Read the full stored bill text
Second Regular Session
Seventy-fifth General Assembly
STATE OF COLORADO
REENGROSSED
This Version Includes All Amendments
Adopted in the House of Introduction
LLS NO. 26-0232.01 Josh Schultz x5486 HOUSE BILL 26-1069
House Committees Senate Committees
Health & Human Services
Appropriations
A BILL FOR AN ACT
CONCERNING INCREASING THE AV AILABILITY OF EMERGENCY101
MEDICAL SERVICES, AND, IN CONNECTION THEREWITH, MAKING102
AND REDUCING AN APPROPRIATION.103
Bill Summary
(Note: This summary applies to this bill as introduced and does
not reflect any amendments that may be subsequently adopted. If this bill
passes third reading in the house of introduction, a bill summary that
applies to the reengrossed version of this bill will be available at
http://leg.colorado.gov.)
The bill clarifies that "emergency services" includes transportation
of an individual to an appropriate location other than a hospital or
community integrated health-care service agency (agency).
The use of telemedicine when an insured person has encountered
an ambulance service or agency to prevent the need to transport the
HOUSE
3rd Reading Unamended
March 9, 2026
HOUSE
Amended 2nd Reading
March 6, 2026
HOUSE SPONSORSHIP
Feret and Stewart K., Bacon, Boesenecker, Bradley, Brown, Camacho, Carter, Duran,
Flanell, Gonzalez R., Hamrick, Jackson, Johnson, Joseph, Keltie, Lieder, Lindsay, Lukens,
Marshall, McCluskie, McCormick, Nguyen, Paschal, Phillips, Rutinel, Slaugh, Smith, Stewart
R., Titone
SENATE SPONSORSHIP
Mullica,
Shading denotes HOUSE amendment. Double underlining denotes SENATE amendment.
Capital letters or bold & italic numbers indicate new material to be added to existing law.
Dashes through the words or numbers indicate deletions from existing law.
person to an emergency department is included in the definition of
"emergency services", which services are required to be made available
to insured persons 24 hours per day, 7 days per week.
The bill defines "first responder" to include:
!A peace officer;
! A firefighter;
! A volunteer firefighter;
! An emergency medical service provider; or
! A mental health professional who responds in a
professional capacity to a justifiable medical emergency.
The bill requires the executive director of the department of public
health and environment to adopt ru les by June 1, 2027, authorizing an
emergency medical service provider with a community paramedic
endorsement who is employed by, volunteering for, or contracting with
a licensed agency to provide for the inventory, compliance, and
administration of, or to directly administer, medications, procedures, or
diagnostic testing.
Beginning January 1, 2027, the bill requires the department of
health care policy and financing to reimburse the following entities under
the "Colorado Medical Assistance Act":
! An ambulance service or an agency for transportation by an
ambulance or other vehicle to a hospital or other
destination as deemed appropriate by the ambulance
service's or agency's medical director;
! An ambulance service or an agency for treatment on the
scene of a medical emergency, which treatment does not
result in transportation; and
! A qualified provider, an ambulance service, or an agency
for evaluation by telemedicine of a person being treated by
an ambulance service or an agency for the purpose of
preventing the need to transport the person to a hospital.
Be it enacted by the General Assembly of the State of Colorado:1
2
SECTION 1. In Colorado Revised Statutes, 10-16-704, amend3
(19)(e)(I) and (19)(e)(II) introductory portion; and add (19)(l.5) as4
follows:5
10-16-704. Network adequacy - required disclosures - balance6
billing - rules - legislative declaration - definitions.7
1069-2-
(19) As used in this section:1
(e) (I) "Emergency services", with respect to an emergency2
medical condition, means:3
(A) A medical screening examination that is within the capability4
of the emergency department of a hospital or a freestanding emergency5
department, as applicable, including ancillary services routinely available6
to the emergency department, AN AMBULANCE SERVICE , AS DEFINED IN7
SECTION 25-3.5-103 (3), OR AN AGENCY PROVIDING OUT-OF-HOSPITAL8
SERVICES to evaluate the emergency medical condition; and9
(B) Within the capabilities of the staff and facilities available at10
the hospital, regardless of the department in which further examination11
or treatment is furnished, or the freestanding emergency department, as12
applicable, further medical examination and treatment as are required to13
stabilize the patient to ensure, within reasonable medical probability, that14
no material deterioration of the condition is NOT likely to result from or15
occur during the transfer of the patient from a facility; 16
(C) THE GROUND TRANSPORTATION OF A COVERED PERSON TO AN17
APPROPRIATE LOCATION OTHER THAN A HOSPITAL, IF THE DESTINATION IS18
A CRISIS STABILIZATION UNIT AND THE PATIENT MEETS CLINICALLY19
VALIDATED CRITERIA APPROVED BY THE EMERGENCY MEDICAL SERVICE20
PROVIDER'S MEDICAL DIRECTOR FOR DIVERSION TO THE SELECTED21
ALTERNATIVE DESTINATION. THE EMERGENCY MEDICAL SERVICE22
PROVIDER SHALL BILL THE CARRIER FOR TRANSPORTATION OF THE23
COVERED PERSON AT THE BASIC LIFE SUPPORT RATE; OR24
(D) THE EXAMINATION AND TREATMENT OF A COVERED PERSON AT25
THE SCENE OF A MEDICAL EMERGENCY OR DURING TRANSPORT FROM THE26
SCENE OF A MEDICAL EMERGENCY BY AN AMBULANCE SERVICE, AS27
1069-3-
DEFINED IN SECTION 25-3.5-103 (3), OR AN AGENCY PROVIDING1
OUT-OF-HOSPITAL SERVICES.2
(II) For a covered person who THAT is provided services described3
in subsections (19)(e)(I)(A) and (19)(e)(I)(B) SUBSECTION (19)(e)(I) of4
this section with respect to an emergency medical condition, unless each5
of the conditions in subsection (19)(e)(III) of this section are met, the6
term "emergency services" includes services that are:7
(l.5) (I) "OUT-OF-HOSPITAL SERVICES" MEANS FURNISHING ANY8
NECESSARY GOODS AND SERVICES OUTSIDE OF A HOSPITAL SETTING FOR9
THE PURPOSE OF PREVENTING, ALLEVIATING, CURING, OR HEALING HUMAN10
ILLNESS, A PHYSICAL DISABILITY, A PHYSICAL INJURY, OR A SUBSTANCE11
USE DISORDER WHILE RESPONDING TO AN EMERGENCY OR OTHER12
HEALTH-CARE CONDITION.13
(II) " O UT-OF-HOSPITAL SERVICES" DOES NOT INCLUDE14
PREHOSPITAL SETTING TRANSPORTS.15
SECTION 2. In Colorado Revised Statutes, 24-1-119, add (19)16
as follows:17
24-1-119. Department of public health and environment -18
creation.19
(19) T HE STATE EMERGENCY MEDICAL AND TRAUMA SERVICES20
ADVISORY COUNCIL, CREATED IN SECTION 25-3.5-104 (1), IS A TYPE 221
ENTITY, AS DEFINED IN SECTION 24-1-105.22
SECTION 3. In Colorado Revised Statutes, 25-3.5-103, amend23
(8.5), (8.6), (8.7), (8.8), and (9); and add (9.5) as follows:24
25-3.5-103. Definitions.25
As used in this article 3.5, unless the context otherwise requires:26
(8.5) "Health information organization network" means an27
1069-4-
organization that oversees and governs the exchange of health-related1
information among organizations according to nationally recognized2
standards. "FIRST RESPONDER" MEANS:3
(a) A PEACE OFFICER, AS DESCRIBED IN SECTION 16-2.5-101;4
(b) A FIREFIGHTER, AS DEFINED IN SECTION 29-5-203 (10);5
(c) A VOLUNTEER FIREFIGHTER , AS DEFINED IN SECTION6
31-30-1102 (9)(a);7
(d) AN EMERGENCY MEDICAL SERVICE PROVIDER; AND8
(e) A MENTAL HEALTH PROFESSIONAL WHO RESPONDS IN A9
PROFESSIONAL CAPACITY TO A JUSTIFIABLE MEDICAL EMERGENCY.10
(8.6) "Justifiable medical emergency" means an underlying11
medical, traumatic, or psychiatric condition posing an immediate safety12
risk to the individual, emergency medical service provider, or public.13
Excited delirium, any subsequent term for excited delirium, or any acute14
psychiatric diagnosis not recognized in the most recent edition of the15
diagnostic and statistical manual of mental disorders is not a justifiable16
medical emergency "HEALTH INFORMATION ORGANIZATION NETWORK "17
MEANS AN ORGANIZATION THAT OVERSEES AND GOVERNS THE EXCHANGE18
OF HEALTH-RELATED INFORMATION AMONG ORGANIZATIONS ACCORDING19
TO NATIONALLY RECOGNIZED STANDARDS.20
(8.7) "Local licensing authority" means the governing body of a21
city and county or the board of county commissioners in a county in the22
state "J USTIFIABLE MEDICAL EMERGENCY " MEANS AN UNDERLYING23
MEDICAL, TRAUMATIC, OR PSYCHIATRIC CONDITION POSING AN IMMEDIATE24
SAFETY RISK TO THE INDIVIDUAL , EMERGENCY MEDICAL SERVICE25
PROVIDER, OR PUBLIC. EXCITED DELIRIUM, ANY SUBSEQUENT TERM FOR26
EXCITED DELIRIUM , OR ANY ACUTE PSYCHIATRIC DIAGNOSIS NOT27
1069-5-
RECOGNIZED IN THE MOST RECENT EDITION OF THE DIAGNOSTIC AND1
STATISTICAL MANUAL OF MENTAL DISORDERS IS NOT A JUSTIFIABLE2
MEDICAL EMERGENCY.3
(8.8) "Medical direction" includes, but is not limited to, the4
following: "LOCAL LICENSING AUTHORITY" MEANS THE GOVERNING BODY5
OF A CITY AND COUNTY OR THE BOARD OF COUNTY COMMISSIONERS IN A6
COUNTY IN THE STATE.7
(a) Approval of the medical components of treatment protocols8
and appropriate prearrival instructions;9
(b) Routine review of program performance and maintenance of10
active involvement in quality improvement activities, including access to11
dispatch tapes as necessary for the evaluation of procedures;12
(c) Authority to recommend appropriate changes to protocols for13
the improvement of patient care; and14
(d) Provision of oversight for the ongoing education, training, and15
quality assurance for providers of emergency care.16
(9) "Patient" means any individual who is sick, injured, or17
otherwise incapacitated or helpless. "MEDICAL DIRECTION" INCLUDES, BUT18
IS NOT LIMITED TO, THE FOLLOWING:19
(a) A PPROVAL OF THE MEDICAL COMPONENTS OF TREATMENT20
PROTOCOLS AND APPROPRIATE PREARRIVAL INSTRUCTIONS;21
(b) R OUTINE REVIEW OF PROGRAM PERFORMANCE AND22
MAINTENANCE OF ACTIVE INVOLVEMENT IN QUALITY IMPROVEMENT23
ACTIVITIES, INCLUDING ACCESS TO DISPATCH TAPES AS NECESSARY FOR24
THE EVALUATION OF PROCEDURES;25
(c) A UTHORITY TO RECOMMEND APPROPRIATE CHANGES TO26
PROTOCOLS FOR THE IMPROVEMENT OF PATIENT CARE; AND27
1069-6-
(d) P ROVISION OF OVERSIGHT FOR THE ONGOING EDUCATION ,1
TRAINING, AND QUALITY ASSURANCE FOR PROVIDERS OF EMERGENCY2
CARE.3
(9.5) "PATIENT" MEANS AN INDIVIDUAL WHO IS SICK, INJURED, OR4
OTHERWISE INCAPACITATED OR HELPLESS.5
SECTION 4. In Colorado Revised Statutes, 25-3.5-104, amend6
(4)(d) as follows:7
25-3.5-104. Emergency medical and trauma services advisory8
council - creation - duties.9
(4) The council shall:10
(d) Review and approve MAKE RECOMMENDATIONS ON new rules11
CONCERNING EMERGENCY MEDICAL AND TRAUMA SERVICES and12
modifications to rules CONCERNING EMERGENCY MEDICAL AND TRAUMA13
SERVICES existing prior to July 1, 2000, prior to the adoption of such rules14
or modifications by the state board of health;15
16
SECTION 5. In Colorado Revised Statutes, add 25.5-4-436 as17
follows:18
25.5-4-436. Transportation by ambulance or other vehicle -19
treatment on scene of a medical emergency - evaluation by20
telemedicine - definitions.21
(1) O N AND AFTER JANUARY 1, 2027, THE STATE DEPARTMENT22
SHALL REIMBURSE:23
(a) AN AMBULANCE SERVICE FOR GROUND TRANSPORTATION BY24
AN AMBULANCE OR OTHER APPROPRIATELY SITUATED VEHICLE TO A25
HOSPITAL OR OTHER DESTINATION AS DEEMED APPROPRIATE BY THE26
AMBULANCE SERVICE'S MEDICAL DIRECTOR;27
1069-7-
(b) AN AMBULANCE SERVICE FOR TREATMENT ON THE SCENE1
OF A MEDICAL EMERGENCY , WHICH TREATMENT DOES NOT RESULT IN2
GROUND TRANSPORTATION; AND3
(c) A QUALIFIED PROVIDER , AN AMBULANCE SERVICE , OR AN4
AGENCY PROVIDING OUT-OF-HOSPITAL SERVICES FOR EVALUATION BY5
TELEMEDICINE OF A PERSON BEING TREATED BY AN AMBULANCE SERVICE6
OR AN AGENCY PROVIDING OUT-OF-HOSPITAL SERVICES FOR THE PURPOSE7
OF PREVENTING THE NEED TO TRANSPORT THE PERSON TO A HOSPITAL .8
TELEMEDICINE SHALL BE BILLED USING AN OFFICE OR OTHER OUTPATIENT9
SERVICES RATE AND NOT USING AN EMERGENCY DEPARTMENT RATE. AN10
AMBULANCE SERVICE OR AN AGENCY PROVIDING OUT -OF-HOSPITAL11
SERVICES IS NOT REQUIRED TO PROCURE TELEMEDICINE FOR A COVERED12
PERSON AS A CONDITION OF PAYMENT.13
(2) AS USED IN THIS SECTION, UNLESS THE CONTEXT OTHERWISE14
REQUIRES:15
(a) "A MBULANCE SERVICE " HAS THE MEANING SET FORTH IN16
SECTION 25-3.5-103 (3).17
(b) (I) " OUT-OF-HOSPITAL SERVICES" MEANS FURNISHING ANY18
NECESSARY GOODS AND SERVICES OUTSIDE OF A HOSPITAL SETTING FOR19
THE PURPOSE OF PREVENTING, ALLEVIATING, CURING, OR HEALING HUMAN20
ILLNESS, A PHYSICAL DISABILITY , A PHYSICAL INJURY, OR A SUBSTANCE21
USE DISORDER WHILE RESPONDING TO AN EMERGENCY OR OTHER22
HEALTH-CARE CONDITION.23
(II) "O UT-OF-HOSPITAL SERVICES" DOES NOT INCLUDE24
PREHOSPITAL SETTING TRANSPORTS.25
SECTION 6. In Colorado Revised Statutes, 12-280-404, amend26
(7)(b) as follows:27
1069-8-
12-280-404. Program operation - access - rules - definitions.1
(7) (b) The board may, within existing funds available for2
operation of the program, provide a means of sharing prescription3
information and electronic health records through a board-approved4
vendor and method with the health information organization network, as5
defined in section 25-3.5-103 (8.5) SECTION 25-3.5-103 (8.6), in order to6
work collaboratively with the statewide health information exchanges7
designated by the department of health care policy and financing. Use of8
the information made available pursuant to this subsection (7)(b) is9
subject to privacy and security protections in state law and the federal10
"Health Insurance Portability and Accountability Act of 1996",11
Pub.L.104-191, as amended, and any implementing regulations. 12
SECTION 7. In Colorado Revised Statutes, 25-54-101, amend13
(4) as follows:14
25-54-101. Definitions.15
As used in this article 54, unless the context otherwise requires:16
(4) "Health information organization network" means a Colorado17
organization that has experience in overseeing and governing the18
exchange of health-related information among organizations according19
to Colorado law and nationally recognized standards including but not20
limited to the federal "Health Insurance Portability and Accountability21
Act of 1996", Pub.L. 104-191, as amended HAS THE MEANING SET FORTH22
IN SECTION 25-3.5-103 (8.6).23
SECTION 8. In Colorado Revised Statutes, 27-50-101, amend24
(14) as follows:25
27-50-101. Definitions.26
As used in this article 50, unless the context otherwise requires:27
1069-9-
(14) "Health information organization network" has the same1
meaning as defined in section 25-3.5-103 (8.5) SECTION 25-3.5-103 (8.6).2
SECTION 9. Appropriation - adjustments to 2026 long bill.3
(1) Except as provided in subsection (3) of this section, to implement this4
act, appropriations made in the annual general appropriation act for the5
2026-27 state fiscal year to the department of health care policy and6
financing for medical and long-term care services for Medicaid eligible7
individuals are adjusted as follows:8
(a) The general fund appropriation is decreased by $548,547; and9
(b) The cash funds appropriation from the healthcare affordability10
and sustainability hospital provider fee cash fund created in section11
25.5-4-402.4 (5)(a), C.R.S., is decreased by $124,822.12
(2) The decrease of the appropriations in subsection (1) of this13
section is based on the assumption that the anticipated amount of federal14
funds received for the 2026-27 state fiscal year by the department of15
health care policy and financing for medical and long-term care services16
for Medicaid eligible individuals will decrease by $1,458,735.17
(3) Subsection (1) of this section does not require a reduction of18
an appropriation in the annual general appropriation act for the 2026-2719
state fiscal year if:20
(a) The amount of the general fund appropriation made in the21
annual general appropriation act for the 2026-27 state fiscal year to the22
department of department of health care policy and financing for medical23
and long-term care services for Medicaid eligible individuals is less than24
the amount of the adjustment required in subsection (1) of this section; or25
(b) The annual general appropriation act for the 2026-27 state26
fiscal year does not include an appropriation to the department of health27
1069-10-
care policy and financing for medical and long-term care services for1
Medicaid eligible individuals.2
SECTION 10. Appropriation. For the 2026-27 state fiscal year,3
$26,353 is appropriated to the department of public health and4
environment for use by the health facilities and emergency medical5
services division. This appropriation is from the general fund. To6
implement this act, the division may use this appropriation for7
administration and operations.8
SECTION 11. Effective date. This act takes effect upon passage;9
except that section 9 of this act takes effect only if the annual general10
appropriation act for the 2026-27 state fiscal year becomes law, in which11
case section 9 takes effect upon the effective date of this act or of the12
annual general appropriation act for state fiscal year 2026-27, whichever13
is later.14
SECTION 12. Safety clause. The general assembly finds,15
determines, and declares that this act is necessary for the immediate16
preservation of the public peace, health, or safety or for appropriations for17
the support and maintenance of the departments of the state and state18
institutions.19
1069-11-