2023 Colorado Revised Statutes › Title 25.5 - HEALTH CARE POLICY AND FINANCING (§§ 25.5-1-101 — 25.5-11-101) › COLORADO MEDICAL ASSISTANCE ACT (§§ 25.5-4-101 — 25.5-6-2001) › Article 6 - COLORADO MEDICAL ASSISTANCE ACT - LONG-TERM CARE (§§ 25.5-6-101 — 25.5-6-2001) › Part 13 - COMPLEMENTARY AND ALTERNATIVE MEDICINE FOR A PERSON WITH A SPINAL CORD INJURY (§§ 25.5-6-1301 — 25.5-6-1304) › Section 25.5-6-1303 - [Effective 8/7/2024] Pilot program - complementary or alternative medicine - rules

(1)
(a)
The general assembly authorizes the state department to implement a pilot program that would allow an eligible person with a disability to receive complementary or alternative medicine to the extent authorized by federal waiver. The pilot program may begin no later than January 1, 2012. The state department shall design and implement the pilot program with input from an advisory committee that must include, but need not be limited to, persons with spinal cord injuries who are receiving complementary or alternative medicine. The state department may seek any federal waivers that may be necessary to implement this part 13.
(b)
Subject to available funds, it is the intent of the general assembly that the state department enroll every eligible person that applies for the waiver and that an eligible person is not placed on a waiting list for services.
(2)
(a)
The purpose of the pilot program is to expand the choice of therapies available to eligible persons with disabilities, to study the success of complementary and alternative medicine, and to produce an overall cost savings for the state compared to the estimated expenditures that would have otherwise been spent for the same persons with spinal cord injuries absent the pilot program.
(b)
In order to qualify and to remain eligible for the pilot program authorized by this section, a person shall:
(I)
Be diagnosed with a primary condition of a spinal cord injury, multiple sclerosis, a brain injury, spina bifida, muscular dystrophy, or cerebral palsy, with the total inability for independent ambulation directly resulting from one of these diagnoses;
(II)
Be willing to participate in the pilot program;
(III)
Demonstrate a current need, as further defined in rule by the state board, for complementary or alternative medicine; and
(IV)
Be eligible for medicaid, including but not limited to persons who meet the functional level of care and financial criteria described in rules promulgated by the state board relating to long-term care services.
(c)
The state department shall implement subsection (2)(b) of this section no later than July 1, 2022.
(d)
The pilot program is available to all eligible individuals in Colorado.
(3)
The state department shall develop the accountability requirements for the pilot program necessary to safeguard the use of public moneys and to promote effective and efficient service delivery.
(4)
The state board shall adopt rules as necessary for the implementation and administration of the pilot program.
(5)
The state department shall cause to be conducted an independent evaluation of the pilot program to be completed no later than January 1, 2025. The state department shall provide a report of the evaluation to the health and human services committee of the senate and the public health care and human services committee of the house of representatives, or any successor committees. The report on the evaluation must include the following:
(a)
The number of eligible persons with disabilities participating in the pilot program;
(b)
The cost-effectiveness of the pilot program;
(c)
Feedback from members and the state department concerning the progress and success of the pilot program;
(d)
Any changes to the health status or health outcomes of the persons participating in the pilot program;
(e)
Other information relevant to the success and problems of the pilot program; and
(f)
Recommendations concerning the feasibility of continuing the pilot program beyond the pilot stage and changes, if any, that are needed.
(6)
Repealed.
(7)
Unless the state department receives sufficient appropriations, the state department is not required to seek federal approval or implement the pilot program.
(8)
(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)
,
25.5-6-409 (6)
,
25.5-6-606 (9)
, and
25.5-6-704 (8)
.
(c)
(I)
Upon completion of the report described in subsection (8)(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 (8)(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 (8)(c), "verify" means a transportation network company meets all requirements resulting from the report described in subsection (8)(a) of this section.
(d)
The state department may seek any necessary federal authorization for the implementation of this subsection (8).
(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 (8)(e).
(f)
This subsection (8) 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.
Amended by 2024 Ch. 152,§ 93, eff. 8/7/2024.
Amended by 2022 Ch. 396, § 6, eff. 8/10/2022.
Amended by 2021 Ch. 404, § 1, eff. 9/7/2021.
Amended by 2019 Ch. 335, § 1, eff. 5/29/2019.
Amended by 2015 Ch. 333, § 3, eff. 6/5/2015.
L. 2009: Entire part added, (HB 09-1047), ch. 2129, p. 2129, § 1, effective August 5. L. 2015: (1), (2)(a), (2)(b)(III), (5), and (7) amended and (6) repealed, (SB 15-011), ch. 333, p. 1355, § 3, effective June 5. L. 2019: IP(5) amended, (SB 19-197), ch. 3089, p. 3089, § 1, effective May 29. L. 2021: (1)(a) and (2)(b) amended and (2)(c) and (2)(d) added, (SB 21-038), ch. 2684, p. 2684, § 1, effective September 7.
2024 Ch. 152, was passed without a safety clause. See Colo. Const. art. V, § 1(3).
2022 Ch. 396, was passed without a safety clause. See Colo. Const. art. V, § 1(3).
2021 Ch. 404, was passed without a safety clause. See Colo. Const. art. V, § 1(3).
This section is set out more than once due to postponed, multiple, or conflicting amendments.