All Roll Calls
Yes: 340 • No: 145
ColoradoSB25-2702025 Regular SessionSenateWALLET
Enterprise Nursing Facility Provider Fees
Sponsored By: Emily Sirota (Democratic), Jeff Bridges (Democratic), Judy Amabile (Democratic), Shannon Bird
Signed by Governor
State Revenue & BudgetHealth Care & Health Insurance
Personalized for You
How does this bill affect your finances?
Personalize government policy and PRIA will tell you what this bill means for your household, plus every other piece of legislation we track. PRIA reads each provision against your financial profile to show you exactly what matters to your wallet.
Bill Overview
Analyzed Economic Effects
11 provisions identified: 4 benefits, 3 costs, 4 mixed.
Medicaid payments continue during facility receivership
When a long-term health-care facility is in receivership, the state health department and Enterprise must reimburse its receiver for Medicaid residents. This supports Medicaid care while the receiver runs the facility. The money goes to the receiver, not directly to residents. The provision sets no household payment amount.
Children’s continuous Medicaid coverage faces cuts
The State Board can end the specified continuous-enrollment protection for children through a rule. It can act only when provider-fee money and federal matches cannot fully fund required uses. The board must first receive recommendations from the Enterprise. The law authorizes this change; it does not automatically end children’s continuous coverage.
Medicaid buy-in coverage faces possible cuts
The law allows cuts to two Medicaid buy-in eligibility groups when provider-fee money and federal matches cannot fund required uses. The State Board must first receive Enterprise recommendations and adopt a rule. For the disability buy-in group, it can cut benefits, lower the income limit below 450% of federal poverty, or end eligibility. For the group under section 25.5-5-206, it can also cut benefits, lower the income limit, or end eligibility. These cuts are authorized, not automatic.
Nursing facility bills cannot itemize fees
Nursing facilities cannot list any part of the provider fee as a separate charge on billing statements. This is a billing protection, not a limit on overall prices. The rule does not prohibit facilities from including their costs in other charges.
Facility fees stop without federal matches
The Enterprise must stop collecting an affected facility fee when federal matching authority changes or ends and matching funds become unavailable. This protection covers nursing facilities and intermediate care facilities for people with intellectual disabilities. The Enterprise must return cash-fund money that is not subject to federal matching to the affected providers.
Nursing facilities get faster Medicaid payments
Beginning May 1, 2025, nursing facility fees and federal matches support sustained or increased Medicaid reimbursements and supplemental payments. The Enterprise must make nursing facility reimbursements and supplemental payments within 15 days after receiving a provider’s fee. Providers receive a fee-funded supplement when the statewide average daily rate, after patient payments, exceeds the General Fund share. Nursing and intermediate care facility fees must add to, not replace, General Fund support, with specified daily-rate and supplemental-payment exceptions. The department must secure federal matches for payments under sections 25.5-4-402.4(5.5)(b) and 25.5-6-208 before pursuing matches under section 25.5-6-210.
Nursing facility payments can face shortfalls
If nursing facility fee revenue cannot cover all authorized uses, the legislature does not have to fill the gap with General Fund money. The Enterprise can reduce or suspend supplemental Medicaid payments after consulting the state health department. It must follow the law’s payment priorities. This provision does not require residents to pay the shortfall.
Care facilities file confidential fee reports
Nursing facilities and intermediate care facilities for people with intellectual disabilities must submit reports used to calculate their fees. Nursing facilities must report annual days of care provided to non-Medicare residents. The submitted information is confidential and is not a public record. The Enterprise can release report summaries, but the underlying information remains protected.
Disability care facilities pay fees, receive reimbursements
Beginning May 1, 2025, the Enterprise can charge privately owned and state-run intermediate care facilities for people with intellectual disabilities. The State Board sets the fee, capped at 5% of covered facilities’ combined annual costs or the federal limit, whichever is lower. Revenue pays administration and supplemental facility reimbursements, subject to annual appropriations and federal matching rules. Supplemental payments are calculated beginning May 1, 2025, and each July 1 afterward, in consultation with the state health department. The law removes the department’s former fee authority and transfers the old fund balance to the successor fund on June 30, 2025.
Nursing facility fees shift to Enterprise
Beginning May 1, 2025, the law authorizes the state’s Healthcare Affordability and Sustainability Enterprise to charge nursing facility fees. Charging and collection require federal approval of a Medicaid plan amendment; the State Board sets fees within federal limits. With federal approval, exemptions can cover facilities with 45 or fewer licensed beds, qualifying retirement communities, and specified state-operated or hospital-based facilities. The Enterprise can also lower some fees to meet federal requirements. The old fund balance transfers to the new nursing facility cash fund on June 30, 2025; the former fee section ends July 1.
Nursing facility payment rules are replaced
The law repeals former nursing facility fee-offset, performance, and condition-based payments and establishes Enterprise-run supplemental payments. Repealed performance minimums were 12% of provider-fee payments starting July 1, 2024, and 15% by July 1, 2026. Repealed condition-based minimums were 2% of the statewide average daily rate for severe mental health conditions and 1% for severe dementia-related conditions or acquired brain injury. New funding follows priorities covering administration, reimbursement appeals, fee offsets, care needs, performance, specified high-needs residents, and statewide daily-rate payments, subject to annual appropriations and available fee revenue and federal matches. Performance payments can stop for failure to meet state measures; specified dementia-related or brain-injury payments can end when case-mix rates already account for those facilities.
Sponsors & Cosponsors
Sponsors
Emily Sirota
Democratic • House
Jeff Bridges
Democratic • Senate
Judy Amabile
Democratic • Senate
Shannon Bird
Affiliation unavailable
Cosponsors
Chad Clifford
Democratic • House
Julie McCluskie
Democratic • House
Cathy Kipp
Democratic • Senate
Dafna Michaelson Jenet
Democratic • Senate
Sen. F. Winter
Affiliation unavailable
James Coleman
Democratic • Senate
Julie Gonzales
Democratic • Senate
Katie Wallace
Democratic • Senate
Lisa Cutter
Democratic • Senate
Nick Hinrichsen
Democratic • Senate
Tom Sullivan
Democratic • Senate
Roll Call Votes
House vote • 4/23/2025
Conference committee report: Adopt
Yes: 45 • No: 20
House vote • 4/23/2025
Conference committee report: Repass
Yes: 45 • No: 20
Senate vote • 4/23/2025
Conference committee report: Repass
Yes: 23 • No: 12
Senate vote • 4/23/2025
Conference committee report: Adopt ccr
Yes: 30 • No: 5
Vote • 4/17/2025
Adopt the first draft conference committee report of the first conference committee on SB 25-270
Yes: 6 • No: 0
House vote • 4/15/2025
Conference committee report: Byd scp
Yes: 54 • No: 10
Senate vote • 4/11/2025
House amendments: Not concur appt cc
Yes: 33 • No: 0
House vote • 4/10/2025
Third reading: Refer (hhs)
Yes: 26 • No: 39
House vote • 4/10/2025
Third reading: Bill
Yes: 44 • No: 21
House vote • 4/8/2025
Refer Senate Bill 25-270 to the Committee of the Whole.
Yes: 8 • No: 3
Senate vote • 4/3/2025
Third reading: Bill
Yes: 22 • No: 12
Senate vote • 4/1/2025
Refer Senate Bill 25-270, as amended, to the Committee of the Whole.
Yes: 4 • No: 3
Actions Timeline
Governor Signed
4/30/2025HouseSigned by the President of the Senate
4/29/2025SenateSigned by the Speaker of the House
4/29/2025HouseSent to the Governor
4/29/2025HouseHouse Consideration of First Conference Committee Report result was to Adopt Committee Report - Repass
4/23/2025HouseSenate Consideration of First Conference Committee Report result was to Adopt Committee Report - Repass
4/23/2025SenateSenate Considered House Amendments - Result was to Not Concur - Request Conference Committee
4/11/2025SenateHouse Third Reading Passed - No Amendments
4/10/2025HouseHouse Second Reading Special Order - Passed with Amendments - Floor
4/9/2025HouseHouse Committee on Appropriations Refer Unamended to House Committee of the Whole
4/8/2025HouseSenate Third Reading Passed - No Amendments
4/3/2025SenateIntroduced In House - Assigned to Appropriations
4/3/2025HouseSenate Second Reading Special Order - Passed with Amendments - Committee
4/2/2025SenateSenate Committee on Appropriations Refer Amended to Senate Committee of the Whole
4/1/2025SenateIntroduced In Senate - Assigned to Appropriations
3/31/2025Senate
Bill Text
Engrossed
Final Act
Introduced
Reengrossed
Rerevised
Revised
Signed Act