This amendment changes the bill to define outpatient therapy services and requires the state department to give providers at least six months' notice before applying new payment reductions for those specific therapies.
Colorado2026Enacted
HB26-1235
Updates to Medicaid Rules and Reporting
Last scannedAug 24, 2026, 8:22 AM
In one sentence
This law requires transportation brokers to report provider data, changes a term for noncitizens, sets rules for payment notices on therapy cuts, allows jail medication reimbursement, updates community engagement reporting, collects cost ratios from service agencies, and removes an advisory council.
What it does
- Requires transportation brokers managing nonemergency medical rides for Medicaid members to send information about their contracted providers to the state department by December 1, 2026, and every year after that.
- Changes the term 'qualified alien' to 'qualified noncitizen' in Medicaid rules to match federal requirements.
- Requires a six-month notice and at least one stakeholder meeting before applying new payment cuts for outpatient therapy services.
- Requires reimbursement for providers licensed to prescribe, dispense, compound, or administer medication-assisted treatment inside jails.
- Orders the medical services board to create rules by January 1, 2027, that meet federal community engagement standards and requires the state department to publish related data online.
- Directs the state health department to collect cost ratio information from home- and community-based service agencies and report it to lawmakers.
Who it affects
- Transportation brokers who manage nonemergency medical rides for Medicaid members
- Health care providers offering outpatient therapy or medication-assisted treatment in jails
- Home- and community-based service provider agencies
- The state department of health care policy and financing
Limits and unknowns
- The law does not specify the exact format or details required in the transportation broker reports.
- It is unclear how much funding will support these new reporting and meeting requirements.
- The specific impact of community engagement rules on enrollment numbers has not been determined yet.
Plain language
Terms to know
- Transportation broker
- A company that manages nonemergency medical transportation for Medicaid members.
- Medication-assisted treatment
- Medical care using medication to treat substance use disorders, which this law allows providers in jails to be reimbursed for if licensed.
- Qualified noncitizen
- A term used instead of 'qualified alien' to describe certain immigrants who may be eligible for Medicaid benefits.
Official record
Sources
Official summary
On or before December 1, 2026, and annually thereafter, the act requires each transportation broker that administers nonemergency medical transportation to medicaid members to submit certain information to the department of health care policy and financing (state department) regarding transportation providers that the transportation broker contracts with. Beginning January 1, 2027, the state department is required to include this information in its annual 'SMART Act' presentation. The act changes the term 'qualified alien' to 'qualified noncitizen' to align with federal requirements. If the state department plans to implement, apply, or enforce new multiple procedure payment reductions for outpatient therapy services, the act requires the state department to provide notice to the impacted providers of the changes at least 6 months prior to implementing the changes and to hold at least one stakeholder meeting to discuss the payment reductions. The act requires the state department to reimburse a provider who is licensed and authorized to prescribe, dispense, compound, or administer medication-assisted treatment in a jail setting. The act requires the medical services board to adopt rules before January 1, 2027, to comply with federal community engagement requirements and requires the state department make available on its website data on the community engagement requirements and their impact on medical assistance enrollment. The act requires the state department to collect direct care service cost to administrative cost ratio information from home- and community-based service provider agencies and submit a report to the general assembly detailing the information collected. The act repeals the state medical assistance and services advisory council. (Note: This summary applies to this bill as enacted.)
Official activity
Bill history
- Governor SignedGovernor
- Sent to the GovernorGovernor
- Signed by the President of the SenateSenate
- Signed by the Speaker of the HouseHouse
- Senate Third Reading Passed - No AmendmentsSenate
- Senate Second Reading Passed - No AmendmentsSenate
- Senate Committee on Health & Human Services Refer Unamended - Consent Calendar to Senate Committee of the WholeSenate
- Introduced In Senate - Assigned to Health & Human ServicesSenate
- House Third Reading Passed - No AmendmentsHouse
- House Third Reading Laid Over Daily - No AmendmentsHouse
- House Second Reading Special Order - Passed with Amendments - Committee, FloorHouse
- House Second Reading Laid Over Daily - No AmendmentsHouse
- House Committee on Health & Human Services Refer Amended to House Committee of the WholeHouse
- Introduced In House - Assigned to Health & Human ServicesHouse
Changes
Amendments
9 stored
This amendment adds a rule that automatically cancels the state board's power to make new regulations if federal laws requiring community engagement for Medicaid are removed.
This amendment requires large home- and community-based service agencies to report detailed financial data about how much they spend on direct care workers versus administrative costs.
This amendment adds a new rule requiring the state to publish monthly data about Medicaid applications and renewals on its website starting in March 2027.
This amendment adds a detailed list of specific costs and data that transportation brokers must report to the state regarding how they pay and support direct care workers.
This amendment updates Colorado Medicaid laws to clarify that noncitizens who arrived before August 22, 1996, are eligible for benefits, while those arriving on or after that date must wait five years unless they are pregnant women or children under nineteen.
This amendment changes the law citation used in a report, lowers the number of members needed to trigger certain rules from one hundred to thirty with new wage requirements, and adds privacy protections for specific data.
This amendment removes a phrase from the bill that required transportation brokers to submit reports for each specific reporting period.
This amendment requires the state to hold at least one meeting with stakeholders before December 1, 2026, to discuss how new payment rules for outpatient therapy will be applied and enforced.