reglab/statecodes huggingface dataset:
2023 Colorado Revised Statutes › Title 25.5 - HEALTH CARE POLICY AND FINANCING (§§ 25.5-1-101 — 25.5-11-101) › INDIGENT CARE (§§ 25.5-3-101 — 25.5-3-507) › Article 3 - INDIGENT CARE (§§ 25.5-3-101 — 25.5-3-507) › Part 5 - HEALTH-CARE BILLING FOR INDIGENT PATIENTS RECEIVING SERVICES NOT REIMBURSED THROUGH THE COLORADO INDIGENT CARE PROGRAM (§§ 25.5-3-501 — 25.5-3-507) › Section 25.5-3-502 - [Effective 7/1/2025] Requirement to screen patients for eligibility for public health-care programs and discounted care - rules

(1)
Beginning September 1, 2022, a health-care facility shall screen, unless a patient declines, each uninsured patient for eligibility for:
(a)
Public health insurance programs including but not limited to medicare; the state medical assistance program, articles
4
, 5, and 6 of this title 25.5; emergency medicaid; and the children's basic health plan, article
8
of this title 25.5; and
(b)
[Repealed by 2024 amendment.]
(c)
Discounted care, as described in section
25.5-3-503
.
(2)
Health-care facilities shall use a single uniform application developed by the state department when screening a patient pursuant to subsection (1) of this section.
(3)
If a health-care facility determines that a patient is ineligible for discounted care, the facility shall provide the patient notice of the determination and an opportunity for the patient to appeal the determination in accordance with state department rules.
(4)
If the patient declines the screening described in subsection (1) of this section, the health-care facility shall document the patient's decision in accordance with state department rules. A patient's decision to decline the screening that is documented and complies with state department rules is a complete defense to a claim brought by a patient under section
25.5-3-506 (2)
for a violation of section
25.5-3-506 (1)(a) or (1)(b)
.
(5)
If requested by the patient, a health-care facility shall screen an insured patient for discounted care pursuant to subsections (1)(b) and (1)(c) of this section.
Amended by 2024 Ch. 76,§ 25, eff. 7/1/2025.
Amended by 2022 Ch. 203, § 1, eff. 5/20/2022.
Added by 2021 Ch. 435, § 1, eff. 9/7/2021.
L. 2021: Entire part added, (HB 21-1198), ch. 2875, p. 2875, §1, effective September 7.
2024 Ch. 76, was passed without a safety clause. See Colo. Const. art. V, § 1(3).
2021 Ch. 435, 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.
2023 Colorado Revised Statutes › Title 25.5 - HEALTH CARE POLICY AND FINANCING (§§ 25.5-1-101 — 25.5-11-101) › INDIGENT CARE (§§ 25.5-3-101 — 25.5-3-507) › Article 3 - INDIGENT CARE (§§ 25.5-3-101 — 25.5-3-507) › Part 5 - HEALTH-CARE BILLING FOR INDIGENT PATIENTS RECEIVING SERVICES NOT REIMBURSED THROUGH THE COLORADO INDIGENT CARE PROGRAM (§§ 25.5-3-501 — 25.5-3-507) › Section 25.5-3-503 - [Effective Until 8/7/2024] Health-care discounts on services not eligible for Colorado indigent care program reimbursement

(1)
Beginning September 1, 2022, if a patient is screened pursuant to section
25.5-3-502
and is determined to be a qualified patient, a health-care facility and a licensed health-care professional shall, for emergency and other non-CICP health-care services:
(a)
Limit the amounts charged to not more than the discounted rate established in state department rule pursuant to section
25.5-3-505 (2)(j)
;
(b)
Collect amounts charged, not including amounts owed by third-party payers, in monthly installments such that the patient is not paying more than four percent of the patient's monthly household income on a bill from a health-care facility and not paying more than two percent of the patient's monthly household income on a bill from each licensed health-care professional; and
(c)
After a cumulative thirty-six months of payments, consider the patient's bill paid in full and permanently cease any and all collection activities on any balance that remains unpaid.
(2)
A health-care facility shall not:
(a)
Deny discounted care on the basis that the patient has not applied for any public benefits program; or
(b)
Adopt or maintain any policies that result in the denial of admission or treatment of a patient because the patient lacks health insurance coverage, may qualify for discounted care, requires extended or long-term treatment, or has an unpaid medical bill.
Amended by 2022 Ch. 203, § 2, eff. 5/20/2022.
Added by 2021 Ch. 435, § 1, eff. 9/7/2021.
L. 2021: Entire part added, (HB 21-1198), ch. 2876, p. 2876 § 1, effective September 7.
2021 Ch. 435, 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.
2023 Colorado Revised Statutes › Title 25.5 - HEALTH CARE POLICY AND FINANCING (§§ 25.5-1-101 — 25.5-11-101) › INDIGENT CARE (§§ 25.5-3-101 — 25.5-3-507) › Article 3 - INDIGENT CARE (§§ 25.5-3-101 — 25.5-3-507) › Part 5 - HEALTH-CARE BILLING FOR INDIGENT PATIENTS RECEIVING SERVICES NOT REIMBURSED THROUGH THE COLORADO INDIGENT CARE PROGRAM (§§ 25.5-3-501 — 25.5-3-507) › Section 25.5-3-503 - [Effective 8/7/2024] Health-care discounts on services not eligible for Colorado indigent care program reimbursement - definition

(1)
Beginning September 1, 2022, if a patient is screened pursuant to section
25.5-3-502
and is determined to be a qualified patient, a health-care facility and a licensed health-care professional shall, for emergency hospital and other health-care services:
(a)
Limit the amounts charged to not more than the discounted rate established in state department rule pursuant to section
25.5-3-505 (2)(j)
;
(b)
Collect amounts charged, not including amounts owed by third-party payers, in monthly installments such that the patient is not paying more than four percent of the patient's monthly household income on a bill from a health-care facility, not paying more than two percent of the patient's monthly household income on a bill from each licensed health-care professional, and not paying more than six percent of the patient's household income on a comprehensive bill containing all health-care facility and licensed health-care professional charges; and
(c)
After a cumulative thirty-six months of payments, consider the patient's bill paid in full and permanently cease any and all collection activities on any balance that remains unpaid.
(2)
A health-care facility shall not:
(a)
Deny discounted care on the basis that the patient has not applied for any public benefits program, unless during the initial screening the patient is determined to be presumptively eligible for the state medical assistance program; or
(b)
Adopt or maintain any policies that result in the denial of admission or treatment of a patient because the patient lacks health insurance coverage, may qualify for discounted care, requires extended or long-term treatment, or has an unpaid medical bill.
(3)
The licensed health-care professional who provides services to a patient pursuant to this part 5 is responsible for billing the patient for those services, unless the services are billed on a comprehensive bill issued by a health-care facility.
(4)
For the purposes of this part 5, "emergency hospital and other health-care services" does not include primary care provided in a clinic located in a designated rural or frontier county that offers a sliding-fee scale as approved by the state department.
Amended by 2024 Ch. 300,§ 2, eff. 8/7/2024.
Amended by 2022 Ch. 203, § 2, eff. 5/20/2022.
Added by 2021 Ch. 435, § 1, eff. 9/7/2021.
L. 2021: Entire part added, (HB 21-1198), ch. 2876, p. 2876 § 1, effective September 7.
2024 Ch. 300, was passed without a safety clause. See Colo. Const. art. V, § 1(3).
2021 Ch. 435, 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.
2023 Colorado Revised Statutes › Title 25.5 - HEALTH CARE POLICY AND FINANCING (§§ 25.5-1-101 — 25.5-11-101) › INDIGENT CARE (§§ 25.5-3-101 — 25.5-3-507) › Article 3 - INDIGENT CARE (§§ 25.5-3-101 — 25.5-3-507) › Part 5 - HEALTH-CARE BILLING FOR INDIGENT PATIENTS RECEIVING SERVICES NOT REIMBURSED THROUGH THE COLORADO INDIGENT CARE PROGRAM (§§ 25.5-3-501 — 25.5-3-507) › Section 25.5-3-504 - Notification of patients' rights

(1)
Beginning September 1, 2022, a health-care facility shall make information developed by the state department about patients' rights under this part 5 and the uniform application developed by the state department pursuant to section
25.5-3-505 (2)(i)
available to the public and to each patient. At a minimum, the health-care facility shall:
(a)
Post the information in all required languages pursuant to this subsection (1) conspicuously on the health-care facility's website, including a link to the information on the health-care facility's main landing page;
(b)
Make the information available in patient waiting areas;
(c)
Make the information available to each patient, or the patient's legal guardian, verbally, which may include using a professional interpretation service, or in writing in the patient's or legal guardian's primary language before the patient is discharged from the health-care facility; and
(d)
Inform each patient on the patient's billing statement of the patient's rights pursuant to this part 5, including the right to apply for discounted care, and provide the website, e-mail address, and telephone number where the information may be obtained in the patient's primary language.
Amended by 2022 Ch. 203, § 3, eff. 5/20/2022.
Added by 2021 Ch. 435, § 1, eff. 9/7/2021.
L. 2021: Entire part added, (HB 21-1198), ch. 2877, p. 2877, § 1, effective September 7.
2021 Ch. 435, was passed without a safety clause. See Colo. Const. art. V, § 1(3).
2023 Colorado Revised Statutes › Title 25.5 - HEALTH CARE POLICY AND FINANCING (§§ 25.5-1-101 — 25.5-11-101) › INDIGENT CARE (§§ 25.5-3-101 — 25.5-3-507) › Article 3 - INDIGENT CARE (§§ 25.5-3-101 — 25.5-3-507) › Part 5 - HEALTH-CARE BILLING FOR INDIGENT PATIENTS RECEIVING SERVICES NOT REIMBURSED THROUGH THE COLORADO INDIGENT CARE PROGRAM (§§ 25.5-3-501 — 25.5-3-507) › Section 25.5-3-507 - [Effective 7/1/2025] Hospital discounted care advisory committee - repeal

(1)
The hospital discounted care advisory committee is created in the state department. The advisory committee consists of the following members, appointed by the executive director:
(a)
Three members who are health-care consumers, of whom no more than two members may be employed by a health-care consumer advocacy organization;
(b)
One member who is a representative of the state department;
(c)
One member who is a representative of a safety net hospital for which the percent of medicaid-eligible inpatient days relative to the hospital's total inpatient days is equal to or greater than one standard deviation above the mean;
(d)
One member who is a representative of a hospital in a rural area;
(e)
One member who is a representative of a hospital in an urban area;
(f)
One member who is a representative of a statewide organization of hospitals;
(g)
One member who is a representative of licensed health-care professionals who provide services to patients in a hospital setting;
(h)
One member who is a representative of an organization of Colorado community health centers or a representative of a Colorado community health center, as defined in 42 U.S.C. sec. 254b; and
(i)
One member who is a representative of an organization of safety-net health providers or a safety-net health provider that is not a community health center.
(2)
Advisory committee members serve three-year terms. Of the members initially appointed to the advisory committee, the executive director shall appoint six members for two-year terms and five members for three-year terms. In the event of a vacancy on the advisory committee, the executive director shall appoint a successor to fill the unexpired portion of the term for the member.
(3)
(a)
The executive director shall designate a member to serve as chair of the advisory committee. The advisory committee shall meet at least twice each year and as necessary at the call of the chair.
(b)
Members of the advisory committee serve without compensation or reimbursement of expenses.
(4)
The advisory committee shall advise the state department on the operations and policies of this part 5 and make recommendations to the state board regarding promulgating rules pursuant to this part 5.
(5)
This section is repealed, effective September 1, 2029. Prior to the repeal, the advisory committee is scheduled for review in accordance with section 2-3-1203.
Added by 2024 Ch. 76,§ 5, eff. 7/1/2025.
2024 Ch. 76, was passed without a safety clause. See Colo. Const. art. V, § 1(3).
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 4 - COLORADO MEDICAL ASSISTANCE ACT - GENERAL MEDICAL ASSISTANCE (§§ 25.5-4-101 — 25.5-4-506) › Part 1 - GENERAL PROVISIONS (§§ 25.5-4-101 — 25.5-4-107) › Section 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".
L. 2006: Entire article added with relocations, p. 1815, § 7, effective July 1.
This section is similar to former § 26-4-101 as it existed prior to 2006.
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 4 - COLORADO MEDICAL ASSISTANCE ACT - GENERAL MEDICAL ASSISTANCE (§§ 25.5-4-101 — 25.5-4-506) › Part 1 - GENERAL PROVISIONS (§§ 25.5-4-101 — 25.5-4-107) › Section 25.5-4-102 - Legislative declaration

It is the purpose of the "Colorado Medical Assistance Act" to promote the public health and welfare of the people of Colorado by providing, in cooperation with the federal government, medical and remedial care and services for individuals and families whose income and resources are insufficient to meet the costs of such necessary services and to assist such individuals and families to attain or retain their capabilities for independence and self-care, as contemplated by the provisions of Title XIX of the social security act. The state of Colorado and its various departments, agencies, and political subdivisions are authorized to promote and achieve these ends by any appropriate lawful means, through cooperation with and the utilization of available resources of the federal government and private individuals and organizations.
L. 2006: Entire article added with relocations, p. 1815, § 7, effective July 1.
This section is similar to former § 26-4-102 as it existed prior to 2006.
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 4 - COLORADO MEDICAL ASSISTANCE ACT - GENERAL MEDICAL ASSISTANCE (§§ 25.5-4-101 — 25.5-4-506) › Part 1 - GENERAL PROVISIONS (§§ 25.5-4-101 — 25.5-4-107) › Section 25.5-4-104 - [Effective Until 8/7/2024] Program of medical assistance - single state agency

(1)
The state department, by rules, shall establish a program of medical assistance to provide necessary medical care for the categorically needy. The state department is hereby designated as the single state agency to administer such program in accordance with Title XIX and this article and articles
5
and
6
of this title. Such program shall not be required to furnish recipients under sixty-five years of age the benefits that are provided to recipients sixty-five years of age and over under Title XVIII of the social security act; but said program shall otherwise be uniform to the extent required by Title XIX of the social security act.
(2)
The state department may review any decision of a county department and may consider any application upon which a decision has not been made by the county department within a reasonable time to determine the propriety of the action or failure to take timely action on an application for medical assistance. The state department shall make such additional investigation as it deems necessary and shall, after giving the county department an opportunity to rebut any findings or conclusions of the state department that the action or delay in taking action was a violation of or contrary to state department rules, make such decision as to the granting of medical benefits and the amount thereof as in its opinion is justifiable pursuant to the provisions of this article and articles
5
and
6
of this title and the rules of the state department. Applicants or recipients affected by such decisions of the state department, upon request, shall be given reasonable notice and opportunity for a fair hearing by the state department.
L. 2006: Entire article added with relocations, p. 1819, § 7, effective July 1.
This section is similar to former § 26-4-104 as it existed prior to 2006.
This section is set out more than once due to postponed, multiple, or conflicting amendments.
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 4 - COLORADO MEDICAL ASSISTANCE ACT - GENERAL MEDICAL ASSISTANCE (§§ 25.5-4-101 — 25.5-4-506) › Part 1 - GENERAL PROVISIONS (§§ 25.5-4-101 — 25.5-4-107) › Section 25.5-4-104 - [Effective 8/7/2024] State medical assistance program - single state agency

(1)
The state department, by rules, shall establish a program of medical assistance to provide necessary medical care for the categorically needy. The state department is designated as the single state agency to administer the medical assistance program in accordance with Title XIX of the federal "Social Security Act" and this article 4 and articles 5 and 6 of this title 25.5. the program is not required to furnish to members under sixty-five years of age the benefits that are provided to members sixty-five years of age and over under Title XVIII of the federal "Social Security Act", but the medical assistance program must otherwise be uniform to the extent required by Title XIX of the federal "Social Security Act".
(2)
The state department may review any decision of a county department and may consider any application upon which a decision has not been made by the county department within a reasonable time to determine the propriety of the action or failure to take timely action on an application for medical assistance. The state department shall conduct any additional investigation the state department deems necessary. After giving the county department an opportunity to rebut the state department's findings or conclusions that the action or delay in taking action was a violation of or contrary to state department rules, the state department shall make a decision whether to grant medical benefits and the amount of medical benefits pursuant to this article 4 and articles 5 and 6 of this title 25.5 and the rules of the state department. Applicants or members affected by the state department's decisions, upon request, must be given reasonable notice and opportunity for a fair hearing by the state department.
Amended by 2024 Ch. 152,§ 19, eff. 8/7/2024.
L. 2006: Entire article added with relocations, p. 1819, § 7, effective July 1.
This section is similar to former § 26-4-104 as it existed prior to 2006.
2024 Ch. 152, 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.
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 4 - COLORADO MEDICAL ASSISTANCE ACT - GENERAL MEDICAL ASSISTANCE (§§ 25.5-4-101 — 25.5-4-506) › Part 1 - GENERAL PROVISIONS (§§ 25.5-4-101 — 25.5-4-107) › Section 25.5-4-105 - Federal requirements under Title XIX

Nothing in this article or articles
5
and
6
of this title shall prevent the state department from complying with federal requirements for a program of medical assistance in order for the state of Colorado to qualify for federal funds under Title XIX of the social security act and to maintain a program within the limits of available appropriations.
L. 2006: Entire article added with relocations, p. 1820, § 7, effective July 1.
This section is similar to former § 26-4-105 as it existed prior to 2006.
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 4 - COLORADO MEDICAL ASSISTANCE ACT - GENERAL MEDICAL ASSISTANCE (§§ 25.5-4-101 — 25.5-4-506) › Part 1 - GENERAL PROVISIONS (§§ 25.5-4-101 — 25.5-4-107) › Section 25.5-4-107 - [Effective Until 8/7/2024] Retaliation definition

(1)
For purposes of any rules promulgated by the state department or state board and any action taken by the state department against any person, "retaliation" means taking any of the following actions against a recipient or someone acting on behalf of a recipient after the recipient or someone acting on behalf of the recipient files a complaint concerning services provided or not provided to the recipient:
(a)
Indicating to a recipient that the recipient cannot have an advocate, family member, or other authorized representative assist the recipient; or
(b)
(I)
An adverse action that negatively affects a recipient's level of eligibility for or receipt of services received at the time of the complaint without verification of a change in the recipient's income, resources, or health-care needs that justifies the adverse action.
(II)
No adverse action shall be taken against a recipient after a complaint has been filed until the recipient is notified of the proposed action, informed of the reason for the proposed action, and provided an opportunity to appeal the proposed action.
(2)
"Retaliation" shall not include instances where a recipient is not eligible for a service or program or where a provider documents a problem with a recipient and shares the documentation with the recipient or a third party prior to the recipient filing a complaint.
L. 2006: Entire section added, p. 1019, § 1, effective May 25.
This section was originally numbered as § 26-4-402.5 in House Bill 06-1211. Section 2 of the act provided for the renumbering and relocation of § 26-4-402.5 to this section. (See L. 2006, p. 1020.)
This section is set out more than once due to postponed, multiple, or conflicting amendments.
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 4 - COLORADO MEDICAL ASSISTANCE ACT - GENERAL MEDICAL ASSISTANCE (§§ 25.5-4-101 — 25.5-4-506) › Part 1 - GENERAL PROVISIONS (§§ 25.5-4-101 — 25.5-4-107) › Section 25.5-4-107 - [Effective 8/7/2024] Retaliation definition

(1)
For purposes of any rules promulgated by the state department or state board and any action taken by the state department against any person, "retaliation" means taking any of the following actions against a Member or someone acting on behalf of a Member after the Member or someone acting on behalf of the Member files a complaint concerning services provided or not provided to the Member:
(a)
Indicating to a Member that the Member cannot have an advocate, family member, or other authorized representative assist the Member; or
(b)
(I)
An adverse action that negatively affects a member's level of eligibility for or receipt of services received at the time of the complaint without verification of a change in the member's income, resources, or health-care needs that justifies the adverse action.
(II)
An adverse action must not be taken against a Member after a complaint has been filed until the Member is notified of the proposed action, informed of the reason for the proposed action, and provided an opportunity to appeal the proposed action.
(2)
"Retaliation" does not include instances when a Member is not eligible for a service or program or when a provider documents a problem with a Member and shares the documentation with the Member or a third party prior to the Member filing a complaint.
Amended by 2024 Ch. 152,§ 20, eff. 8/7/2024.
L. 2006: Entire section added, p. 1019, § 1, effective May 25.
This section was originally numbered as § 26-4-402.5 in House Bill 06-1211. Section 2 of the act provided for the renumbering and relocation of § 26-4-402.5 to this section. (See L. 2006, p. 1020.)
2024 Ch. 152, 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.
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 4 - COLORADO MEDICAL ASSISTANCE ACT - GENERAL MEDICAL ASSISTANCE (§§ 25.5-4-101 — 25.5-4-506) › Part 2 - ADMINISTRATION (§§ 25.5-4-201 — 25.5-4-216) › Section 25.5-4-201 - Cash system of accounting - financial administration of medical services premiums - medical programs administered by department of human services - federal contributions - rules

(1)
The state department shall utilize the cash system of accounting, as enunciated by the governmental accounting standards board, regardless of the source of revenues involved, for all activities of the state department relating to the financial administration of any nonadministrative expenditure that qualifies for federal financial participation under Title XIX of the federal "Social Security Act", and for the administration of the state-funded health and medical care program, created pursuant to section
25.5-2-104
, and for the state children's basic health plan, created pursuant to section
25.5-2-105
, except for expenditures under the program for the medically indigent, article
3
of this title 25.5.
(1.5)
(a)
The state department shall utilize the cash system of accounting, as enunciated by the governmental accounting standards board, for the contributions required by
42 U.S.C. sec. 1396u
-
5 (c)
.
(b)
The contributions required by
42 U.S.C. sec. 1396u
-
5 (c)
shall be made in the manner required by the federal centers for medicare and medicaid services, or any successor agency. Nothing in this paragraph (b) shall require the state department to make the contribution before the contribution is due.
(2)
The executive director shall promulgate rules to identify the programs utilizing the cash system of accounting.
Amended by 2022 Ch. 399, § 12, eff. 6/7/2022.
L. 2006: Entire section amended, p. 917, § 1, effective May 11; entire article added with relocations, p. 1821, § 7, effective July 1. L. 2007: (1.5) added, p. 465, § 2, effective July 1. L. 2009: (1.5) amended, (SB 09 -265), ch. 205, p. 935, § 1, effective May 1.
(1) This section is similar to former § 26-4-110.7 as it existed prior to 2006.
(2) Amendments to section 26-4-110.7 by Senate Bill 06-129 were harmonized with this section as it appeared in Senate Bill 06-219.
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 4 - COLORADO MEDICAL ASSISTANCE ACT - GENERAL MEDICAL ASSISTANCE (§§ 25.5-4-101 — 25.5-4-506) › Part 2 - ADMINISTRATION (§§ 25.5-4-201 — 25.5-4-216) › Section 25.5-4-202 - [Repealed]

Repealed by 2016 Ch. 22,§6, eff. 8/10/2016.
L. 2006: Entire article added with relocations, p. 1821, § 7, effective July 1. L. 2016: Entire section repealed, (HB 16-1081), ch. 22, p. 52, § 6, effective August 10.
This section was similar to former § 26-4-107 as it existed prior to 2006.
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 4 - COLORADO MEDICAL ASSISTANCE ACT - GENERAL MEDICAL ASSISTANCE (§§ 25.5-4-101 — 25.5-4-506) › Part 2 - ADMINISTRATION (§§ 25.5-4-201 — 25.5-4-216) › Section 25.5-4-203 - [Effective Until 8/7/2024] Advisory council established

(1)
There is created the state medical assistance and services advisory council, referred to in this article 4 as the "advisory council", consisting of sixteen members, as follows:
(a)
The executive director of the state department and the executive director of the department of public health and environment, the executive directors' designees, or the executive directors' successors in function, as ex officio members; and
(b)
Fourteen members, appointed by the governor and chosen by the governor to represent the various areas of medical services and the public as follows:
(I)
Two members who are doctors of medicine licensed in this state;
(II)
One member who is a doctor of osteopathy licensed in this state;
(III)
One member who is a dentist licensed in this state;
(IV)
One member who is an optometrist licensed in this state;
(V)
One member who is an owner or operator of a licensed nursing facility in this state;
(VI)
One member who represents licensed hospitals in this state;
(VII)
One member who is a pharmacist licensed in this state;
(VIII)
One member who is a professional nurse licensed in this state;
(IX)
One member who has provided home health-care services for three years;
(X)
Three members who are not directly associated with the areas of medical services to represent the public; and
(XI)
One member who may represent any other area of medical services not specifically enumerated but shall not be limited thereto.
(2)
Members serve at the pleasure of the governor and receive no compensation but are entitled to reimbursement for their actual and necessary expenses. The advisory council shall advise the state department on the provision of health and medical care services to recipients.
Amended by 2023 Ch. 303,§ 45, eff. 8/7/2023.
Amended by 2022 Ch. 2, § 87, eff. 2/25/2022.
L. 2006: Entire article added with relocations, p. 1822, § 7, effective July 1.
This section is similar to former § 26-4-108 as it existed prior to 2006.
2023 Ch. 303, 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.
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 4 - COLORADO MEDICAL ASSISTANCE ACT - GENERAL MEDICAL ASSISTANCE (§§ 25.5-4-101 — 25.5-4-506) › Part 2 - ADMINISTRATION (§§ 25.5-4-201 — 25.5-4-216) › Section 25.5-4-203 - [Effective 8/7/2024] Advisory council established

(1)
There is created the state medical assistance and services advisory council, referred to in this article 4 as the "advisory council", consisting of sixteen members, as follows:
(a)
The executive director of the state department and the executive director of the department of public health and environment, the executive directors' designees, or the executive directors' successors in function, as ex officio members; and
(b)
Fourteen members, appointed by the governor and chosen by the governor to represent the various areas of medical services and the public as follows:
(I)
Two members who are doctors of medicine licensed in this state;
(II)
One member who is a doctor of osteopathy licensed in this state;
(III)
One member who is a dentist licensed in this state;
(IV)
One member who is an optometrist licensed in this state;
(V)
One member who is an owner or operator of a licensed nursing facility in this state;
(VI)
One member who represents licensed hospitals in this state;
(VII)
One member who is a pharmacist licensed in this state;
(VIII)
One member who is a professional nurse licensed in this state;
(IX)
One member who has provided home health-care services for three years;
(X)
Three members who are not directly associated with the areas of medical services to represent the public; and
(XI)
One member who may represent any other area of medical services not specifically enumerated but shall not be limited thereto.
(2)
Advisory council members serve at the pleasure of the governor and receive no compensation but are entitled to reimbursement for actual and necessary expenses. The advisory council shall advise the state department on the provision of health and medical care services to members of medical assistance.
Amended by 2024 Ch. 152,§ 21, eff. 8/7/2024.
Amended by 2023 Ch. 303,§ 45, eff. 8/7/2023.
Amended by 2022 Ch. 2, § 87, eff. 2/25/2022.
L. 2006: Entire article added with relocations, p. 1822, § 7, effective July 1.
This section is similar to former § 26-4-108 as it existed prior to 2006.
2024 Ch. 152, was passed without a safety clause. See Colo. Const. art. V, § 1(3).
2023 Ch. 303, 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.
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 4 - COLORADO MEDICAL ASSISTANCE ACT - GENERAL MEDICAL ASSISTANCE (§§ 25.5-4-101 — 25.5-4-506) › Part 2 - ADMINISTRATION (§§ 25.5-4-201 — 25.5-4-216) › Section 25.5-4-204 - Automated medical assistance administration

(1)
The general assembly hereby finds and declares that the agency responsible for the administration of the state's medical assistance program would be more effective in its ability to streamline administrative functions of program administrators and providers under the program through the implementation of an automated system that will provide for the following:
(a)
Electronic claim submittals;
(b)
Online eligibility determinations;
(c)
Electronic remittance statements;
(d)
Electronic fund transfers; and
(e)
Automation of other administrative functions associated with the medical assistance program.
(2)
Therefore, the general assembly declares that it is appropriate to enact legislation, as set forth in subsection (3) of this section, that authorizes the state department to develop and implement an automated system for processing claims and payments under the medical assistance program, as well as for other administrative functions associated with the program.
(3)
The executive director of the state department shall develop and implement an automated system through which medical assistance claims and payments and eligibility determinations or other related transactions may be processed. The system shall provide for the use of automated electronic technologies. The automated system may be implemented in phases if deemed necessary by the executive director. The automated system shall be implemented only after the executive director determines that:
(a)
Technology is available and proven to perform satisfactorily in a production environment;
(b)
Adequate financing is available to facilitate the implementation and maintenance of the system. Financing may include, but is not limited to, federal funds, appropriations from the general fund, provider transaction fees, or any other financing mechanisms which the state department may impose, and grants or contributions from public or private entities.
(c)
The system has been successfully installed and fully tested; and
(d)
Adequate provider training has been provided for an orderly implementation.
L. 2006: Entire article added with relocations, p. 1822, § 7, effective July 1.
This section is similar to former § 26-4-403.7 as it existed prior to 2006.
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 4 - COLORADO MEDICAL ASSISTANCE ACT - GENERAL MEDICAL ASSISTANCE (§§ 25.5-4-101 — 25.5-4-506) › Part 2 - ADMINISTRATION (§§ 25.5-4-201 — 25.5-4-216) › Section 25.5-4-205.5 - [Effective Until 8/7/2024] 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 recipient 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 continues to be eligible for receipt of medical benefits 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 recertify his or her eligibility for medical assistance pursuant to this article 4 or article 5 or 6 of this title 25.5.
Amended by 2021 Ch. 136, § 122, eff. 10/1/2021.
Amended by 2017 Ch. 381, § 59, eff. 6/6/2017.
L. 2008: Entire section added, p. 903, § 1, effective May 20. L. 2017: (2) amended, (HB 17-1329), ch. 1983, p. 1983, § 59, effective June 6. L. 2021: (2) amended, (SB 21-059), ch. 746, p. 746, § 122, effective October 1.
This section is set out more than once due to postponed, multiple, or conflicting amendments.
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 4 - COLORADO MEDICAL ASSISTANCE ACT - GENERAL MEDICAL ASSISTANCE (§§ 25.5-4-101 — 25.5-4-506) › Part 2 - ADMINISTRATION (§§ 25.5-4-201 — 25.5-4-216) › Section 25.5-4-205.5 - [Effective 8/7/2024] 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.
Amended by 2024 Ch. 152,§ 23, eff. 8/7/2024.
Amended by 2021 Ch. 136, § 122, eff. 10/1/2021.
Amended by 2017 Ch. 381, § 59, eff. 6/6/2017.
L. 2008: Entire section added, p. 903, § 1, effective May 20. L. 2017: (2) amended, (HB 17-1329), ch. 1983, p. 1983, § 59, effective June 6. L. 2021: (2) amended, (SB 21-059), ch. 746, p. 746, § 122, effective October 1.
2024 Ch. 152, 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.
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 4 - COLORADO MEDICAL ASSISTANCE ACT - GENERAL MEDICAL ASSISTANCE (§§ 25.5-4-101 — 25.5-4-506) › Part 2 - ADMINISTRATION (§§ 25.5-4-201 — 25.5-4-216) › Section 25.5-4-206 - Reimbursement to counties - costs of administration

The state department shall reimburse the county departments for costs of administration incurred by the counties under this article and articles
5
and
6
of this title in accordance with the provisions of section
26-1-122(5)
, C.R.S.
L. 2006: Entire article added with relocations, p. 1825, § 7, effective July 1.
This section is similar to former § 26-4-411 as it existed prior to 2006.
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 4 - COLORADO MEDICAL ASSISTANCE ACT - GENERAL MEDICAL ASSISTANCE (§§ 25.5-4-101 — 25.5-4-506) › Part 2 - ADMINISTRATION (§§ 25.5-4-201 — 25.5-4-216) › Section 25.5-4-208 - County duties - transitional medicaid

County departments shall assist families in completing the reporting requirements for transitional medicaid. This shall include informing families of the transitional medicaid eligibility requirements and the required reporting calendar.
Amended by 2014 Ch. 12,§ 11, eff. 2/27/2014.
L. 2006: Entire article added with relocations, p. 1826, § 7, effective July 1. L. 2014: Entire section amended, (SB 14-067), ch. 12, p. 116, § 11, effective February 27.
This section is similar to former § 26-4-106.5 as it existed prior to 2006.
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 4 - COLORADO MEDICAL ASSISTANCE ACT - GENERAL MEDICAL ASSISTANCE (§§ 25.5-4-101 — 25.5-4-506) › Part 2 - ADMINISTRATION (§§ 25.5-4-201 — 25.5-4-216) › Section 25.5-4-211 - Medicaid management information system - appropriation in annual general appropriation act - expenditure in next fiscal year

(1)
Subject to the limitation in subsection (2) of this section, unexpended and unencumbered moneys from an appropriation in the annual general appropriation act to the state department for the medicaid management information system remain available for expenditure by the state department in the next fiscal year without further appropriation. This section applies to appropriations made by the general assembly for fiscal years beginning on and after July 1, 2013.
(2)
On or before June 30, 2014, and on or before June 30 of each year thereafter, the state department shall notify the state controller of the amount of the appropriation from the annual general appropriation act for the medicaid management information system for the current fiscal year that the state department needs to remain available for expenditure in the next fiscal year. The state department may not expend more than the amount notified under the authority granted in this section.
(3)
Repealed.
Amended by 2017 Ch. 6,§ 8, eff. 3/1/2017.
Added by 2013 Ch. 205,§ 1, eff. 5/11/2013.
L. 2013: Entire section added, (HB 13-1281), ch. 205, p. 851, § 1, effective May 11. L. 2017: (3) amended, (HB 17-1060), ch. 6, p. 16, § 8, effective March 1.
Subsection (3)(b) provided for the repeal of subsection (3), effective January 3, 2018. (See L. 2017, p. 16.)
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 4 - COLORADO MEDICAL ASSISTANCE ACT - GENERAL MEDICAL ASSISTANCE (§§ 25.5-4-101 — 25.5-4-506) › Part 2 - ADMINISTRATION (§§ 25.5-4-201 — 25.5-4-216) › Section 25.5-4-214 - [Repealed]

Added by 2017 Ch. 288,§2, eff. 6/2/2017.
L. 2017: Entire section added, (HB 17-1351), ch. 288, p. 1600, § 2, effective June 2.
Subsection (5) provided for the repeal of this section, effective July 1, 2019. (See L. 2017, p. 1600.)
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 4 - COLORADO MEDICAL ASSISTANCE ACT - GENERAL MEDICAL ASSISTANCE (§§ 25.5-4-101 — 25.5-4-506) › Part 2 - ADMINISTRATION (§§ 25.5-4-201 — 25.5-4-216) › Section 25.5-4-215 - Study - benefits for persons on work release - repeal

(1)
The state department shall determine whether federal authority is necessary to provide benefit coverage under the medical assistance program to people who are on work release from jail, as described in section
18-1.3-207
. On or before October 1, 2023, the state department shall report the results of the assessment and analysis to the joint budget committee of the general assembly.
(2)
This section is repealed, effective June 30, 2024.
Added by 2022 Ch. 193,§8, eff. 5/19/2022.
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 4 - COLORADO MEDICAL ASSISTANCE ACT - GENERAL MEDICAL ASSISTANCE (§§ 25.5-4-101 — 25.5-4-506) › Part 3 - RECOVERY (§§ 25.5-4-300.4 — 25.5-4-310) › Section 25.5-4-300.4 - [Effective Until 8/7/2024] Last resort for payment - legislative intent

It is the intent of the general assembly that medicaid be the last resort for payment for medically necessary goods and services furnished to recipients and that all other sources of payment are primary to medical assistance provided by medicaid.
L. 2008: Entire section added, p. 1771, § 2, effective June 2.
This section is set out more than once due to postponed, multiple, or conflicting amendments.
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 4 - COLORADO MEDICAL ASSISTANCE ACT - GENERAL MEDICAL ASSISTANCE (§§ 25.5-4-101 — 25.5-4-506) › Part 3 - RECOVERY (§§ 25.5-4-300.4 — 25.5-4-310) › Section 25.5-4-300.4 - [Effective 8/7/2024] Last resort for payment - legislative intent

It is the intent of the general assembly that medicaid is the last resort for payment for medically necessary goods and services furnished to members and that all other sources of payment are primary to medical assistance provided by medicaid.
Amended by 2024 Ch. 152,§ 29, eff. 8/7/2024.
L. 2008: Entire section added, p. 1771, § 2, effective June 2.
2024 Ch. 152, 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.