2023 Colorado Revised Statutes › Title 25.5 - HEALTH CARE POLICY AND FINANCING (§§ 25.5-1-101 — 25.5-11-101) › ADMINISTRATION (§§ 25.5-1-101 — 25.5-2-105) › Article 1 - DEPARTMENT OF HEALTH CARE POLICY AND FINANCING (§§ 25.5-1-101 — 25.5-1-1001) › Part 1 - GENERAL PROVISIONS (§§ 25.5-1-101 — 25.5-1-134) › Section 25.5-1-128 - [Effective 7/1/2025] Provider payments - compliance with state fiscal requirements - rules - definitions

(1)
(a)
Notwithstanding any provision of law to the contrary, when the state department has regulatory authority over a program and when the provider has already signed a state department-approved provider application to provide a service or to bill the state department or its authorized contractor for a service, the state department-approved provider application shall serve to fulfill the requirements of a commitment voucher and the fiscal requirements of section
24-30-202 (1)
, C.R.S.
(b)
The executive director may promulgate rules to exempt a provider who provides services through a program as described in subsection (1)(a) of this section for any program the state department is authorized by law to administer, including, but not limited to:
(I)
The "Colorado Medical Assistance Act", articles
4
to 6 of this title;
(II)
The "Children's Basic Health Plan Act", article
8
of this title;
(III)
[Repealed by 2024 amendment.]
(IV)
The school health services program authorized by section
25.5-5-318
;
(V)
Programs that are funded through the primary care fund, created in section
24-22-117 (2)(b)
, C.R.S.; and
(VI)
The state-funded old age pension health and medical care program pursuant to article
2
of this title.
(1.5)
The state department shall maintain a list of enrolled school-based health centers and school-linked health-care services providers. The state department shall develop the list based on grant enrollment data pursuant to section 25-20.5-503 that is provided to the state department by the department of public health and environment. The state department shall establish a process for identifying claims for services provided in these settings.
(2)
As used in this section, unless the context otherwise requires, "provider" means a health-care provider; a mental health-care provider; a pharmacist; a home health agency; a general hospital, birth center, or community 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; a school district as defined in section
25.5-5-318 (1)(a)
; or any other entity that provides health care, health-care coordination, outreach, enrollment, or administrative support services to members through fee-for-service, , a managed care entity, a behavioral health organization, a medical home, or any system of care that coordinates health care or services as defined and authorized through rules promulgated by the state board or by the executive director.
Amended by 2024 Ch. 404,§ 4, eff. 8/7/2024.
Amended by 2024 Ch. 152,§ 8, eff. 8/7/2024.
Amended by 2024 Ch. 76,§ 21, eff. 7/1/2025.
L. 2012: Entire section added, (HB 12-1054), ch. 14, p. 36, § 1, effective March 15.
2024 Ch. 404, was passed without a safety clause. See Colo. Const. art. V, § 1(3).
2024 Ch. 152, was passed without a safety clause. See Colo. Const. art. V, § 1(3).
2024 Ch. 76, 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.