25.5-6-409.3 — CO Code / Title 25.5 / Article 6 / Part 4 / Section 25.5-6-409.3
25.5-6-409.3. Consolidated waiver - intellectual and developmental disabilities - conflict-fre
Status: repealed

25.5-6-409.3. Consolidated waiver - intellectual and developmental disabilities - conflict-free case management - legislative declaration - repeal. (Repealed)
C.R.S. § 25.5-5-507 — CO Code / Title 25.5 / Article 5 / Part 5 / Section 25.5-5-507
25.5-5-507. Prescription drug information and technical assistance program - rules
Status: in_force

25.5-5-507. Prescription drug information and technical assistance program - rules. There is hereby created the prescription drug information and technical assistance program. The program shall provide advice on the prudent use of prescription drugs to persons who receive prescription drug benefits pursuant to this part 5. The state department shall contract with licensed pharmacists for statewide medicaid pharmacy services and pharmacy consultations for persons receiving prescription drug benefits pursuant to this part 5 regarding how each person may, with the approval of the appropriate prescribing health-care provider, avoid dangerous drug interactions, improve patient outcomes, and save the state money for the drugs prescribed. The state department shall promulgate rules to establish and administer the program and to provide incentive payments to pharmacists and physicians who participate in the program. The state department shall design a calculation for savings under the program.
C.R.S. § 25.5-5-324 — CO Code / Title 25.5 / Article 5 / Part 3 / Section 25.5-5-324
25.5-5-324. Nonemergency medical transportation - urgent and secure transportation need - re
Status: repealed

25.5-5-324. Nonemergency medical transportation - urgent and secure transportation need - report - repeal. (1) On or before January 1, 2019, the state department shall create and implement an efficient and cost-effective method for meeting urgent transportation needs within the existing nonemergency medical transportation benefit under the medical assistance program. Urgent transportation needs include discharge from inpatient, emergency services, and other urgent but nonemergency services, as determined by the state department.

(2) The method created by the state department must include, at a minimum:

(a) Medical service provider or facility access to approved transportation providers for patients with urgent transportation needs;

(b) Access to transportation providers that have obtained the necessary background checks, drug tests, training, and vehicle inspections, as required by the state department; and

(c) An efficient method for obtaining and paying for transportation services for urgent transportation needs.

(3) The state department may contract for background checks, drug tests, training, and vehicle inspections that may be required pursuant to subsection (2) of this section.

(4) (a) The state department shall annually report on the implementation and effectiveness of the process created in this section for meeting urgent and secure transportation needs within the nonemergency medical transportation benefit and secure transportation services benefit. The state department shall present the report as part of its annual "State Measurement for Accountable, Responsive, and Transparent (SMART) Government Act" presentation required by section 2-7-203 to the health and human services committee of the senate and the public and behavioral health and human services committee of the house of representatives, or any successor committees.

(b) Notwithstanding the provisions of section 24-1-136 (11)(a)(I) to the contrary, the report required pursuant to this section shall continue until the beginning of the 2025 legislative session.

(c) This section is repealed, effective July 1, 2025.
C.R.S. § 25.5-6-1403 — CO Code / Title 25.5 / Article 6 / Part 14 / Section 25.5-6-1403
25.5-6-1403. Waivers and amendments
Status: repealed

25.5-6-1403. Waivers and amendments.

(1) Repealed.

(2) If approved by the joint budget committee and subject to available appropriations, the state department shall submit to the federal centers for medicare and medicaid services an amendment to the state medical assistance plan, and shall request any necessary waivers from the secretary of the federal department of health and human services, to permit the state department to expand medical assistance eligibility as provided in this part 14 for the purpose of implementing a medicaid buy-in program for people with disabilities who are in the basic coverage group or the medical improvement group. In addition, the state department shall apply to the secretary of the federal department of health and human services for a medicaid infrastructure grant, if available, to develop and implement the federal "Ticket to Work and Work Incentives Improvement Act of 1999", Pub.L. 106-170.

(3) If the state medical assistance plan amendment and all necessary waivers are approved, the state department shall implement the medicaid buy-in program provided in this part 14 not later than three months after receiving full federal approval, whichever is later.

(4) The state department shall seek federal authorization to implement a medicaid buy-in program for adults who are eligible to receive home- and community-based services pursuant to the supported living services waiver; the developmental disabilities waiver or its successor, part 4 of this article 6; the persons with brain injury waiver, part 7 of this article 6; and the spinal cord injury waiver pilot program, part 13 of this article 6. The state department shall prepare and submit any requests necessary for federal approval not later than January 1, 2023, and shall implement the medicaid buy-in program pursuant to this subsection (4) not later than three months after receiving federal approval.

(5) (a) Except as provided in subsection (5)(b) of this section:

(I) The state department shall seek federal authorization through an amendment to the state medical assistance plan to implement the federal "Balanced Budget Act of 1997", Pub.L. 105-33, 111, as amended, which provides individuals an opportunity to buy into medicaid consistent with the federal "Social Security Act", 42 U.S.C. sec. 1396a (a)(10)(A)(ii)(XIII), as amended, to permit the state department to provide medical assistance eligibility to individuals in the work incentives eligibility group, age sixty-five and older, after they are no longer eligible under the federal "Ticket to Work and Work Incentives Improvement Act of 1999", Pub.L. 106-170.

(II) In addition to submitting an amendment to the state medical assistance plan pursuant to subsection (5)(a)(I) of this section, the state department shall submit a state plan amendment pursuant to section 1902(r)(2) of the federal "Social Security Act" to use less restrictive income and resource methodologies to match the income, household, and asset levels of the medicaid buy-in program for implementation no later than July 1, 2022.

(b) The state department shall not prepare and submit the amendments to the state medical assistance plan pursuant to this subsection (5) if there are insufficient revenues from the healthcare affordability and sustainability fee cash fund, created in section 25.5-4-402.4, for the administrative expenses associated with preparing and submitting the state plan amendments. If there are insufficient revenues from the healthcare affordability and sustainability fee cash fund, the state department may accept and expend gifts, grants, or donations for this purpose.
C.R.S. § 25.5-10-201 — CO Code / Title 25.5 / Article 10 / Part 2 / Section 25.5-10-201
25.5-10-201. Legislative declaration
Status: in_force

25.5-10-201. Legislative declaration. (1) In recognition of the varied, extensive, and substantial needs of persons with intellectual and developmental disabilities, including the urgent need to enhance the development of children with intellectual and developmental disabilities, the general assembly, subject to available appropriations and subject to the existence of appropriate services and supports with available resources, hereby declares that the purposes of this article are:

(a) To provide appropriate services and supports to persons with intellectual and developmental disabilities throughout their lifetimes regardless of their age or degree of disability;

(b) To prohibit deprivation of liberty of persons with intellectual and developmental disabilities, except when such deprivation is for the purpose of providing services and supports which constitute the least restrictive available alternative adequate to meet the person's needs, and to ensure that these services and supports afford due process protections;

(c) To ensure the fullest measure of privacy, dignity, rights, and privileges to persons with intellectual and developmental disabilities;

(d) To ensure the provision of services and supports to all persons with intellectual and developmental disabilities on a statewide basis;

(e) To enable persons with intellectual and developmental disabilities to remain with their families and in the community of their choice, to minimize the likelihood of out-of-home placement, and to enhance the capacity of families to meet the needs of children with intellectual and developmental disabilities;

(f) To provide community services and supports for persons with intellectual and developmental disabilities which reflect typical patterns of everyday living;

(g) To encourage state and local agencies to provide a wide array of innovative and cost-effective services and supports for persons with intellectual and developmental disabilities;

(h) To ensure that persons with intellectual and developmental disabilities receive services and supports which encourage and build on existing social networks and natural sources of support, and result in increased interdependence, contribution to, and inclusion in community life; and

(i) To recognize the efficacy of early intervention services and supports in minimizing developmental delays and reducing the future education costs to our society.
C.R.S. § 25.5-5-317 — CO Code / Title 25.5 / Article 5 / Part 3 / Section 25.5-5-317
25.5-5-317. Obesity treatment pilot program - development and implementation - report - repe
Status: repealed

25.5-5-317. Obesity treatment pilot program - development and implementation - report - repeal. (Repealed)
C.R.S. § 25.5-2-105 — CO Code / Title 25.5 / Article 2 / Section 25.5-2-105
25.5-2-105. State children's basic health plan
Status: in_force

25.5-2-105. State children's basic health plan. (1) Beginning no later than January 1, 2025, there is created the state children's basic health plan. The state children's basic health plan includes all benefits and services, at the same cost to the beneficiary, as are offered pursuant to the children's basic health plan in section 25.5-8-107, such that, to the maximum extent possible, eligible individuals must not be able to tell that they are enrolled in a different program from the plan described in section 25.5-8-107.

(2) A child who is less than nineteen years of age is eligible to receive the state children's basic health plan if the child would be eligible for the children's basic health plan as described in section 25.5-8-107 but is not eligible due solely to the child's immigration status.

(3) A child who is less than nineteen years of age is presumptively eligible for the state children's basic health plan and will receive services specified by state law only if a parent or legal guardian of the child declares all pertinent information relating to the criteria of income and assets of the child's family.

(4) The state children's basic health plan must be funded by state funds only, except to the extent federal funds are made available through express written authorization through a federal waiver, state plan amendment, or otherwise, by the federal centers for medicare and medicaid services.

(5) The state department shall seek any necessary federal approvals to maximize any available federal financial participation in implementing this section.

(6) To the maximum extent allowable under federal law, the state department shall, using appropriate funding, use the same infrastructure and provider network to deliver the state's children's basic health plan as it does to deliver the children's basic health plan described in section 25.5-8-107.

(7) This section constitutes state authority within the meaning of 8 U.S.C. sec. 1621 (d), as that law existed on January 1, 2022.

(8) (a) During its 2024 presentation to the joint budget committee of the general assembly and in its presentation to the health and human services committee of the senate and the health and insurance committee of the house of representatives, or any successor committees, at the hearing held pursuant to section 2-7-203 (2)(a) of the "State Measurement for Accountable, Responsive, and Transparent (SMART) Government Act", the state department shall report on its plans and progress in implementing the state children's basic health plan.

(b) Beginning January 1, 2026, and continuing every January thereafter, the state department, in its presentation to the joint budget committee of the general assembly and in its presentation to the health and human services committee of the senate and the health and insurance committee of the house of representatives, or any successor committees, at the hearing held pursuant to section 2-7-203 (2)(a) of the "State Measurement for Accountable, Responsive, and Transparent (SMART) Government Act", shall report on the cost savings and health improvements associated with the state children's basic health plan.
C.R.S. § 25.5-1-704 — CO Code / Title 25.5 / Article 1 / Part 7 / Section 25.5-1-704
25.5-1-704. Hospital community investment compliance - rules
Status: in_force

25.5-1-704. Hospital community investment compliance - rules. (1) (a) If the state department finds that a reporting hospital is not in compliance with the community benefit requirements of this part 7, the state department shall notify the reporting hospital of its noncompliance and identify the information that needs to be provided. If a reporting hospital does not comply, the state department shall require the reporting hospital to submit to the state department a corrective action plan within one hundred and twenty days for approval by the state department.

(b) If noncompliance continues or a reporting hospital fails to submit a corrective action plan, or if the state department determines a hospital's noncompliance with this section is knowing or willful or a repeated pattern of noncompliance exists, the state department shall consider the size of the hospital and the seriousness of the violation in setting a fine amount. For a reporting hospital owned by or affiliated with a hospital system comprised of three or more hospitals, the fine must be not more than twenty thousand dollars per week per violation. For all other reporting hospitals, the fine must be not more than five thousand dollars per week per violation.

(2) Reporting hospitals shall expend the amount fined pursuant to subsection (1)(b) of this section on community benefit investment priorities described in the hospital's current community benefit implementation plan within one year after the fine is imposed. Each reporting hospital shall report on how the money collected through fines is expended in the reporting hospital's annual report to the state department pursuant to section 25.5-1-703.

(3) The state board shall promulgate any rules necessary for the implementation of this section.
C.R.S. § 25.5-6-1204 — CO Code / Title 25.5 / Article 6 / Part 12 / Section 25.5-6-1204
25.5-6-1204. Provision of services - duties of state department - gifts - grants
Status: in_force

25.5-6-1204. Provision of services - duties of state department - gifts - grants. (1) The provision of the in-home support services set forth in this part 12 shall be subject to the availability of federal matching medicaid funds, pursuant to Title XIX of the federal "Social Security Act", as amended, for payment of the costs for administration and the costs for the provision of such services.

(2) The state department shall seek and utilize any available federal, state, or private funds that are available for carrying out the purposes of this part 12, including but not limited to medicaid funds, pursuant to Title XIX of the federal "Social Security Act", as amended.

(3) The executive director of the state department is authorized to accept and expend on behalf of the state any grants or gifts from any public or private source for the purpose of implementing this part 12.
C.R.S. § 25.5-5-330 — CO Code / Title 25.5 / Article 5 / Part 3 / Section 25.5-5-330
25.5-5-330. Screening for perinatal mood and anxiety disorder
Status: in_force

25.5-5-330. Screening for perinatal mood and anxiety disorder. (1) For the caregiver of each child enrolled in the medical assistance program in the state, the program must include screening for perinatal mood and anxiety disorders in accordance with the health resources and services administration guidelines.

(2) The screening must be made available to the caregiver of each child enrolled in the medical assistance program, regardless of whether the caregiver is enrolled in the medical assistance program, so long as the caregiver's child is enrolled in the medical assistance program.
C.R.S. § 25.5-3-104 — CO Code / Title 25.5 / Article 3 / Part 1 / Section 25.5-3-104
25.5-3-104. Program for the medically indigent established - eligibility - rules
Status: in_force

25.5-3-104. Program for the medically indigent established - eligibility - rules. (1) A program for the medically indigent is hereby established, to commence July 1, 1983, which shall be administered by the state department, to provide payment to providers for the provision of medical services to eligible persons who are medically indigent. The state board may promulgate rules as are necessary for the implementation of this part 1 in accordance with article 4 of title 24, C.R.S.

(2) A person's eligibility to receive discounted services under the program for the medically indigent is determined by rule of the state board based on a specified percentage of the federal poverty line, adjusted for family size, which percentage must not be less than two hundred fifty percent.

(3) No later than June 1, 2022, for providers defined as hospital providers in 10 CCR 2505-10, sec. 8.901.J, the state department shall promulgate rules:

(a) Prohibiting hospitals from considering assets when determining whether a patient meets the specified percentage of the federal poverty line required in subsection (2) of this section; and

(b) Ensuring the method used to determine whether a patient meets the specified percentage of the federal poverty line is uniform across hospitals and aligned with the method for counting income for the purposes of determining eligibility for discounted care, as described in section 25.5-3-503.
C.R.S. § 25.5-4-501 — CO Code / Title 25.5 / Article 4 / Part 5 / Section 25.5-4-501
25.5-4-501. State plan amendment - federal authorization - repeal
Status: repealed

25.5-4-501. State plan amendment - federal authorization - repeal. (Repealed)
C.R.S. § 25.5-10-203 — CO Code / Title 25.5 / Article 10 / Part 2 / Section 25.5-10-203
25.5-10-203. Division of intellectual and developmental disabilities - creation - functions -
Status: repealed

25.5-10-203. Division of intellectual and developmental disabilities - creation - functions - reporting - legislative declaration. (1) (a) The general assembly finds and declares that:

(I) An effective system of community-based services and supports is essential to enable children and adults with intellectual and developmental disabilities to live in their communities;

(II) The demand for high-quality intellectual and developmental disabilities services is expected to grow; and

(III) Persons with intellectual and developmental disabilities need a system that promotes self-direction of services and self-determination and that is designed to improve personal outcomes.

(b) (I) The general assembly further finds and declares that state agencies should be organized in a manner that allows for improved delivery of long-term services and supports for persons and providers; and

(II) The transfer pursuant to part 1 of this article of the powers, duties, and functions relating to the programs, services, and supports for persons with intellectual and developmental disabilities to the office for administration by the division of intellectual and developmental disabilities, created in this section, is an initial step in the process of redesigning Colorado's long-term care system.

(2) There is created in the office the division of intellectual and developmental disabilities. The division is a type 2 entity, as defined in section 24-1-105.

(3) The division shall administer the programs, services, and supports for persons with intellectual and developmental disabilities contained in this article.

(4) Because of the unique goal of the division in administering lifelong programs, services, and supports for persons with intellectual and developmental disabilities, as part of its annual briefing to the joint budget committee, the state department shall allow sufficient briefing time devoted solely to issues relating to the division and its administration of the programs, services, and supports contained in this article.

(5) Repealed.
C.R.S. § 25.5-10-224 — CO Code / Title 25.5 / Article 10 / Part 2 / Section 25.5-10-224
25.5-10-224. Right to fair employment practices
Status: in_force

25.5-10-224. Right to fair employment practices. (1) No person receiving services shall be required to perform labor; except that persons receiving services may voluntarily engage in such labor if the labor is compensated in accordance with applicable minimum wage laws.

(2) No person receiving services shall be involved in the physical care, care and treatment, training, or supervision of other persons receiving services unless such person has volunteered, has been specifically trained in the necessary skills, and has the judgment required for such activities, is adequately supervised, and is reimbursed in accordance with the applicable minimum wage laws.

(3) Each person receiving services may perform vocational training tasks, subject to a presumption that an assignment longer than three months to any task is not a training task, if the specific task or any change in task assignment is an integral part of such person's individualized plan. If such person performs vocational training tasks for which the service agency is receiving compensation from any outside source, the person shall be compensated in accordance with the applicable minimum wage laws.

(4) Each person receiving services may voluntarily engage in labor for which the service agency would otherwise have to pay an employee if the specific labor or any change in labor is an integral part of such person's individualized plan and the person is compensated in accordance with the applicable minimum wage laws.

(5) Each person receiving services may be required to perform tasks of a personal housekeeping nature or tasks oriented to improving community living skills in accordance with the person's individualized plan.

(6) Payment to persons receiving services pursuant to this section shall not be collected by the service agency to offset the costs of providing services and supports to such person.
C.R.S. § 25.5-5-309 — CO Code / Title 25.5 / Article 5 / Part 3 / Section 25.5-5-309
25.5-5-309. Pregnant women - needs assessment - referral to treatment program - definition
Status: in_force

25.5-5-309. Pregnant women - needs assessment - referral to treatment program - definition. (1) The health-care practitioner for each pregnant woman who is enrolled or eligible for services pursuant to section 25.5-5-101 (1)(c) or 25.5-5-201 (1)(m.5) is encouraged to identify as soon as possible after the woman is determined to be pregnant whether the woman is at risk of a poor birth outcome due to substance use during the prenatal period and in need of special assistance in order to reduce the risk. If the health-care practitioner makes such determination regarding any pregnant woman, the health-care practitioner is encouraged to refer the woman to any entity approved and licensed by the behavioral health administration in the department of human services for the performance of a needs assessment. Any county department of human or social services may refer an eligible woman for a needs assessment, or any pregnant woman who is eligible for services pursuant to section 25.5-5-201 (1)(m.5) may refer herself for a needs assessment.

(2) For the purposes of this section, unless the context otherwise requires, a "needs assessment" means an assessment that is designed to determine the services that are needed for a pregnant woman to minimize the occurrence of a poor birth outcome due to substance use by the pregnant woman.
C.R.S. § 25.5-10-212 — CO Code / Title 25.5 / Article 10 / Part 2 / Section 25.5-10-212
25.5-10-212. Procedure for resolving disputes over eligibility, modification of services or s
Status: in_force

25.5-10-212. Procedure for resolving disputes over eligibility, modification of services or supports, and termination of services or supports. (1) Every state or local service agency receiving state money pursuant to section 25.5-10-206 shall adopt a procedure for the resolution of disputes arising between the service agency and any member of, or applicant for, services or supports authorized pursuant to section 25.5-10-206. Procedures for the resolution of disputes regarding early intervention services must comply with IDEA and with part 4 of article 3 of title 26.5. The procedures must be consistent with rules promulgated by the state board pursuant to article 4 of title 24 and must apply to the following disputes:

(a) A contested decision that the applicant is not eligible for services or supports;

(b) A contested decision to provide, modify, reduce, or deny services or supports set forth in the individualized plan or individualized family service plan of the person receiving services;

(c) A contested decision to terminate services or supports;

(d) A contested decision that the person receiving services is no longer eligible for services or supports.

(2) The state board shall promulgate rules pursuant to article 4 of title 24, C.R.S., setting forth procedures for the resolution of disputes specified in subsection (1) of this section that must:

(a) Require that all applicants for services and supports and the parents or guardian of a minor, the guardian, or an authorized representative be informed orally and in writing, in their native language, of the dispute resolution procedures at the time of application, at the time the individualized plan is developed, and any time changes in the plan are contemplated;

(b) Require that a service agency keep a written record of all proceedings specified pursuant to this section;

(c) Require that no person receiving services be terminated from such services or supports during the resolution process;

(d) Require that utilizing the dispute resolution procedure must not prejudice the future provision of appropriate services or supports to persons; and

(e) Require that the intended action not occur until after reasonable notice has been provided to the person, the parents or guardian of a minor, the guardian, or an authorized representative, along with an opportunity to utilize the resolution process, except in emergency situations, as determined by the state department.

(3) The resolution process need not conform to the requirements of section 24-4-105, C.R.S., as long as the rules adopted by the state board include provisions specifically setting forth procedures, time frames, notice, an opportunity to be heard and to present evidence, and the opportunity for impartial review of the decision in dispute by the executive director or designee, if the resolution process has failed.
C.R.S. § 25.5-1-109.5 — CO Code / Title 25.5 / Article 1 / Part 1 / Section 25.5-1-109.5
25.5-1-109.5. Clinical standards - development
Status: repealed

25.5-1-109.5. Clinical standards - development. (1) The general assembly finds that:

(a) It is important to collect and analyze objective clinical standards to maximize the scarce dollars available for medical care; and

(b) The development of an ongoing, transparent measurement of health outcomes is essential to ensure quality health care for Coloradans.

(2) (a) The state department, following consultation with external clinical advisors, shall develop clinical standards and methods for collecting, analyzing, and disclosing information regarding clinical performance, including but not limited to immunization rates, medical home standards, clinical care guidelines, care coordination, case management, disease management, and coordination and integration of mental health services. The standards and methods shall be consistent with national guidelines and standards regarding the collection and analysis of health data, where feasible, and shall meet the federal reporting requirements established under Titles XIX and XXI of the federal "Social Security Act", 42 U.S.C. secs. 1396 and 1397.

(b) Repealed.
C.R.S. § 25.5-10-402 — CO Code / Title 25.5 / Article 10 / Part 4 / Section 25.5-10-402
25.5-10-402. Colorado family support loan fund - creation - loans to families - repeal
Status: repealed

25.5-10-402. Colorado family support loan fund - creation - loans to families - repeal. (Repealed)
C.R.S. § 25.5-6-103 — CO Code / Title 25.5 / Article 6 / Part 1 / Section 25.5-6-103
25.5-6-103. Court-approved trusts - transfer of property for persons seeking medical assista
Status: in_force

25.5-6-103. Court-approved trusts - transfer of property for persons seeking medical assistance - rule-making authority for trusts created on or after July 1, 1994 - undue hardship. (1) The state board shall adopt such rules as are necessary with respect to trusts established pursuant to sections 15-14-412.6 to 15-14-412.9. The state board shall adopt rules that address, but need not be limited to, the following:

(a) The definition, including any limitations, of permissible distributions from trusts, taking federal guidelines into consideration;

(b) Reasonable financial reimbursement or incentives to the state department, county departments of human or social services, and any other designated agencies for the efforts and expenses in monitoring trusts, and where necessary, for the recovery of trust property that has been improperly distributed or otherwise expended.

(2) The state board shall comply with Title XIX of the federal "Social Security Act", 42 U.S.C. sec. 1396p (d)(5), as amended, which requires the state medicaid agency to establish procedures, in accordance with standards specified by the secretary of the United States department of health and human services, under which the state medicaid agency may waive the application of the general rules for considering trust property in determining eligibility for medical assistance if the applicant for medical assistance establishes that the application of the general rules would work an undue hardship on the individual.

(3) The state department shall determine the feasibility of providing ongoing support of dependents by using the trust corpus during the life of the person for whom a trust is created or using the remainder of the trust after the death of the person for whom the trust was created. If the state department determines that it is feasible to provide that support, the state department shall seek a waiver from the federal government to permit the use of trust property for that purpose.
C.R.S. § 25.5-4-416 — CO Code / Title 25.5 / Article 4 / Part 4 / Section 25.5-4-416
25.5-4-416. Providers - medical equipment and supplies - requirements
Status: in_force

25.5-4-416. Providers - medical equipment and supplies - requirements. (1) As used in this section, unless the context otherwise requires, "provider" means a person or entity that delivers disposable medical supplies or durable medical equipment products or services directly to a member.

(2) On and after January 1, 2007, the state board rules for the payment for disposable medical supplies and durable medical equipment, including but not limited to prosthetic and orthotic devices, shall prohibit a provider from being reimbursed unless the provider:

(a) (I) Has one or more physical locations within the state of Colorado or within fifty miles of a border of Colorado with a street address, a local business telephone number, an inventory, and a sufficient staff to service or repair products; except that the requirements of this paragraph (a) shall not apply to durable medical equipment or disposable medical supplies that are medically necessary and cannot be purchased from a provider meeting the requirements of this paragraph (a);

(II) Complies with all state and local licensing, insurance, and regulatory requirements for operating the provider's business;

(III) Is responsible for the delivery of and instructing the member on the proper use of the equipment; and

(IV) Provides repairs, replacements, or adjustments to the provider's products pursuant to rules of the state board; or

(b) Contracts with a provider who meets the criteria established in paragraph (a) of this subsection (2).

(3) The provisions of this section shall apply to fee-for-service and primary care physician program recipients.
C.R.S. § 25.5-6-1301 — CO Code / Title 25.5 / Article 6 / Part 13 / Section 25.5-6-1301
25.5-6-1301. Legislative declaration
Status: in_force

25.5-6-1301. Legislative declaration. (1) The general assembly finds that:

(a) A person with a spinal cord injury could benefit from complementary and alternative medicine such as chiropractic care, massage therapy, or acupuncture; and

(b) Complementary and alternative medicine could improve the quality of life and help reduce the need for continuous or more expensive procedures, medications, and hospitalizations for a person with a spinal cord injury and could allow a person with a spinal cord injury to be employed.
C.R.S. § 25.5-6-1901 — CO Code / Title 25.5 / Article 6 / Part 19 / Section 25.5-6-1901
25.5-6-1901. Definitions
Status: in_force

25.5-6-1901. Definitions. As used in this part 19, unless the context otherwise requires:

(1) "Electronic monitoring" means the installation, purchase, or rental of electronic monitoring devices that enable an individual to secure help in the event of an emergency; provide the individual reminders about medical appointments, treatment, or medication schedules; are required because of the individual's illness, impairment, or disability; and include personal emergency response systems and medication reminders through an automated medication dispensing system.

(2) "Health maintenance activities" means routine and repetitive health-related tasks furnished to a member in the community or in the member's home that are necessary for the health and normal bodily functioning that a person with a disability is physically unable to carry out. "Health maintenance activities" includes skilled tasks typically performed by a certified nursing assistant or a licensed nurse that do not require the clinical assessment and judgment of a licensed nurse.

(3) "Homemaker services" means general household activities provided by an attendant in a member's home to maintain a healthy and safe environment for the member through hands-on assistance, supervision, or cueing. "Homemaker services" must only be provided in the member's primary living space and multiple attendants shall not be reimbursed for duplicating such services.

(4) "Personal care services" means services that are furnished to a member to meet the member's physical, maintenance, and supportive needs through hands-on assistance, supervision, or cueing that do not require a nurse's supervision or physician's order.
C.R.S. § 25.5-5-205 — CO Code / Title 25.5 / Article 5 / Part 2 / Section 25.5-5-205
25.5-5-205. Baby and kid care program - creation - eligibility
Status: repealed

25.5-5-205. Baby and kid care program - creation - eligibility. (Repealed)
C.R.S. § 25.5-6-1302 — CO Code / Title 25.5 / Article 6 / Part 13 / Section 25.5-6-1302
25.5-6-1302. Definitions
Status: in_force

25.5-6-1302. Definitions. As used in this part 13, unless the context otherwise requires:

(1) "Complementary or alternative medicine" means a form of diverse health-care services not provided for under this article or article 4 or 5 of this title prior to August 5, 2009, but authorized by the rules of the state board adopted pursuant to section 25.5-6-1303 (4). The medicine is limited to chiropractic care, massage therapy, and acupuncture performed by licensed or certified providers.

(2) "Eligible person with a disability" means a person with a disability who meets the eligibility criteria specified in section 25.5-6-1303 (2)(b).

(3) "Pilot program" means the pilot program authorized pursuant to section 25.5-6-1303 to allow an eligible person with a disability to receive complementary and alternative medicine.
C.R.S. § 25.5-6-1902 — CO Code / Title 25.5 / Article 6 / Part 19 / Section 25.5-6-1902
25.5-6-1902. Community first choice option - covered services - state plan amendment
Status: in_force

25.5-6-1902. Community first choice option - covered services - state plan amendment. (1) No later than July 1, 2025, the state department shall seek federal authorization through an amendment to the state medical assistance plan to implement the community first choice option.

(2) At a minimum, the state plan amendment must provide for, but is not limited to:

(a) The following services:

(I) Personal care services;

(II) Homemaker services;

(III) Health maintenance activities;

(IV) Electronic monitoring services; and

(V) Voluntary training on how to select, manage, and dismiss an attendant; and

(b) The delivery of covered services, if applicable, through:

(I) In-home support services;

(II) Consumer-directed services and supports; and

(III) Licensed home care services.
C.R.S. § 25.5-3-401 — CO Code / Title 25.5 / Article 3 / Part 4 / Section 25.5-3-401
25.5-3-401. Short title
Status: in_force

25.5-3-401. Short title. This part 4 is known as and may be cited as the "Colorado Dental Health Care Program for Low-income Seniors".
C.R.S. § 25.5-6-901 — CO Code / Title 25.5 / Article 6 / Part 9 / Section 25.5-6-901
25.5-6-901. Disabled children care program - eligibility criteria - documentation requiremen
Status: in_force

25.5-6-901. Disabled children care program - eligibility criteria - documentation requirements - report to the general assembly. (1) The general assembly hereby finds and declares that a program shall be established by the state department to provide services not otherwise available to eligible disabled children outside the confines of an acute care hospital or nursing facility. Such program shall be known as the "disabled children care program" and shall be designed to safely provide services to eligible disabled children in a home- or community-based setting at a cost to the medicaid program equal to or less than the medicaid cost of inpatient hospital or nursing facility care.

(2) (a) The state department is authorized to seek a waiver from the federal department of health and human services to qualify for federal financial participation in the disabled children care program. Application for such waiver is contingent upon a finding that continuation of the disabled children care program results in less expenditures from the general fund than if such program were terminated.

(b) If federal financial participation is secured, eligibility for participation in the program and the number of children to be served under the program shall be in accordance with federal regulations.

(3) (a) "Eligible disabled children" means any children eighteen years of age and under who:

(I) Have medical needs which would qualify them, pursuant to state department criteria, for institutionalization or place them at risk for institutionalization in any one of the following: An acute care hospital or a nursing facility; and

(II) Have gross incomes which do not exceed three hundred percent of the current federal supplemental security income benefit level. The amount of parental or spousal income and resources which shall be attributable to a child's gross income for purposes of eligibility shall be set forth in rules promulgated by the state board and shall be in relation to the parent's or spouse's financial responsibility for such child; and

(III) Are not receiving services from any of the alternatives to long-term care waiver programs established under this title.

(b) "Home care services" means all services available under sections 25.5-5-102, 25.5-5-103, 25.5-5-202, and 25.5-5-203 that may be received in a noninstitutional setting.

(4) (a) The state department shall require the following documentation on each applicant for the program:

(I) An assessment by the disabled child's attending physician of the child's medical, functional, and social status and a determination by such physician that the quality of care which can be provided in the noninstitutional setting is equal to or exceeds the quality of care the child could receive in an acute care hospital or nursing facility;

(II) An analysis of the cost of services for the disabled child in an institutional setting as compared to the cost of such services in a noninstitutional setting;

(III) An assessment of the caregiver's ability to provide the needed services to the disabled child in a noninstitutional setting and an assessment of such caregiver's social history.

(b) The information required under paragraph (a) of this subsection (4) shall be collected and reviewed by the state department at least every six months for disabled children who enter the disabled children care program in order to ensure that the quality of noninstitutional care continues to equal or exceed such care in an institutional setting and that the costs for care under the program are less than the costs for such care in an institution. When the disabled child is found to no longer qualify for institutionalization or be at risk for institutionalization pursuant to state department criteria, the child shall no longer be eligible for the disabled children care program.
C.R.S. § 25.5-4-427 — CO Code / Title 25.5 / Article 4 / Part 4 / Section 25.5-4-427
25.5-4-427. State payment to the Denver health and hospital authority
Status: in_force

25.5-4-427. State payment to the Denver health and hospital authority. (1) The state department shall distribute money appropriated for a payment to the Denver health and hospital authority created in section 25-29-103.

(2) (Deleted by amendment, L. 2024.)
C.R.S. § 25.5-6-602 — CO Code / Title 25.5 / Article 6 / Part 6 / Section 25.5-6-602
25.5-6-602. Legislative declaration - no entitlement created
Status: in_force

25.5-6-602. Legislative declaration - no entitlement created. (1) The general assembly finds and declares that the purpose of this part 6 is to provide, under federal authorization and subject to available appropriations, home- and community-based services for persons with major mental health disorders.

(2) Nothing in this part 6 shall be construed to establish that eligible persons as defined in section 25.5-6-603 (1) are entitled to receive services from the state department or the department of human services. The provision of any services pursuant to this part 6 shall be subject to federal waiver authorization and available appropriations.
C.R.S. § 25.5-6-1605 — CO Code / Title 25.5 / Article 6 / Part 16 / Section 25.5-6-1605
25.5-6-1605. Exemptions
Status: in_force

25.5-6-1605. Exemptions. (1) Notwithstanding any provision of this part 16 to the contrary, this part 16 does not apply to services provided under:

(a) The consumer-directed attendant support services model; or

(b) The pediatric personal care benefit.
C.R.S. § 25.5-5-101 — CO Code / Title 25.5 / Article 5 / Part 1 / Section 25.5-5-101
25.5-5-101. Mandatory provisions - eligible groups - rules - repeal
Status: repealed

25.5-5-101. Mandatory provisions - eligible groups - rules - repeal. (1) In order to participate in the medicaid program, the federal government requires the state to provide medical assistance to certain eligible groups. Pursuant to federal law and except as provided in subsection (2) of this section, any person who is eligible for medical assistance under the mandated groups specified in this section must receive both the mandatory services that are specified in sections 25.5-5-102 and 25.5-5-103 and the optional services that are specified in sections 25.5-5-202 and 25.5-5-203. Subject to the availability of federal financial participation, the following are the individuals or groups that are mandated under federal law to receive benefits under this article 5 and articles 4 and 6 of this title 25.5:

(a) Repealed.

(b) Parents and caretaker relatives living with a dependent child who meet the eligibility criteria pursuant to section 1902 (a)(10)(A) of the federal "Social Security Act", including those who subsequently would have become ineligible under such eligibility criteria because of increased earnings or increased hours of employment whose eligibility is specified for a period of time by the federal government;

(c) Pregnant women whose family income does not exceed one hundred thirty-three percent of the federal poverty line, adjusted for family size, who meet the requirements pursuant to section 1902 (a)(10)(A) of the federal "Social Security Act". Once initial eligibility has been established, the pregnant woman is continuously eligible throughout the pregnancy and for the sixty days following the pregnancy, even if the woman's eligibility would otherwise terminate during such period due to an increase in income.

(d) A newborn child born of a woman who is categorically needy. Such child is deemed medicaid-eligible on the date of birth and remains eligible for one year.

(e) Children for whom adoption assistance or foster care maintenance payments are made under Title IV-E of the federal "Social Security Act", as amended, including foster care children, pursuant to section 1902 (a)(10)(A)(i)(IX) of the federal "Social Security Act", who are under twenty-six years of age, who were in foster care under the responsibility of the state or a tribe, and who were enrolled in medicaid under the state medicaid plan when they turned eighteen years of age;

(f) Individuals receiving supplemental security income;

(g) Individuals receiving mandatory state supplement, including but not limited to individuals receiving old age pensions;

(h) Institutionalized individuals who were eligible for medical assistance in December 1973;

(i) Individuals who would be eligible except for the increase in old-age, survivors, and disability insurance under Pub.L. 92-336;

(j) Individuals who become ineligible for cash assistance as a result of old-age, survivors, and disability insurance cost-of-living increases after April 1977;

(k) Disabled widows or widowers fifty through sixty years of age who have become ineligible for federal supplemental security income or state supplementation as a result of becoming eligible for federal social security survivor's benefits, in accordance with the social security act, 42 U.S.C. sec. 1383c;

(l) Individuals with income and resources at a level which qualifies them as medicare-eligible under section 301 of Title III of the federal "Medicare Catastrophic Coverage Act";

(m) Children under the age of nineteen who meet the eligibility criteria pursuant to section 1902 (a)(10)(A) of the federal "Social Security Act".

(2) (a) A qualified alien who entered the United States before August 22, 1996, who meets the exceptions described in the federal "Personal Responsibility and Work Opportunity Reconciliation Act of 1996", Public Law 104-193, as amended, shall receive benefits under this article and articles 4 and 6 of this title.

(b) (I) A qualified alien who entered the United States on or after August 22, 1996, shall not be eligible for benefits under this article or article 4 or 6 of this title, except as provided in section 25.5-5-103 (3), for five years after the date of entry into the United States unless he or she meets the exceptions described in the federal "Personal Responsibility and Work Opportunity Reconciliation Act of 1996", Public Law 104-193, as amended.

(II) Notwithstanding the five-year waiting period established in subparagraph (I) of this paragraph (b), but subject to the availability of sufficient appropriations and the receipt of federal financial participation, the state department may provide benefits under this article and articles 4 and 6 of this title to a pregnant woman who is a qualified alien and a child under nineteen years of age who is a qualified alien so long as such woman or child meets eligibility criteria other than citizenship.

(3) Repealed.

(4) An asset test shall not be applied as a condition of eligibility for individuals or families described in paragraphs (b), (c), (d), and (e) of subsection (1) of this section.

(5) The county departments responsible for administering benefits programs under the department of health care policy and financing and the department of human services shall identify and review all current county guidance materials, including forms, training materials, websites, and any other materials that reference a prohibition on sponsorship as a condition of eligibility for benefits and shall remove all such references from verbal and digital communications and from all physical materials currently provided to applicants or beneficiaries.

(6) (a) To ensure that the state department maintains access to state and federal funding provided by the federal "Families First Coronavirus Response Act", Pub.L. 116-127, and the federal "Consolidated Appropriations Act, 2023", the following subsections of this section are suspended until January 1, 2025:

(I) Subsection (1)(c) of this section requiring the state department to disenroll a woman receiving medical assistance sixty days following the woman's pregnancy;

(II) Subsection (1)(d) of this section requiring the state department to disenroll a child at one year of age who was eligible to receive medical assistance at birth;

(III) Subsection (1)(e) of this section requiring the state department to disenroll former foster care children; and

(IV) Any other provision of this section that requires the state department to disenroll an individual receiving medical assistance prior to the state department processing the individual's next annual renewal for eligibility following the end of the continuous enrollment requirements implemented pursuant to the federal "Families First Coronavirus Response Act", Pub.L. 116-127, and the federal "Consolidated Appropriations Act, 2023".

(b) The state board may adopt rules to implement this subsection (6) to ensure that the state department can resume routine operations that follow guidance issued by the federal centers for medicare and medicaid services, including terminations of eligibility, the processing of eligibility renewals, and the transition between medical assistance and children's basic health plan eligibility categories.

(c) This subsection (6) is repealed, effective January 1, 2025.
C.R.S. § 25.5-5-311 — CO Code / Title 25.5 / Article 5 / Part 3 / Section 25.5-5-311
25.5-5-311. Treatment program for high-risk pregnant and parenting women - data collection
Status: in_force

25.5-5-311. Treatment program for high-risk pregnant and parenting women - data collection. The state department, in cooperation with the behavioral health administration in the department of human services, shall create a data collection mechanism regarding persons receiving services pursuant to the treatment program for high-risk pregnant and parenting women that includes the collection of any data that the state department and behavioral health administration in the department of human services deem appropriate.
C.R.S. § 25.5-6-605 — CO Code / Title 25.5 / Article 6 / Part 6 / Section 25.5-6-605
25.5-6-605. Relationship to single entry point for long-term care - repeal
Status: repealed

25.5-6-605. Relationship to single entry point for long-term care - repeal. (Repealed)