Bill > HB1235

This bill makes several changes to Medicaid services and administration in Colorado. Beginning December 1, 2026, transportation brokers that manage non-emergency medical transportation for Medicaid members will be required to report specific data about their contracted transportation providers, such as the number of rides requested and completed, cancellation rates, costs, and average hold times for calls, as well as information on grievances and provider terminations; this data will be included in the state department's annual "SMART Act" presentation. The bill also requires the Medical Services Board to create rules for federal community engagement requirements for Medicaid eligibility, aiming to reduce administrative burdens for applicants and members, and starting January 1, 2027, home- and community-based service agencies will need to submit their medical loss ratio, which is the percentage of revenue spent on direct care versus administrative costs, to the state department, which will then publish this data annually. Additionally, the bill prohibits the state department from implementing certain reimbursement reductions for outpatient therapy services, clarifies that licensed providers, not just opioid treatment programs, can be reimbursed for administering medication-assisted treatment in jails, and repeals the State Medical Assistance and Services Advisory Council. It also updates definitions related to noncitizen eligibility for Medicaid and modifies provisions regarding when qualified noncitizens can receive benefits, including exceptions for pregnant individuals and children under nineteen.