2023 Colorado Revised Statutes › Title 26.5 - EARLY CHILDHOOD PROGRAMS AND SERVICES (§§ 26.5-1-101 — 26.5-6-103) › Article 3 - FAMILY AND CHILD HEALTH AND WELL-BEING (§§ 26.5-3-101 — 26.5-3-904) › Part 4 - COORDINATED SYSTEM OF PAYMENT FOR EARLY INTERVENTION SERVICES FOR INFANTS AND TODDLERS (§§ 26.5-3-401 — 26.5-3-410) › Section 26.5-3-408 - Certified early intervention service brokers - duties - payment for early intervention services - fees - repeal

(1)
(a)
(I)
Prior to July 1, 2024, for each designated service area in the state, the certified early intervention service broker for the area shall:
(A)
Establish a registry of qualified early intervention service providers to provide early intervention services to eligible children in the designated service area. The certified early intervention service broker for a designated service area may provide early intervention services directly or may subcontract the provision of services to other qualified providers on the registry.
(B)
Accept and process claims for reimbursement for early intervention services provided pursuant to this part 4 by qualified providers;
(C)
Negotiate for the payment of early intervention services provided to eligible children in the designated service area by qualified providers, to the extent permissible pursuant to federal law; and
(D)
Ensure payment to a qualified provider for early intervention services rendered by the qualified provider.
(II)
This subsection (1)(a) is repealed, effective July 1, 2024.
(b)
On and after July 1, 2024, for each defined service area in the state, the certified early intervention service broker for the area shall:
(I)
Establish a registry of qualified early intervention service providers to provide early intervention services to eligible children in the defined service area. The certified early intervention service broker for a defined service area may provide early intervention services directly or may subcontract the provision of services to other qualified providers on the registry.
(II)
Accept and process claims for reimbursement for early intervention services provided pursuant to this part 4 by qualified providers;
(III)
Negotiate for the payment of early intervention services provided to eligible children in the defined service area by qualified providers, to the extent permissible under federal law; and
(IV)
Ensure payment to a qualified provider for early intervention services rendered by the qualified provider.
(2)
Certified early intervention service brokers shall use procedures and forms determined by the department to document the provision or purchase of early intervention services on behalf of eligible children. Invoices or insurance claims for early intervention services must be submitted based on the available funding source for each eligible child and the reimbursement rate for the appropriate federal, state, local, or private funding sources, including public medical assistance and private health insurance.
(3)
The department shall establish a schedule of fees to be charged by certified early intervention service brokers for providing broker services pursuant to this part 4. In developing the fee schedule, the department shall obtain input from certified early intervention service brokers and shall consider the duties of brokers pursuant to this part 4, the expenses incurred by brokers, and the relevant market conditions.
(4)
Use of a certified early intervention broker is voluntary; except that private health insurance carriers that are included pursuant to section
10-16-104
(1.3) are required to make payment in trust pursuant to section
26.5-3-409
. Nothing in this part 4 prohibits a qualified provider of early intervention services from directly billing the appropriate program of public medical assistance or a participating provider, as defined in section
10-16-102 (46)
, or from directly billing a private health insurance carrier for services rendered pursuant to this part 4 for insurance plans that are not included pursuant to section
10-16-104
(1.3).
(5)
To the extent requested by the department, certified early intervention service brokers shall participate in ongoing reviews of funding practices for early intervention services and the development or revision of procedures for a coordinated system of payment for early intervention services.
Renumbered from C.R.S. §
27-10.5-708
and amended by 2022 Ch. 123, §3, eff. 7/1/2022.
Amended by 2022 Ch. 123, §136, eff. 7/1/2022.
Amended by 2021 Ch. 83, §67, eff. 7/1/2024.
L. 2008: Entire part R&RE, p. 1465, § 11, effective August 5. L. 2009: (4) amended, (HB 09-1237), ch. 979, p. 979, § 3, effective May 2. L. 2013: (4) amended, (HB 13-1266), ch. 994, p. 994, § 68, effective May 13. L. 2021: IP(1), (1)(a), and (1)(c) amended, (HB 21 -1187), ch. 353, p. 353, § 67, effective 7/1/2024.