HB26-1235 • 2026

Updates to Medicaid

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

Children Healthcare Labor Taxes

Passed Legislature

This bill passed both chambers and reached final enrollment, even if later executive action is not shown here.

Sponsor: Rep. L. Feret, Sen. L. Daugherty
Last action: 2026-04-13
Official status: House Second Reading Special Order - Passed with Amendments - Committee, Floor
Effective date: Not listed

Plain English Breakdown

The official source material does not provide information on outpatient therapy reimbursement prohibitions or home- and community-based service agency reporting requirements. These sections were removed as they are not supported by the provided text.

Medicaid Updates

This bill updates the Medicaid program by requiring transportation brokers to report information about nonemergency medical transportation and changing reimbursement rules for medication-assisted treatment in jails.

What This Bill Does

Requires transportation brokers that provide nonemergency medical rides to Medicaid members to give the state department details about their service providers starting December 1, 2026.
Changes how the state pays for medication-assisted treatment in jails by allowing licensed providers to be reimbursed instead of just opioid treatment programs.

Who It Names or Affects

Transportation brokers providing nonemergency medical rides for Medicaid members
Licensed providers offering medication-assisted treatment in jails

Terms To Know

SMART Act presentation: An annual report by the state department on Medicaid-related matters.

Limits and Unknowns

The bill does not specify what happens if transportation brokers do not comply with the reporting requirements.
It is unclear how the new rules for outpatient therapy reimbursement will affect current practices and costs.

Amendments

These notes stay tied to the official amendment files and metadata from the legislature.

L.001

HOU Health & Human Services

Passed [*]

Plain English: The amendment changes the bill to focus on outpatient therapy services and requires the state department to notify providers six months in advance if there are any new rules about how these services are paid for under Medicaid.

Removes certain lines that refer to nonemergency medical transportation and replaces them with definitions related to outpatient therapy services.
Adds a definition of 'outpatient therapy services' which includes professional care provided by therapists in settings other than hospitals.
Requires the state department to give providers at least six months notice before implementing any new rules about how outpatient therapy services are paid for under Medicaid.

The amendment text does not provide details on what specific changes might be made to payment procedures, only that providers must be notified in advance.

L.002

HOU Health & Human Services

Passed [*]

Plain English: The amendment changes the rules for transportation brokers who manage nonemergency medical rides for Medicaid members by removing certain rule-making powers and adding new requirements related to federal law.

Removes the state board's authority to make rules if a specific part of federal law is removed or changed.
Requires the state board to notify the Revisor of Statutes via email when a condition specified in the amendment occurs.

The exact impact and implementation details are unclear due to references to future changes in federal law.

L.004

HOU Health & Human Services

Passed [*]

Plain English: The amendment requires home- and community-based service provider agencies serving more than one hundred Medicaid members to report detailed information about their direct care workforce compensation and administrative costs by September 30, 2027.

Adds a new section requiring home- and community-based service providers to submit specific financial data related to direct care services and administrative expenses.
Specifies that the state department must collect detailed information on Medicaid revenue, workforce classification, compensation details for both employees and independent contractors, and total compensation paid by affiliated entities.

The amendment text does not specify penalties or enforcement mechanisms for non-compliance with reporting requirements.
It is unclear how the collected data will be used beyond legislative informational purposes.

L.005

Second Reading

Passed [**]

Plain English: The amendment updates the bill to require the state department to report certain Medicaid enrollment data monthly starting March 1, 2027, and adds a requirement for the executive director to notify the revisor of statutes if specific federal requirements are repealed.

Adds new reporting requirements for the state department to publish monthly data on Medicaid applications and renewals on its website.
Requires the executive director to notify the revisor of statutes via email if certain federal community engagement requirements under Title XIX of the Social Security Act are repealed.

The exact nature and impact of the federal 'community engagement requirements' mentioned in the amendment may be unclear without additional context.
Some technical details about how the reporting will occur and what data is necessary might not be fully explained by this amendment text alone.

L.006

Second Reading

Passed [**]

Plain English: The amendment changes the information that transportation brokers must submit to the state department regarding Medicaid members' nonemergency medical transportation.

Removes specific lines from the original bill text and replaces them with new requirements for reporting detailed wage, benefit, and operational data related to direct care workers.

The exact impact of these changes on current practices is not fully explained in the provided amendment text.

L.008

Second Reading

Passed [**]

Plain English: The amendment changes the definition of 'qualified alien' and updates Medicaid rules to specify which non-citizens are eligible for benefits based on when they entered the United States.

Changes the term 'qualified alien' in Colorado Revised Statutes to align with federal definitions.
Adds new provisions that allow certain qualified noncitizens who entered before August 22, 1996, to receive Medicaid benefits.
Specifies that qualified noncitizens entering on or after August 22, 1996, are not eligible for Medicaid benefits for five years, with exceptions for pregnant women and children under 19.

The amendment text is complex and may require further clarification to understand all implications.
Details about federal financial participation and state appropriations are mentioned but not fully explained in the provided text.

L.009

Second Reading

Passed [**]

Plain English: The amendment changes certain references and requirements related to transportation brokers administering nonemergency medical transportation for Medicaid members.

Changes the reference from '25.5-5-428' to '25.5-6-120' in multiple places within the bill and report.
Reduces the number of members served by a home- and community-based service provider agency from 100 to 30, adds base wage requirements set by the state department, and specifies information that can be collected from these agencies.

The amendment text does not provide clear details about what '25.5-6-120' refers to or how it affects existing regulations.
It is unclear how reducing the number of members served and adding base wage requirements will impact service providers.

L.010

Second Reading

Passed [**]

Plain English: The amendment removes the phrase 'for each reporting period' from a section of HB26-1235.

Removes the requirement for transportation brokers to submit information 'for each reporting period'.

It is unclear what specific impact this removal will have on how often transportation brokers must report information.

L.011

Second Reading

Passed [**]

Plain English: The amendment requires the state department to hold at least one stakeholder meeting to discuss the implementation of new outpatient therapy service changes.

Adds a requirement for the state department to organize and host at least one stakeholder meeting to discuss how the new multiple procedure payment reduction for outpatient therapy services will be implemented, applied, and enforced.

The amendment does not specify when or where these meetings must take place.
It is unclear what specific metrics the state department plans to use in implementing the changes.

Bill History

2026-04-13 House
House Second Reading Special Order - Passed with Amendments - Committee, Floor
2026-03-16 House
House Second Reading Laid Over Daily - No Amendments
2026-03-11 House
House Committee on Health & Human Services Refer Amended to House Committee of the Whole
2026-02-18 House
Introduced In House - Assigned to Health & Human Services

Official Summary Text

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 i mplement 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.
(Note: This summary applies to this bill as introduced.)

Current Bill Text

Read the full stored bill text

Second Regular Session
Seventy-fifth General Assembly
STATE OF COLORADO
ENGROSSED
This Version Includes All Amendments Adopted
on Second Reading in the House of Introduction
LLS NO. 26-0390.01 Chelsea Princell x4335 HOUSE BILL 26-1235
House Committees Senate Committees
Health & Human Services
A BILL FOR AN ACT
CONCERNING UPDATES TO THE MEDICAL ASSISTANCE PROGRAM.101
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.)
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
HOUSE
Amended 2nd Reading
April 13, 2026
HOUSE SPONSORSHIP
Feret,
SENATE SPONSORSHIP
Daugherty,
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.
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.
Be it enacted by the General Assembly of the State of Colorado:1
SECTION 1. In Colorado Revised Statutes, add 25.5-1-803 as2
follows:3
25.5-1-803. Transportation provider data reporting4
requirements.5
(1) ON OR BEFORE DECEMBER 1, 2026, AND ON OR BEFORE EACH6
DECEMBER 1 THEREAFTER , EACH TRANSPORTATION BROKER SHALL7
REPORT THE FOLLOWING INFORMATION TO THE STATE DEPARTMENT:8
(a) R EGARDING EACH TRANSPORTATION PROVIDER THAT THE9
TRANSPORTATION BROKER CONTRACTS WITH:10
(I) THE TOTAL NUMBER OF RIDES REQUESTED;11
(II) THE TOTAL NUMBER OF RIDES COMPLETED;12
(III) THE TOTAL NUMBER OF RIDES CANCELED BY MEMBERS AND13
THE TRANSPORTATION PROVIDER;14
(IV) T HE TOTAL COST OF RIDES COMPLETED CATEGORIZED BY15
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PROCEDURE CODE; AND1
(V) T HE TOTAL NUMBER OF CALLS RECEIVED FROM MEMBERS2
REQUESTING NONEMERGENCY MEDICAL TRANSPORTATION AND THE3
AVERAGE TIME A MEMBER SPENT ON HOLD;4
(b) T HE NUMBER OF GRIEVANCES SUBMITTED BY MEMBERS5
REGARDING A TRANSPORTATION PROVIDER THAT WERE SUBSTANTIATED,6
AND THE TRANSPORTATION PROVIDER THAT THE GRIEVANCE CONCERNS;7
AND8
(c) T HE TOTAL NUMBER OF TRANSPORTATION PROVIDERS9
TERMINATED FROM THE TRANSPORTATION BROKER 'S NETWORK , ON A10
CORRECTIVE ACTION PLAN, OR ON A PERFORMANCE IMPROVEMENT PLAN.11
(2) BEGINNING JANUARY 1, 2027, THE STATE DEPARTMENT SHALL12
INCLUDE AS PART OF THE STATE DEPARTMENT 'S "SMART ACT"13
PRESENTATION REQUIRED BY SECTION 2-7-203 THE INFORMATION14
SUBMITTED TO THE STATE DEPARTMENT BY THE TRANSPORTATION15
BROKERS AS REQUIRED BY SUBSECTION (1) OF THIS SECTION.16
SECTION 2. In Colorado Revised Statutes, 25.5-4-103, amend17
(20) as follows:18
25.5-4-103. Definitions.19
As used in this article 4 and articles 5 and 6 of this title 25.5,20
unless the context otherwise requires:21
(20) "Qualified alien"shall have "QUALIFIED NONCITIZEN" HAS the22
meaning ascribed to that term in section 431 (b) of the federal "Personal23
Responsibility and Work Opportunity Reconciliation Act of 1996", Public24
Law 104-193, as amended.25
SECTION 3. In Colorado Revised Statutes, add 25.5-4-217 as26
follows:27
1235-3-
25.5-4-217. Multiple procedure payment reductions for1
outpatient therapy - prohibition - definitions.2
(1) AS USED IN THIS SECTION, UNLESS THE CONTEXT OTHERWISE3
REQUIRES:4
5
(a) "M ULTIPLE PROCEDURE PAYMENT REDUCTION " MEANS A6
REIMBURSEMENT METHODOLOGY THAT REDUCES PAYMENT FOR ONE OR7
MORE DIFFERENT SERVICES FURNISHED TO A MEMBER DURING THE SAME8
DATE OF SERVICE, ENCOUNTER, OR EPISODE OF CARE BASED SOLELY ON9
THE NUMBER , SEQUENCING , OR COMBINATION OF DIFFERENT SERVICES10
PERFORMED.11
(b) " O UTPATIENT THERAPY SERVICES" MEANS PROFESSIONAL12
SERVICES PROVIDED BY AN OCCUPATIONAL THERAPIST, PHYSICAL13
THERAPIST, OR SPEECH LANGUAGE PATHOLOGIST IN A SETTING OTHER14
THAN A HOSPITAL.15
(2) IF THE STATE DEPARTMENT PLANS TO IMPLEMENT, APPLY, OR16
ENFORCE A NEW MULTIPLE PROCEDURE PAYMENT REDUCTION FOR17
OUTPATIENT THERAPY SERVICES PROVIDED UNDER THE MEDICAL18
ASSISTANCE PROGRAM, THE STATE DEPARTMENT MUST PROVIDE NOTICE TO19
THE IMPACTED PROVIDERS OF THE FORTHCOMING CHANGE AT LEAST SIX20
MONTHS PRIOR TO IMPLEMENTING THE CHANGE TO ENSURE ADEQUATE21
TIME FOR PROVIDERS TO PREPARE AND HOLD AT LEAST ONE STAKEHOLDER22
MEETING TO DISCUSS THE IMPLEMENTATION, APPLICATION, AND23
ENFORCEMENT OF THE NEW MULTIPLE PROCEDURE PAYMENT REDUCTION24
FOR OUTPATIENT THERAPY SERVICES. THE STAKEHOLDER PROCESS MUST25
INCLUDE A DISCUSSION REGARDING THE METRICS THE STATE DEPARTMENT26
PLANS TO USE IN IMPLEMENTING THE CHANGES.27
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SECTION 4. In Colorado Revised Statutes, add 25.5-4-218 as1
follows:2
25.5-4-218. Community engagement re quirements for3
medicaid eligibility - notice to revisor of statutes - rules - reporting -4
repeal.5
(1) O N OR BEFORE JANUARY 1, 2027, THE STATE BOARD SHALL6
ADOPT RULES THAT ARE NECESSARY TO IMPLEMENT THE COMMUNITY7
ENGAGEMENT REQUIREMENTS OF TITLE XIX OF THE FEDERAL "SOCIAL8
SECURITY ACT OF 1965", 42 U.S.C. SEC. 1396a(xx), AS AMENDED OR9
RELOCATED, IN A MANNER THAT ENSURES ALL APPLICANTS AND MEMBERS10
CAN OBTAIN OR MAINTAIN COVERAGE WITH THE LEAST AMOUNT OF11
ADMINISTRATIVE BURDENS. 12
(2) THE STATE BOARD'S AUTHORITY TO ADOPT RULES PURSUANT13
TO SUBSECTION (1) OF THIS SECTION IS REPEALED IF THE COMMUNITY14
ENGAGEMENT REQUIREMENTS OF TITLE XIX OF THE FEDERAL "SOCIAL15
SECURITY ACT OF 1965", 42 U.S.C. SEC. 1396a(xx), AS AMENDED OR16
RELOCATED, ARE REPEALED.17
(3) THE STATE BOARD SHALL NOTIFY THE REVISOR OF STATUTES18
IN WRITING OF THE DATE WHEN THE CONDITION SPECIFIED IN SUBSECTION19
(2) OF THIS SECTION HAS OCCURRED BY EMAILING THE NOTICE TO20
REVISOROFSTATUTES.GA@COLEG.GOV. THIS SECTION IS REPEALED,21
EFFECTIVE UPON THE DATE IDENTIFIED IN THE NOTICE, OR IF THE NOTICE22
DOES NOT SPECIFY THAT DATE, UPON THE DATE OF THE NOTICE TO THE23
REVISOR OF STATUTES.24
(4) (a) B EGINNING MARCH 1, 2027, AND EACH MONTH25
THEREAFTER, THE STATE DEPARTMENT SHALL MAKE THE FOLLOWING DATA26
CONCERNING ENROLLMENT IN THE MEDICAL ASSISTANCE PROGRAM27
1235-5-
AVAILABLE ON THE STATE DEPARTMENT'S WEBSITE:1
(I) THE NUMBER OF APPLICATIONS FOR MEDICAL ASSISTANCE THAT2
WERE APPROVED AND DENIED;3
(II) T HE NUMBER OF RENEWAL APPLICATIONS FOR MEDICAL4
ASSISTANCE THAT WERE APPROVED AND DENIED;5
(III) T HE NUMBER OF MEMBERS WHOSE MEDICAL ASSISTANCE6
ELIGIBILITY WAS RENEWED USING EXISTING DATA AND RECORDS WITHOUT7
REQUIRING THE MEMBER TO SUBMIT ADDITIONAL INFORMATION;8
(IV) THE RATE OF REENROLLMENT IN THE MEDICAL ASSISTANCE9
PROGRAM WITHIN NINETY DAYS AFTER A MEMBER 'S RENEWAL10
APPLICATION FOR MEDICAL ASSISTANCE WAS DENIED; AND11
(V) O THER DATA THE STATE DEPARTMENT DETERMINES IS12
NECESSARY TO SHARE WITH THE PUBLIC AND ANY OTHER DATA THAT MAY13
BE FEDERALLY REQUIRED TO COMPLY WITH THE COMMUNITY14
ENGAGEMENT REQUIREMENTS OF TITLE XIX OF THE FEDERAL "SOCIAL15
SECURITY ACT OF 1965", 42 U.S.C. SEC. 1396a (xx), AS AMENDED OR16
RELOCATED.17
(b) THE PURPOSE OF THE REPORTING REQUIREMENT SET FORTH IN18
THIS SUBSECTION (4) IS TO DEMONSTRATE THE IMPACTS OF THE19
COMMUNITY ENGAGEMENT REQUIREMENTS OF TITLE XIX OF THE FEDERAL20
"SOCIAL SECURITY ACT OF 1965", 42 U.S.C. SEC. 1396a (xx), AS21
AMENDED OR RELOCATED , ON ELIGIBILITY AND ENROLLMENT IN THE22
MEDICAL ASSISTANCE PROGRAM.23
(c) THE STATE DEPARTMENT'S DUTY TO POST DATA ON THE STATE24
DEPARTMENT'S WEBSITE PURSUANT TO THIS SUBSECTION (4) IS REPEALED25
IF THE COMMUNITY ENGAGEMENT REQUIREMENTS OF TITLE XIX OF THE26
FEDERAL "SOCIAL SECURITY ACT OF 1965", 42 U.S.C. SEC. 1396a (xx), AS27
1235-6-
AMENDED OR RELOCATED, ARE REPEALED.1
(d) THE EXECUTIVE DIRECTOR OF THE STATE DEPARTMENT SHALL2
NOTIFY THE REVISOR OF STATUTES IN WRITING OF THE DATE WHEN THE3
CONDITION SPECIFIED IN SUBSECTION (4)(c) OF THIS SECTION HAS4
OCCURRED BY EMAILING THE NOTICE TO5
REVISOROFSTATUTES.GA@COLEG.GOV. THIS SECTION (4) IS REPEALED6
EFFECTIVE UPON THE DATE IDENTIFIED IN THE NOTICE, OR IF THE NOTICE7
DOES NOT SPECIFY THAT DATE, UPON THE DATE OF THE NOTICE TO THE8
REVISOR OF STATUTES.9
SECTION 5. In Colorado Revised Statutes, 25.5-4-401.5, amend10
(1)(c)(I) as follows:11
25.5-4-401.5. Review of provider rates - advisory committee12
- recommendations - repeal.13
(1) (c) (I) The state department may propose to exclude rates from14
the schedule established pursuant to subsection (1)(a) of this section if15
those rates are adjusted OR REVIEWED on a periodic basis as a result of16
other state statute or federal law or regulation. The state department shall17
include the proposed list of exclusions with the schedule established18
pursuant to subsection (1)(a) of this section.19
SECTION 6. In Colorado Revised Statutes, 25.5-4-505.5, amend20
(5) as follows:21
25.5-4-505.5. Federal authorization related to persons involved22
in the criminal justice system - report - rules - legislative declaration.23
(5) (a) The state department shall only reimburse an opioid24
treatment program, as defined in section 27-80-203, for administering25
medication-assisted treatment REIMBURSE A PROVIDER WHO IS LICENSED26
AND AUTHORIZED TO PRESCRIBE, DISPENSE, COMPOUND, OR ADMINISTER27
1235-7-
MEDICATION-ASSISTED TREATMENT in a jail setting. At a minimum, an1
opioid treatment program that administers medication-assisted treatment2
shall:3
(I) Employ a physician medical director;4
(II) Ensure the individual receiving medication-assisted treatment5
undergoes a minimum observation period after receiving6
medication-assisted treatment as determined by behavioral health7
administration rule pursuant to section 27-80-204; and8
(III) Meet all critical incident reporting requirements as9
determined by behavioral health administration rule pursuant to section10
27-80-204.11
(b) The state department shall ensure as part of the state12
department's quality oversight that opioid treatment programs that13
LICENSED PROVIDERS WHO administer medication-assisted treatment in a14
jail setting maintain emergency policies and procedures that address15
adverse outcomes.16
SECTION 7. In Colorado Revised Statutes, 25.5-5-101, repeal17
(2); and add (1)(n) and (1)(o) as follows:18
25.5-5-101. Mandatory provisions - eligible groups - rules.19
(1) In order to participate in the medicaid program, the federal20
government requires the state to provide medical assistance to certain21
eligible groups. Pursuant to federal law and except as provided in22
subsection (2) of this section, any person who is eligible for medical23
assistance under the mandated groups specified in this section must24
receive both the mandatory services that are specified in sections25
25.5-5-102 and 25.5-5-103 and the optional services that are specified in26
sections 25.5-5-202 and 25.5-5-203. Subject to the availability of federal27
1235-8-
financial participation, the following are the individuals or groups that are1
mandated under federal law to receive benefits under this article 5 and2
articles 4 and 6 of this title 25.5:3
(n) A QUALIFIED NONCITIZEN WHO ENTERED THE UNITED STATES4
BEFORE AUGUST 22, 1996, SHALL RECEIVE BENEFITS UNDER THIS ARTICLE5
5 AND ARTICLES 4 AND 6 OF THIS TITLE 25.5;6
(o) A QUALIFIED NONCITIZEN WHO ENTERED THE UNITED STATES7
ON OR AFTER AUGUST 22,1996, IS NOT ELIGIBLE FOR BENEFITS UNDER THIS8
ARTICLE 5 OR ARTICLE 4 OR 6 OF THIS TITLE 25.5 FOR FIVE YEARS AFTER9
THE DATE OF ENTRY IN THE UNITED STATES; EXCEPT THAT THE STATE10
DEPARTMENT MAY PROVIDE BENEFITS UNDER THIS ARTICLE 5 AND11
ARTICLES 4 AND 6 OF THIS TITLE 25.5 TO A PREGNANT PERSON WHO IS A12
QUALIFIED ALIEN NONCITIZEN AND A CHILD UNDER NINETEEN YEARS OLD13
WHO IS A QUALIFIED NONCITIZEN, SO LONG AS THE PREGNANT PERSON OR14
CHILD MEETS ELIGIBILITY CRITERIA OTHER THAN CITIZENSHIP. COVERAGE15
OF INDIVIDUALS IN THIS GROUP IS SUBJECT TO THE RECEIPT OF FEDERAL16
FINANCIAL PARTICIPATION, UNLESS STATE FUNDS ARE SPECIFICALLY17
APPROPRIATED FOR COVERAGE OF GROUPS FOR WHOM FEDERAL FINANCIAL18
PARTICIPATION IS UNAVAILABLE.19
(2) (a) A qualified alien who entered the United States before20
August 22, 1996, who meets the exceptions described in the federal21
"Personal Responsibility and Work Opportunity Reconciliation Act of22
1996", Public Law 104-193, as amended, shall receive benefits under this23
article and articles 4 and 6 of this title.24
(b) (I) A qualified alien who entered the United States on or after25
August 22, 1996, shall not be eligible for benefits under this article or26
article 4 or 6 of this title, except as provided in section 25.5-5-103 (3), for27
1235-9-
five years after the date of entry into the United States unless he or she1
meets the exceptions described in the federal "Personal Responsibility2
and Work Opportunity Reconciliation Act of 1996", Public Law 104-193,3
as amended.4
(II) Notwithstanding the five-year waiting period established in5
subparagraph (I) of this paragraph (b), but subject to the availability of6
sufficient appropriations and the receipt of federal financial participation,7
the state department may provide benefits under this article and articles8
4 and 6 of this title to a pregnant woman who is a qualified alien and a9
child under nineteen years of age who is a qualified alien so long as such10
woman or child meets eligibility criteria other than citizenship.11
SECTION 8. In Colorado Revised Statutes, 25.5-5-201, amend12
(1)(j) and (1)(k); and repeal (2) as follows:13
25.5-5-201. Optional provisions - optional groups - rules.14
(1) The federal government allows the state to select optional15
groups to receive medical assistance. Pursuant to federal law, any person16
who is eligible for medical assistance under the optional groups specified17
in this section must receive both the mandatory services specified in18
sections 25.5-5-102 and 25.5-5-103 and the optional services specified in19
sections 25.5-5-202 and 25.5-5-203. Subject to the availability of federal20
financial aid funds, the following are the individuals or groups that21
Colorado has selected as optional groups to receive medical assistance22
pursuant to this article 5 and articles 4 and 6 of this title 25.5:23
(j) Individuals who are qualified aliens NONCITIZENS and were or24
would have been eligible for supplemental security income as a result of25
a disability but are not eligible for such supplemental security income as26
a result of the passage of the federal "Personal Responsibility and Work27
1235-10-
Opportunity Reconciliation Act of 1996", Public Law 104-193;1
(k) Other qualified aliens NONCITIZENS who entered or were2
present in the United States before August 22, 1996;3
(2) (a) A qualified alien, who entered the United States on or after4
August 22, 1996, shall not be eligible for benefits under this article and5
articles 4 and 6 of this title, except as provided in section 25.5-5-103 (3),6
for five years after the date of entry into the United States unless he or she7
meets the exceptions described in the federal "Personal Responsibility8
and Work Opportunity Reconciliation Act of 1996", Public Law 104-193,9
as amended. After five years, such qualified alien shall be eligible for10
benefits under this article and articles 4 and 6 of this title but shall have11
sponsor income and resources deemed to the individual or family under12
rules established by the state board of human services pursuant to section13
26-2-137, C.R.S.14
(b) Notwithstanding the five-year waiting period established in15
paragraph (a) of this subsection (2), but subject to the availability of16
sufficient appropriations and the receipt of federal financial participation,17
the state department may provide benefits under this article and articles18
4 and 6 of this title to a pregnant woman who is a qualified alien and a19
child under nineteen years of age who is a qualified alien so long as such20
woman or child meets eligibility criteria other than citizenship.21
SECTION 9. In Colorado Revised Statutes, add 25.5-6-120 as22
follows:23
25.5-6-120. Home- and community-based service provider24
agencies - disclosure of direct care service cost ratio to administrative25
cost ratio - definition.26
(1) AS USED IN THIS SECTION , UNLESS THE CONTEXT OTHERWISE27
1235-11-
REQUIRES, "DIRECT CARE SERVICE COST TO ADMINISTRATIVE COST RATIO"1
MEANS THE PERCENTAGE OF MEDICAID SERVICES REVENUE THAT A HOME-2
AND COMMUNITY-BASED SERVICE PROVIDER AGENCY THAT RENDERS BASE3
WAGE QUALIFYING SERVICES SPENDS ON DIRECT CARE WORKFORCE4
COMPENSATION AND DIRECT CARE SERVICE RELATED TRAINING AND5
SUPPORTS AS COMPARED TO ADMINISTRATIVE AND GENERAL EXPENSES.6
(2) (a) THE STATE DEPARTMENT SHALL COLLECT THE FOLLOWING7
INFORMATION FROM EACH HOME- AND COMMUNITY-BASED SERVICE8
PROVIDER AGENCY THAT SERVES MORE THAN THIRTY MEMBERS AND IS9
SUBJECT TO THE BASE WAGE REQUIREMENTS SET BY THE STATE10
DEPARTMENT IN RULE, AND MAY COLLECT THE FOLLOWING INFORMATION11
FROM A HOME- AND COMMUNITY-BASED SERVICE PROVIDER AGENCY THAT12
SERVES THIRTY OR FEWER MEMBERS:13
(I) THE TOTAL MEDICAL ASSISTANCE PROGRAM REIMBURSEMENT14
AND VOLUME DATA FOR HOME- AND COMMUNITY-BASED SERVICES THAT15
ARE SUBJECT TO THE BASE WAGE REQUIREMENTS, SORTED BY SERVICE16
CODES AND SUBMITTED SEPARATELY FOR EMPLOYEES AND INDEPENDENT17
CONTRACTORS;18
(II) DIRECT WAGES AND CASH COMPENSATION, WHICH ARE LIMITED19
TO WAGES, OVERTIME PAY , BONUSES, AND OTHER DIRECT MONETARY20
COMPENSATION PAID TO DIRECT CARE WORKERS;21
(III) PAID LEAVE AND EMPLOYEE BENEFITS, WHICH ARE LIMITED TO22
PAID LEAVE, HEALTH INSURANCE, RETIREMENT CONTRIBUTIONS, AND23
OTHER INSURANCE BENEFITS , WELLNESS SUPPORT, TRANSPORTATION24
BENEFITS, AND OTHER MONETARY OR NON-MONETARY EMPLOYMENT25
BENEFITS;26
(IV) EMPLOYER PAYROLL TAXES AND STATUTORY EMPLOYMENT27
1235-12-
COSTS, WHICH ARE LIMITED TO EMPLOYER PAYROLL TAXES , STATE1
UNEMPLOYMENT INSURANCE CONTRIBUTIONS , AND FEDERAL2
UNEMPLOYMENT INSURANCE CONTRIBUTIONS;3
(V) W ORKFORCE RECRUITMENT, RETENTION, AND INCENTIVE4
SUPPORTS, WHICH ARE LIMITED TO STIPENDS, REIMBURSEMENTS,5
ALLOWANCES, INCENTIVE PROGRAMS, AND OTHER BENEFITS DESIGNED TO6
RECRUIT, RETAIN AND SUPPORT THE WELL -BEING OF DIRECT CARE7
WORKERS;8
(VI) W ORKFORCE SUPERVISION, TRAINING AND OPERATIONAL9
SUPPORT, WHICH ARE LIMITED TO COSTS RELATED TO SUPERVISING DIRECT10
CARE WORKERS, PROVIDING TRAINING, AND MAINTAINING WORKFORCE11
SUPPORT SERVICES NECESSARY FOR SAFE SERVICE DELIVERY AND12
REGULATORY COMPLIANCE;13
(VII) O PERATIONAL AND COMPLIANCE COSTS TIED TO14
EMPLOYMENT OF DIRECT CARE WORKERS, WHICH ARE LIMITED TO15
EMPLOYER EXPENSES NECESSARY TO RECRUIT, EMPLOY, SUPERVISE,16
SUPPORT, AND RETAIN DIRECT CARE WORKERS, INCLUDING OPERATIONAL17
COSTS REQUIRED TO SAFELY DELIVER MEDICAL ASSISTANCE SERVICES AND18
COMPLY WITH MEDICAL ASSISTANCE PROGRAM REQUIREMENTS; AND19
(VIII) E XISTING BASE WAGE REPORTING AND ATTESTATION20
DOCUMENTATION VERIFYING THAT DIRECT CARE WORKER WAGES MEET21
THE STATE BASE WAGE REQUIREMENTS.22
(b) A HOME- AND COMMUNITY-BASED SERVICE PROVIDER AGENCY23
SHALL SUBMIT TO THE STATE DEPARTMENT ITS DIRECT CARE SERVICE COST24
TO ADMINISTRATIVE COST RATIO AND THE INFORMATION REQUIRED25
PURSUANT TO THIS SUBSECTION (2) NO LATER THAN SEPTEMBER 30, 2027.26
(3) THE STATE DEPARTMENT SHALL SUBMIT A REPORT DETAILING27
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THE INFORMATION COLLECTED PURSUANT TO SUBSECTION (2) OF THIS1
SECTION TO THE HOUSE OF REPRESENTATIVES AND SENATE HEALTH AND2
HUMAN SERVICES COMMITTEES AND THE JOINT BUDGET COMMITTEE , OR3
ANY SUCCESSOR COMMITTEES, NO LATER THAN DECEMBER 31, 2027.4
(4) T HE DATA COLLECTED AND PUBLISHED PURSUANT TO THIS5
SECTION MUST BE USED SOLELY FOR LEGISLATIVE INFORMATIONAL6
PURPOSES AND IS NOT SUBJECT TO DISCLOSURE UNDER THE "COLORADO7
OPEN RECORDS ACT," PART 2 OF ARTICLE 72 OF TITLE 24.8
SECTION 10. In Colorado Revised Statutes, repeal 25.5-4-203.9
SECTION 11. Act subject to petition - effective date. This act10
takes effect at 12:01 a.m. on the day following the expiration of the11
ninety-day period after final adjournment of the general assembly (August12
12, 2026, if adjournment sine die is on May 13, 2026); except that, if a13
referendum petition is filed pursuant to section 1 (3) of article V of the14
state constitution against this act or an item, section, or part of this act15
within such period, then the act, item, section, or part will not take effect16
unless approved by the people at the general election to be held in17
November 2026 and, in such case, will take effect on the date of the18
official declaration of the vote thereon by the governor.19
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