Title 25.5, Health Care Policy and Financing

(1) The board shall have the authority set forth in subsection (3) of this section over the following programs administered by the state department: (a) The "Colorado Medical Assistance Act", as specified in articles 4, 5, and 6 of this title; (b) and (c) Repealed. (d) The "Child…

(1) The general assembly hereby finds and declares that: (a) Physicians engaged in family medicine are in critically short supply in this state; (b) Because of the distribution of such physicians, many rural and urban areas of the state are underserved; (c) A significant portion …

As used in this part 6, unless the context otherwise requires: (1) "Commission" means the commission on family medicine created in section 25.5-1-602 (1). Source: L. 2025: Entire section added, (SB 25-275), ch. 377, p. 2081, § 223, effective August 6.

(1) There is created, in the department of health care policy and financing, the commission on family medicine. The commission consists of the following members: (a) The deans of accredited allopathic and osteopathic schools of medicine in the state or their designated representa…

(1) The commission shall: (a) Assure that family medicine residency program standards are equal to or more stringent than the standards established by the accreditation council on graduate medical education of the American medical association or the American osteopathic associati…

As used in this part 7, unless the context otherwise requires: (1) "Community" means the community that a hospital has defined as the community that it serves pursuant to 26 CFR 1.501(r)-3 (b)(3). (2) "Community benefit implementation plan" means a plan that satisfies the require…

(1) At least once each year, each reporting hospital shall convene a public meeting to seek feedback regarding the reporting hospital's community benefit activities during the previous year and the reporting hospital's community benefit implementation plan for the following year.…

(1) On or before a date to be determined by rules promulgated by the state board, and on or before such date every three years thereafter, each reporting hospital shall complete a community health needs assessment. (2) On or before a date to be determined by rules promulgated by …

(1) (a) If the state department finds that a reporting hospital is not in compliance with the community benefit requirements of this part 7, the state department shall notify the reporting hospital of its noncompliance and identify the information that needs to be provided. If a …

As used in this part 8, unless the context otherwise requires: (1) "Nonemergency medical transportation" or "NEMT" means transportation to or from medically necessary nonemergency treatment. (2) "Nonmedical transportation" means transportation to enable passengers who are medicai…

(1) The state department shall collaborate with the transportation community advisory board to establish rules and processes for the safety and oversight of nonmedical transportation services and nonemergency medical transportation services provided to medicaid members pursuant t…

(1) On or before December 1, 2026, and on or before each December 1 thereafter, each transportation broker shall report the following information to the state department: (a) Regarding each transportation provider that the transportation broker contracts with: (I) The total numbe…

(1) (a) The state department may contract with a transportation broker. (b) A transportation broker shall create a publicly available contingency plan to ensure uninterrupted NEMT services in the event the transportation broker experiences system outages or is otherwise unable to…

(1) The transportation broker, or a transportation provider if there is no broker, shall ensure during scheduling that individuals who sign up to receive transportation services are members who are eligible to receive nonemergency medical transportation services. (2) The member e…

(1) The state department shall, subject to available appropriations, audit transportation providers to ensure reimbursement is made only for trips performed by credentialed drivers operating credentialed vehicles pursuant to the rules adopted pursuant to section 25.5-1-802. (2) T…

(1) The general assembly finds and declares that: (a) Section 1001 of the "Patient Protection and Affordable Care Act", Pub.L. 111-148, as amended by the "Health Care and Education Reconciliation Act of 2010", Pub.L. 111-152, amended Title XXVII of the "Public Health Service Act"…

As used in this part 9, unless the context otherwise requires: (1) "Collection action" means any of the following actions taken with respect to a debt for items and services that were purchased from or provided to a patient by a hospital on a date during which the hospital was no…

(1) A hospital that is not in material compliance with hospital price transparency laws on the date that items or services are purchased from or provided to a patient by the hospital shall not initiate or pursue a collection action against the patient or patient guarantor for a d…

(1) On or before October 1, 2023, each hospital shall make public and post the hospital's medicare reimbursement rates, if applicable. (2) (a) The state department shall conduct performance assessments for adherence to federal transparency rules by: (I) Reviewing relevant informa…

(1) (Deleted by amendment, L. 2011, (SB 11-210), ch. 187, p. 719, § 2, effective July 15, 2012.) (2) Any money remaining in the state old age pension fund after full payment of basic minimum awards to qualified old age pension members, and after establishment and maintenance of t…

(1) As used in this section, unless the context otherwise requires: (a) Repealed. (b) "Eligible individual" means an individual with reproductive capacity, regardless of gender, who would be eligible to enroll in the medical assistance program, as described in section 25.5-4-103 …

(1) (a) There is created the state medical assistance program, referred to in this section as "state medical assistance". Subject to the limitations detailed in subsection (1)(b) of this section, state medical assistance includes all benefits and services at the same cost to the …

When abortion care services are provided in accordance with articles 4, 5, and 6 of this title 25.5, the services must be reimbursed by state funds only. Source: L. 2025: Entire section added, (SB 25-183), ch. 97, p. 443, § 2, effective January 1, 2026.

(1) The state department shall reimburse a prohibited entity, as defined in Pub.L. 119-21 sec. 71113, using only state funds for services covered under Title XIX of the federal "Social Security Act" and provided on or after July 1, 2025, except those services covered pursuant to …

As used in this part 3, unless the context otherwise requires: (1) "Comprehensive primary care" means the basic, entry-level health care provided by health-care practitioners or non-physician health-care practitioners that is generally provided in an outpatient setting. "Comprehe…

(1) The state department shall annually allocate the moneys appropriated by the general assembly to the primary care fund created in section 24-22-117 (2)(b), C.R.S., to all eligible qualified providers in the state who comply with the requirements of subsection (2) of this secti…

At least annually, the state department shall consult with representatives of federally qualified health centers, school-based health centers, family residency directors, certified rural health clinics, other qualified providers, and consumer advocates regarding the implementatio…

(1) Beginning February 1, 2026, and each February 1 thereafter, the executive director shall prepare and submit an annual report to the house of representatives health and human services committee and the senate health and human services committee, or their successor committees; …

This part 4 is known as and may be cited as the "Colorado Dental Health Care Program for Low-income Seniors". Source: L. 2014: Entire part added, (SB 14-180), ch. 314, p. 1358, § 1, effective May 31.

(1) The general assembly hereby finds and declares that: (a) The purpose of this part 4 is to promote the health and welfare of Colorado low-income seniors by providing access to patient-centered dental care and services to individuals sixty years of age or older whose income and…

As used in this part 4, unless the context otherwise requires: (1) "Advisory committee" means the senior dental advisory committee created in section 25.5-3-406. (2) "Covered dental care services" are to be defined by rules of the medical services board pursuant to section 25.5-3…

(1) (a) There is created in the state department the Colorado dental health care program for low-income seniors to provide covered dental care services for eligible seniors who are not eligible for dental services under medicaid, the old age pension health and medical care progra…

(1) On or before September 1, 2015, and each September 1 thereafter, each qualified grantee receiving a dental health-care services grant shall report to the state department concerning the number of eligible seniors served, the types of dental and oral health services provided, …

(1) (a) There is created in the state department a senior dental advisory committee comprised of eleven members appointed by the executive director as follows: (I) A member representing the state department; (II) A dentist in private practice providing dental care to the senior p…

As used in this part 5, unless the context otherwise requires: (1) "Health-care facility" means: (a) A hospital licensed as a general hospital pursuant to part 1 of article 3 of title 25; (b) A hospital established pursuant to section 23-21-503 or 25-29-103; (c) Any freestanding …

(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 described in articles 4, …

(1) After completion of the screening conducted pursuant to section 25.5-3-502, a health-care facility shall request information from a patient to complete a uniform application for discounted care if: (a) The health-care facility needs more information to make a determination of…

(1) Beginning September 1, 2022, if a patient is screened pursuant to section 25.5-3-502 or has completed a uniform application pursuant to section 25.5-3-502.5 and is determined to be a qualified patient, a health-care facility and a licensed health-care professional shall, for …

(1) A health-care facility shall make information developed by the state department about patients' rights under this part 5 and a link on the state department website to access the uniform application developed by the state department pursuant to section 25.5-3-505 (2)(i) availa…

(1) Beginning September 1, 2023, and each September 1 thereafter, each health-care facility and licensed health-care professional shall report to the state department data that the state department determines is necessary to evaluate compliance across race, ethnicity, age, and pr…

(1) Beginning September 1, 2022, before assigning or selling patient debt to a collection agency, as defined in section 5-16-103 (3)(a), or a debt buyer, as defined in section 5-16-103 (8.5), or before pursuing, either directly or indirectly, any permissible extraordinary collect…

(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…

(1) The general assembly finds and declares that: (a) Safety net providers in the state incur significant costs by providing services to a large portion of the state's low-income, uninsured populations and individuals and families enrolled in medicaid or the children's basic heal…

As used in this part 6, unless the context otherwise requires: (1) "Children's basic health plan" has the same meaning as set forth in section 25.5-8-103 (2). (2) "Eligible safety net provider" means a safety net provider determined, pursuant to section 25.5-3-604 (2), to be elig…

(1) (a) The provider stabilization fund is created in the state treasury. The provider stabilization fund consists of: (I) Money credited to the fund as a loan from the unclaimed property trust fund pursuant to section 38-13-801 (6); (II) Any other money the general assembly may …

(1) (a) The state department, in collaboration with the provider stabilization fund advisory board, shall annually allocate money appropriated by the general assembly from the provider stabilization fund as provider stabilization payments to safety net providers in the state that…