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CO HB1235

CO HB1235
Updates to Medicaid


summary

Introduced
02/18/2026
In Committee
04/21/2026
Crossed Over
04/21/2026
Passed
Dead

Introduced Session

2026 Regular Session

Bill Summary

Beginning December 1, 2026, the bill requires each transportation broker that administers nonemergency medical transportation to medicaid members to submit certain information to the state department regarding transportation providers that the transportation broker contracts with. The department of health care policy and financing (state department) is required to include this information in its annual "SMART Act" presentation. The bill requires the medical services board to adopt rules to implement the federal community engagement requirements. Under current law, the state department is required to reimburse an opioid treatment program for administering medication-assisted treatment in a jail setting. The bill amends this requirement to require the state department to reimburse a licensed provider who is licensed and authorized to prescribe, dispense, compound, or administer medication-assisted treatment in a jail setting. The bill prohibits the state department from implementing a multiple procedure payment reduction, compound billing methodology, or substantially similar reimbursement policy for outpatient therapy services. Beginning January 1, 2027, the bill requires home- and community-based service agencies to submit their medical loss ratio to the state department. The state department is required to publish this medical loss ratio data on the state department's website on an annual basis. The bill repeals the state medical assistance and services advisory council.

AI Summary

This bill makes several changes to Medicaid in Colorado, including requiring transportation brokers that arrange nonemergency medical transportation for Medicaid members to report detailed information about their providers to the state by December 1, 2026, which will then be included in the state's annual "SMART Act" presentation. It also mandates that the Medical Services Board create rules to comply with 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 report their medical loss ratio, which is the percentage of revenue spent on direct care versus administrative costs, to the state, with this data to be published annually. The bill also clarifies that licensed providers, not just opioid treatment programs, can be reimbursed for administering medication-assisted treatment in jails and prohibits the state from implementing certain payment reduction policies for outpatient therapy services. Finally, the bill repeals the state medical assistance and services advisory council and updates definitions related to noncitizen eligibility for Medicaid benefits.

Committee Categories

Health and Social Services

Sponsors (8)

Last Action

Introduced In Senate - Assigned to Health & Human Services (on 04/21/2026)

bill text


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