Back to Colorado

HB26-1328 • 2026

Medicaid Nonemergency Medical Transportation

Healthcare

Passed Legislature

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

Sponsor: Rep. K. Stewart, Rep. T. Winter, Sen. B. Kirkmeyer, Sen. K. Mullica
Last action: 2026-03-31
Official status: House Committee on Health & Human Services Refer Amended to Appropriations
Effective date: Not listed

Plain English Breakdown

Checked against official source text during the last sync.

Medicaid Nonemergency Medical Transportation

This bill creates a transportation advisory board to help oversee and improve nonemergency medical transportation services for Medicaid members in Colorado.

What This Bill Does

Creates the Transportation Community Advisory Board (TCAB) within the Department of Health Care Policy and Financing.
Requires the state department to collaborate with TCAB before making rules about safety and oversight of nonmedical and nonemergency medical transportation services.
Establishes guidelines for a transportation broker who must provide software, training, and support to service providers.
Prohibits brokers from operating or owning transportation companies in Colorado.
Requires the state department to annually audit transportation brokers and randomly selected providers.

Who It Names or Affects

Medicaid members needing nonemergency medical transportation services
Transportation providers offering these services
The Department of Health Care Policy and Financing

Terms To Know

Nonemergency Medical Transportation (NEMT): Services that transport Medicaid members to or from medically necessary nonemergency treatment.
Transportation Broker: An entity designated by the state department to manage and coordinate NEMT services for Medicaid members.

Limits and Unknowns

The bill does not specify how long it will take for the TCAB to be established.
It is unclear what specific changes will be made to improve efficiency and outcomes of the program.

Amendments

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

L.002

HOU Health & Human Services

Passed [*]

Plain English: The amendment changes the name of the Transportation Community Advisory Board's governing body from 'the state department' to 'the transportation broker', and specifies that the board includes representatives from various stakeholders involved in nonemergency medical transportation (NEMT).

Changes the governing body of the TCAB from 'the state department' to 'the transportation broker'.
Specifies that the advisory board is composed of representatives from a cross-section of NEMT stakeholders, including members, transportation providers, health-care treatment providers, and disability advocates.
Adds requirements for transportation providers to maintain electronic trip records and establishes that members have a right to receive accessible and appropriate NEMT services based on their individual medical and functional needs.

The amendment text is extensive and includes many detailed changes. Some parts may be too technical or context-specific for a simple summary.
Specific operational details of the transportation broker's role are not fully explained in this excerpt.

L.003

HOU Health & Human Services

Passed [*]

Plain English: The amendment changes how the state department audits transportation providers and brokers to ensure they follow rules and provide proper services.

Removes previous audit requirements for transportation providers and replaces them with new guidelines that focus on using data analytics, complaints, and other indicators to prioritize which providers need auditing.
Adds a requirement for annual audits of each transportation broker by the state department, allowing the use of third-party contractors.

The exact details of how audits will be conducted are not fully explained in the amendment text.

L.004

HOU Health & Human Services

Passed [*]

Plain English: The amendment allows transportation network companies to provide nonemergency medical transportation (NEMT) services under certain conditions and requires documentation of their use.

Transportation network companies can now offer NEMT if the originally assigned provider cannot complete the trip or no other provider is available in the member's area.
Each time a transportation network company provides NEMT, it must be documented by the transportation broker with details about why they were used and when.
The transportation network company providing NEMT services must follow all safety rules including video recording requirements.

The amendment does not specify how often or under what circumstances these companies can provide NEMT, only the conditions allowing it.

L.005

HOU Health & Human Services

Passed [*]

Plain English: The amendment changes Colorado's Medicaid program to include nonemergency medical transportation services as a mandated service and requires the state department to report on savings from federal funding.

Adds nonemergency medical transportation (NEMT) services as a required part of Medicaid under federal law.
Requires the state department to classify NEMT expenditures as medical services for all eligible populations.
Directs the state department to ensure that NEMT expenses receive federal financial support where allowed by federal rules.
Instructs the state department to submit reports about expected or received savings from classifying NEMT as a medical service.

The amendment text does not specify how the changes will be implemented in detail, leaving some aspects unclear.

L.006

HOU Health & Human Services

Passed [*]

Plain English: The amendment adds a new rule that allows licensed ambulance service providers to offer nonemergency medical transportation (NEMT) services without following the usual requirements.

Licensed ambulance service providers are exempt from certain rules and can provide NEMT services.

The amendment does not specify which exact requirements the ambulance providers are exempt from, so more details would be needed to understand fully what changes this makes.

Bill History

2026-03-31 House
House Committee on Health & Human Services Refer Amended to Appropriations
2026-03-11 House
Introduced In House - Assigned to Health & Human Services

Official Summary Text

The bill creates the transportation community advisory board (TCAB) within the department of health care policy and financing (state department) and requires the state department to collaborate with the TCAB prior to establishing rules and processes for the safety and oversight of nonmedical transportation services and nonemergency medical transportation (NEMT) services. The bill states which rules for NEMT the state department, in collaboration with the TCAB, must adopt.
The bill establishes how a transportation broker (broker) must roll out their implementation and requires the broker to provide all transportation providers (providers) with software, a communication toolkit, training, and technical assistance to facilitate NEMT services. The broker may require medicaid members (members) to book transportation services more than 2 days before their requested transportation date. The bill requires providers to accommodate member requests for preferred or alternate drivers when operationally feasible.
The bill requires the broker, and, if there is no broker, the transportation providers to verify that individuals using the transportation services are eligible members during the scheduling of transportation services. The bill prohibits the broker from operating, owning, or controlling a provider in Colorado. The bill requires providers to provide their trip assignment rules and procedures to the state department for approval and for publication on the state department's website.
The bill prohibits the state department from denying payment of services to transportation providers solely because the broker or state department determines that a member's eligibility or trip information was inaccurate. The bill requires the state department to annually audit brokers and a random group of providers and to make the audit reports publicly available.
The bill requires the state department to categorize all NEMT expenditures as medical services and make changes to the NEMT program as necessary to obtain medical services federal match rates for NEMT services. The bill also eliminates the requirement that the state department provide transportation services as an administrative cost.
(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
INTRODUCED

LLS NO. 26-0680.01 Ken Fowler x2372 HOUSE BILL 26-1328
House Committees Senate Committees
Health & Human Services
A BILL FOR AN ACT
CONCERNING NONEMERGENCY ME DICAL TRANSPORTATION FOR101
MEDICAID MEMBERS.102
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 creates the transportation community advisory board
(TCAB) within the department of health care policy and financing (state
department) and requires the state department to collaborate with the
TCAB prior to establishing rules and processes for the safety and
oversight of nonmedical transportation services and nonemergency
medical transportation (NEMT) services. The bill states which rules for
HOUSE SPONSORSHIP
Stewart K. and Winter T.,
SENATE SPONSORSHIP
Mullica and Kirkmeyer,
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.
NEMT the state department, in collaboration with the TCAB, must adopt.
The bill establishes how a transportation broker (broker) must roll
out their implementation and requires the broker to provide all
transportation providers (providers) with software, a communication
toolkit, training, and technical assistance to facilitate NEMT services. The
broker may require medicaid members (members) to book transportation
services more than 2 days before their requested transportation date. The
bill requires providers to accommodate member requests for preferred or
alternate drivers when operationally feasible.
The bill requires the broker, and, if there is no broker, the
transportation providers to verify that individuals using the transportation
services are eligible members during the scheduling of transportation
services. The bill pr ohibits the broker from operating, owning, or
controlling a provider in Colorado. The bill requires providers to provide
their trip assignment rules and procedures to the state department for
approval and for publication on the state department's website.
The bill prohibits the state department from denying payment of
services to transportation providers solely because the broker or state
department determines that a member's eligibility or trip information was
inaccurate. The bill requires the state department to annually audit brokers
and a random group of providers and to make the audit reports publicly
available.
The bill requires the state department to categorize all NEMT
expenditures as medical services and make changes to the NEMT
program as necessary to obtain medical services federal match rates for
NEMT services. The bill also eliminates the requirement that the state
department provide transportation services as an administrative cost.
Be it enacted by the General Assembly of the State of Colorado:1
SECTION 1. In Colorado Revised Statutes, 25.5-1-801, amend2
the introductory portion, (1), (3), and (4); and add (6) and (7) as follows: 3
25.5-1-801. Definitions.4
As used in this section PART 8, unless the context otherwise5
requires:6
(1) "Nonemergency medical transportation" OR "NEMT" means7
transportation to or from medically necessary nonemergency treatment.8
(3) "Transportation broker" means an entity designated by9
CONTRACTED WITH the department of health care policy and financing to10
HB26-1328-2-
administer nonemergency medical transportation for medicaid members.1
(4) "Transportation provider" means an individual or business2
entity, other than a transportation broker OR TRANSPORTATION NETWORK3
COMPANY AS DEFINED IN SECTION 40-10.1-602, that:4
(a) Provides transportation services; or5
(b) Arranges the facilitation of transportation services by an6
individual.7
(6) "T RANSPORTATION COMMUNITY ADVISORY BOARD " OR8
"BOARD" MEANS THE TRANSPORTATION COMMUNITY ADVISORY BOARD9
DESCRIBED IN SECTION 25.5-1-802 (4).10
(7) "T RIP CAPS" MEANS NUMERICAL LIMITS ON THE NUMBER OF11
TRIPS A TRANSPORTATION PROVIDER IS ASSIGNED AND MAY ACCEPT12
WITHIN A SPECIFIED PERIOD OF TIME THAT ARE NOT BASED ON13
TRANSPORTATION PROVIDER CAPACITY , PERFORMANCE , SAFETY , OR14
COMPLIANCE CONSIDERATIONS.15
SECTION 2. In Colorado Revised Statutes, amend 25.5-1-80216
as follows:17
25.5-1-802. Medicaid transportation services - transportation18
community advisory board - safety and oversight - rules.19
(1) The state department shall collaborate with stakeholders,20
including, but not limited to, disability and consumer advocates, PACE21
providers operating pursuant to section 25.5-5-412, transportation22
brokers, and transportation providers, THE TRANSPORTATION COMMUNITY23
ADVISORY BOARD to establish rules and processes for the safety and24
oversight of nonmedical transportation services and nonemergency25
medical transportation services provided to medicaid members pursuant26
to articles 4 to 6 of this title 25.5. The rules and processes must:27
HB26-1328-3-
(a) Ensure the safety of passengers;1
(b) Protect passenger access to transportation services; and2
(c) Establish driver and vehicle requirements that minimize3
financial and administrative burdens for transportation providers, direct4
support professionals as defined in section 25.5-6-406, long-term care5
direct care workers, independent contractors, and employees providing6
transportation services.7
(2) To the extent possible, the state department shall use existing8
oversight procedures to ensure compliance with the requirements as9
described in subsection (1) of this section.10
(3) If a provider of transportation services already complies with11
transportation safety standards established by another state department12
which meet or exceed the rules and processes established pursuant to13
subsection (1) of this section, demonstrating such compliance to the state14
department is sufficient to verify compliance with the requirements of this15
section.16
(4) T HE STATE DEPARTMENT SHALL ESTABLISH THE17
TRANSPORTATION COMMUNITY ADVISORY BOARD . THE BOARD18
MEMBERSHIP MUST INCLUDE:19
(a) MEDICAID MEMBERS FROM BOTH RURAL AND URBAN AREAS20
WHO UTILIZE NEMT SERVICES;21
(b) BEHAVIORAL HEALTH, PRIMARY CARE, AND OTHER TREATMENT22
PROVIDERS SERVING MEDICAID MEMBERS;23
(c) NEMT PROVIDERS REPRESENTING:24
(I) RURAL AND URBAN SERVICE AREAS; AND25
(II) LARGE, MEDIUM, AND SMALL PROVIDER ORGANIZATIONS;26
(d) NEMT PROVIDERS WITH EXPERIENCE IN MANAGEMENT ,27
HB26-1328-4-
DISPATCH, DRIVING, AND COMPLIANCE;1
(e) C ONSUMER AND DISABILITY ADVOCATES REPRESENTING2
POPULATIONS WITH DIVERSE MOBILITY, HEALTH, AND ACCESS NEEDS; AND3
(f) T RANSPORTATION BROKERS OR ENTITIES RESPONSIBLE FOR4
COORDINATING NEMT SERVICES.5
(5) (a) T O ENSURE THAT THE COMPOSITION OF THE BOARD6
REPRESENTS ACTIVE TRANSPORTATION PROVIDERS , FORTY PERCENT OF7
BOARD MEMBERS MUST BE PROVIDERS WITH DIRECT NEMT OPERATIONAL8
EXPERIENCE, INCLUDING MANAGEMENT , DISPATCH , DRIVING , OR9
COMPLIANCE.10
(b) THE BOARD SHALL ELECT A CHAIR FROM AMONG ITS MEMBERS.11
(6) BOARD MEMBERS SERVE TWO-YEAR TERMS. BOARD MEMBERS12
SERVE WITHOUT COMPENSATION AND WITHOUT REIMBURSEMENT FOR13
EXPENSES.14
(7) THE BOARD CHAIR AND STATE DEPARTMENT SHALL CIRCULATE15
MEETING AGENDAS TO THE BOARD MEMBERS AT LEAST TEN DAYS IN16
ADVANCE OF MEETINGS. THE BOARD SHALL DOCUMENT MEETING MINUTES17
AND APPROVE MEETING MINUTES WITHIN FIFTEEN BUSINESS DAYS AFTER18
EACH MEETING . THE BOARD MUST GIVE BOARD MEMBERS THE19
OPPORTUNITY TO SUBMIT WRITTEN RECOMMENDATIONS OR COMMENTS TO20
THE BOARD PRIOR TO BOARD ACTION OR ADVICE.21
(8) T HE BOARD IS AN ADVISORY BODY . THE BOARD DOES NOT22
REPLACE OR LIMIT THE STATE DEPARTMENT 'S COLLABORATION WITH23
NEMT PROVIDERS WHEN DEVELOPING RULES, PROCESSES, OR POLICIES.24
(9) T HE BOARD SHALL PROVIDE RECOMMENDATIONS TO THE25
DEPARTMENT ABOUT THE STATE DEPARTMENT'S RULES, PROCESSES, AND26
POLICIES THAT GOVERN NEMT. FINAL DECISIONS REGARDING RULES ,27
HB26-1328-5-
PROCESSES, AND POLICIES REMAIN THE RESPONSIBILITY OF THE STATE1
DEPARTMENT.2
(10) T HE STATE DEPARTMENT , IN COLLABORATION WITH THE3
BOARD, SHALL ADOPT RULES THAT:4
(a) ESTABLISH DRIVER, VEHICLE, AND TRANSPORTATION PROVIDER5
CREDENTIALING REQUIREMENTS;6
(b) PROHIBIT TRIP CAPS, MARKET-SHARE RESTRICTIONS, OR OTHER7
POLICIES THAT LIMIT TRANSPORTATION PROVIDER PARTICIPATION IN THE8
MARKET;9
(c) REQUIRE THE STATE DEPARTMENT TO HOST MEETINGS WITH10
THE BOARD NO LESS THAN QUARTERLY TO REVIEW PROGRAM11
PERFORMANCE, IDENTIFY AND ADDRESS PROGRAM CHALLENGES, DISCUSS12
PROGRESS TOWARD PROGRAM GOALS, AND IDENTIFY OPPORTUNITIES TO13
ENHANCE EFFICIENCY AND OUTCOMES OF THE PROGRAM;14
(d) R EQUIRE REASONABLE ACCOMMODATION OF MEMBER15
REQUESTS FOR AN ALTERNATE OR SPECIFIC TRANSPORTATION PROVIDER16
WHEN OPERATIONALLY FEASIBLE;17
(e) C REATE A PROCESS FOR MEMBERS AND TRANSPORTATION18
PROVIDERS TO FILE CONCERNS WITH THE STATE DEPARTMENT AND FOR THE19
STATE DEPARTMENT TO REPORT TO THE BOARD THE NUMBER OF CONCERNS20
FILED;21
(f) E STABLISH PROCESSES FOR CLAIM SUBMISSION FROM22
TRANSPORTATION PROVIDERS AND PAYMENT OF TRANSPORTATION23
PROVIDERS;24
(g) E STABLISH POLICIES REGARDING THE STORAGE , ACCESS ,25
RETENTION, AND DELETION OF VIDEO RECORDINGS OF MEMBERS MADE26
DURING NONEMERGENCY MEDICAL TRANSPORTATION. THE POLICIES MUST27
HB26-1328-6-
NOT PROHIBIT THE USE OF VIDEO RECORDING FOR SAFETY OR DRIVER1
ACCOUNTABILITY PURPOSES;2
(h) DEVELOP BILLING PROCEDURES AND REQUIREMENTS FOR THE3
PAYMENT OF TRANSPORTATION PROVIDERS;4
(i) D EVELOP A PROCESS FOR TRANSPORTATION PROVIDERS TO5
RESOLVE BILLING ISSUES WITH THE STATE DEPARTMENT OR6
TRANSPORTATION BROKER; AND7
(j) E STABLISH POLICIES AND PROCEDURES TO VERIFY MEMBER8
ELIGIBILITY PRIOR TO A MEMBER RECEIVING TRANSPORTATION SERVICES.9
(11) T HE POLICIES REGARDING THE USE OF VIDEO RECORDING10
DURING NONEMERGENCY MEDICAL TRANSPORTATION OF MEMBERS ,11
ESTABLISHED PURSUANT TO SUBSECTION (10)(g) OF THIS SECTION, MUST12
ADDRESS MEMBER PRIVACY , OPERATIONAL FEASIBILITY , AND13
COMPLIANCE. VIDEO RECORDING OF MEMBERS MUST NOT BE REQUIRED14
FOR BILLING PURPOSES. NOTHING IN THIS SUBSECTION (11) PROHIBITS THE15
USE OF VIDEO RECORDING FOR SAFETY OR DRIVER ACCOUNTABILITY16
PURPOSES.17
(12) THE STATE DEPARTMENT SHALL, IN ACCORDANCE WITH THE18
"STATE ADMINISTRATIVE PROCEDURE ACT", ARTICLE 4 OF TITLE 24,19
PROVIDE ADVANCED NOTICE AND THE OPPORTUNITY FOR PUBLIC COMMENT20
PRIOR TO THE IMPLEMENTATION OF AN NEMT RULE CHANGE.21
(13) T HE STATE DEPARTMENT SHALL ESTABLISH BILLING22
PROCEDURES , DOCUMENTATION REQUIREMENTS , AND PAYMENT23
STANDARDS FOR TRANSPORTATION PROVIDERS PURSUANT TO SUBSECTION24
(10)(f) OF THIS SECTION. THE PROCEDURES MUST ESTABLISH:25
(a) REQUIRED CLAIM FORMATS AND SUPPORTING DOCUMENTS;26
(b) CLAIM DENIAL CRITERIA; AND27
HB26-1328-7-
(c) REIMBURSEMENT REQUIREMENTS.1
(14) THE STATE DEPARTMENT MAY ISSUE INTERIM OPERATIONAL2
GUIDANCE TO CLARIFY PROCEDURES , IMPROVE ADMINISTRATIVE3
EFFICIENCY, OR PROVIDE TECHNICAL INSTRUCTIONS TO TRANSPORTATION4
PROVIDERS. INTERIM GUIDANCE MUST NOT SUBSTANTIVELY CHANGE5
BILLING, DOCUMENTATION, OR PAYMENT STANDARDS IDENTIFIED IN THE6
RULES ADOPTED PURSUANT TO SUBSECTION (13) OF THIS SECTION.7
(15) T HE STATE DEPARTMENT SHALL NOTIFY TRANSPORTATION8
PROVIDERS OF NEW BILLING OR DOCUMENTATION REQUIREMENTS OR9
SUBSTANTIVE CHANGES , WHETHER ISSUED BY RULE OR BY INTERIM10
GUIDANCE, AT LEAST THIRTY DAYS BEFORE THE CHANGES BECOME11
EFFECTIVE. FORMS, TEMPLATES, OR DOCUMENTATION THAT WAS VALID12
PRIOR TO THE EFFECTIVE DATE OF A NEW RULE CONTINUES TO BE VALID13
THROUGH ITS EXPIRATION OR UNTIL THE END OF THE NOTICE PERIOD ,14
WHICHEVER IS LATER.15
SECTION 3. In Colorado Revised Statutes, add 25.5-1-803 as16
follows:17
25.5-1-803. State nonemergency transportation broker -18
transportation providers.19
(1) (a) T HE STATE DEPARTMENT MAY CONTRACT WITH A20
TRANSPORTATION BROKER.21
(b) A TRANSPORTATION BROKER SHALL CREATE A PUBLICLY22
AVAILABLE CONTINGENCY PLAN TO ENSURE UNINTERRUPTED NEMT23
SERVICES IN THE EVENT THE TRANSPORTATION BROKER EXPERIENCES24
SYSTEM OUTAGES OR IS OTHERWISE UNABLE TO PERFORM REQUIRED25
FUNCTIONS. THE TRANSPORTATION BROKER SHALL SHARE THE26
CONTINGENCY PLAN WITH TRANSPORTATION PROVIDERS.27
HB26-1328-8-
(c) I F THE STATE DEPARTMENT CONTRACTS WITH A1
TRANSPORTATION BROKER, THE STATE DEPARTMENT SHALL DESIGNATE2
REGIONS WITHIN THE STATE FOR IMPLEMENTATION OF A BROKERED NEMT3
PROGRAM.4
(2) THE TRANSPORTATION BROKER SHALL IMPLEMENT A BROKERED5
NEMT PROGRAM ON A PHASED BASIS, ONE REGION AT A TIME, AND SHALL6
NOT BEGIN IMPLEMENTATION IN A SUBSEQUENT REGION UNTIL THE7
PROGRAM IS FULLY IMPLEMENTED IN THE PRIOR REGION. FOR PURPOSES OF8
THIS SECTION, A PROGRAM IS FULLY IMPLEMENTED IN A REGION WHEN:9
(a) T ECHNOLOGY SYSTEMS FOR SCHEDULING , ELIGIBILITY10
VERIFICATION, TRIP ASSIGNMENT , PROVIDER PAYMENT , AND CUSTOMER11
SUPPORT ARE FULLY OPERATIONAL;12
(b) TRANSPORTATION PROVIDERS IN THE REGION ARE PROVIDED A13
REASONABLE OPPORTUNITY TO COMPLETE THE BROKER ONBOARDING14
PROCESS, INCLUDING PROVIDER TRAINING, SYSTEM ACCESS, AND REQUIRED15
VEHICLE AND DRIVER VERIFICATION;16
(c) A SUFFICIENT NETWORK OF TRANSPORTATION PROVIDERS IS17
AVAILABLE TO MEET MEMBER DEMAND AND ENSURE TIMELY ACCESS TO18
NEMT SERVICES; AND19
(d) T HE STATE DEPARTMENT HAS VERIFIED THAT PROVIDER20
PAYMENT PROCESSES AND CUSTOMER SUPPORT FUNCTIONS OPERATE21
EFFECTIVELY.22
(3) T HE STATE DEPARTMENT AND TRANSPORTATION BROKER23
SHALL PROVIDE TIMELY NOTICE AND TECHNICAL ASSISTANCE TO24
TRANSPORTATION PROVIDERS REGARDING THE ONBOARDING PROCESS .25
PROVIDERS MAY CONTINUE TO COMPLETE ONBOARDING DURING THE26
IMPLEMENTATION PERIOD.27
HB26-1328-9-
(4) FOR TRIPS ORIGINATING IN REGIONS THAT HAVE NOT YET BEEN1
DESIGNATED BY THE STATE DEPARTMENT FOR IMPLEMENTATION OF A2
BROKERED NEMT PROGRAM , TRANSPORTATION PROVIDERS MAY3
CONTINUE TO PROVIDE TRANSPORTATION SERVICES AND BILL THE STATE4
DEPARTMENT DIRECTLY . ONCE A REGION HAS BEEN DESIGNATED FOR5
IMPLEMENTATION OF A BROKERED NEMT PROGRAM, TRANSPORTATION6
SERVICES PROVIDED TO MEMBERS IN THAT REGION MUST BE SCHEDULED7
AND AUTHORIZED THR OUGH THE TRANSPORTATION BROKER IN8
ACCORDANCE WITH STATE DEPARTMENT RULES.9
(5) N OTHING IN THIS SECTION LIMITS MEMBER ACCESS TO10
TRANSPORTATION SERVICES OR CREATES SERVICE GAPS DURING11
IMPLEMENTATION OF A BROKERED PROGRAM.12
(6) T RANSPORTATION PROVIDERS MAY COMMUNICATE WITH13
MEMBERS REGARDING TRANSPORTATION SERVICES , INCLUDING TRIP14
SCHEDULING, SERVICE DELIVERY , AND OPERATIONAL QUESTIONS . THE15
STATE DEPARTMENT AND BOARD SHALL DEVELOP POLICIES REGARDING16
WHEN AND HOW TRANSPORTATION PROVIDERS CAN COMMUNICATE WITH17
MEMBERS.18
(7) T HE STATE DEPARTMENT SHALL DEVELOP AND PROVIDE19
TRANSPORTATION PROVIDERS A PROVIDER COMMUNICATION TOOLKIT TO20
ASSIST TRANSPORTATION PROVIDERS IN DISCUSSING THE TRANSITION TO21
TRANSPORTATION BROKER CONTROL OR OTHER PROGRAM CHANGES. THE22
PROVIDER COMMUNICATION TOOLKIT MUST INCLUDE TALKING POINTS ,23
SCRIPTS, AND GUIDANCE TO ENSURE ACCURATE AND CONSISTENT24
INFORMATION IS COMMUNICATED TO MEMBERS. THE STATE DEPARTMENT25
SHALL MAKE THE PROVIDER COMMUNICATION TOOLKIT AVAILABLE TO26
TRANSPORTATION PROVIDERS AT LEAST NINETY DAYS PRIOR TO THE27
HB26-1328-10-
IMPLEMENTATION OF A BROKERED NEMT PROGRAM IN THE REGION IN1
WHICH THE PROVIDER OPERATES.2
(8) AT LEAST NINETY DAYS PRIOR TO THE IMPLEMENTATION OF A3
BROKERED NEMT PROGRAM IN A REGION, THE TRANSPORTATION BROKER,4
IN COORDINATION WITH THE STATE DEPARTMENT , SHALL PROVIDE5
TRAINING AND TECHNICAL SUPPORT TO TRANSPORTATION PROVIDERS THAT6
PROVIDE SERVICES IN THE REGION. THE STATE DEPARTMENT MAY EXTEND7
THE NINETY-DAY PERIOD AS NEEDED BASED ON PROVIDER READINESS OR8
DELAYS IN MATERIALS OR INSTRUCTION. THE TRANSPORTATION BROKER9
SHALL PROVIDE TRAINING AND TECHNICAL SUPPORT TO TRANSPORTATION10
PROVIDERS, WITH SUPPORT AND OVERSIGHT BY THE STATE DEPARTMENT.11
(9) T HE TRANSPORTATION BROKER SHALL PROVIDE ALL12
TRANSPORTATION PROVIDERS IN A BROKERED NEMT PROGRAM REGION13
WITH SOFTWARE TO FACILITATE NEMT SERVICES. THE TRANSPORTATION14
BROKER SHALL NOT REQUIRE TRANSPORTATION PROVIDERS TO PAY THE15
COST OF SOFTWARE LICENSING , IMPLEMENTATION , MAINTENANCE ,16
UPGRADES, OR TRAINING.17
(10) THE TRANSPORTATION BROKER MAY REQUIRE A MEMBER TO18
SCHEDULE TRANSPORTATION SERVICES MORE THAN TWO DAYS PRIOR TO19
THEIR REQUESTED TRANSPORTATION DATE . THE TRANSPORTATION20
BROKER SHALL ACCEPT AND MAKE REASONABLE EFFORTS TO FULFILL21
SAME-DAY TRANSPORTATION REQUESTS. THE TRANSPORTATION BROKER22
SHALL ALLOW MEMBERS TO SCHEDULE SINGLE AND RECURRING23
TRANSPORTATION SERVICES . THE TRANSPORTATION BROKER SHALL24
ALLOW MEMBERS, PRIOR TO THE REQUESTED TRANSPORTATION SERVICES,25
TO REQUEST A TRANSPORTATION PROVIDER OR REQUEST A DIFFERENT26
TRANSPORTATION PROVIDER. THE TRANSPORTATION BROKER SHALL NOT27
HB26-1328-11-
DIRECT MEMBERS AWAY FROM THEIR PREFERRED TRANSPORTATION1
PROVIDER. THE TRANSPORTATION BROKER SHALL DOCUMENT AND RETAIN2
ALL PROVIDER PREFERENCE REQUESTS FOR AUDIT PURPOSES.3
(11) A TRANSPORTATION BROKER , OR A TRANSPORTATION4
PROVIDER IF THERE IS NO TRANSPORTATION BROKER , SHALL VERIFY A5
MEMBER'S ELIGIBILITY FOR NEMT SERVICES IMMEDIATELY UPON A6
MEMBER'S REQUEST FOR NEMT TRANSPORTATION SERVICES USING7
REAL-TIME ACCESS TO THE STATE DEPARTMENT'S ELIGIBILITY SYSTEM. IF8
VERIFICATION CANNOT BE COMPLETED DUE TO SYSTEM ISSUES OR9
INCOMPLETE INFORMATION, THE TRANSPORTATION BROKER SHALL NOTIFY10
THE MEMBER AND THE STATE DEPARTMENT AS SOON AS PRACTICABLE AND11
TAKE ACTION TO RESOLVE THE ISSUE PROMPTLY . ONCE ELIGIBILITY IS12
VERIFIED, THE MEMBER IS IMMEDIATELY ELIGIBLE TO SCHEDULE TRIPS, IN13
ACCORDANCE WITH PROGRAM RULES.14
(12) T HE TRANSPORTATION BROKER SHALL NOT IMPOSE15
ADDITI ONAL CREDENTIAL REQUIREMENTS ON TRANSPORTATION16
PROVIDERS THAT ARE NOT REQUIRED IN RULES ADOPTED BY THE STATE17
DEPARTMENT.18
(13) THE TRANSPORTATION BROKER SHALL NOT OPERATE, OWN, OR19
CONTROL A TRANSPORTATION PROVIDER THAT OPERATES IN COLORADO.20
THE TRANSPORTATION BROKER SHALL MAINTAIN POLICIES CONCERNING21
PREVENTING CONFLICTS OF INTEREST AND ENSURE THAT TRIP22
ASSIGNMENTS ARE MADE CONSISTENT WITH SAFETY , COMPLIANCE, AND23
OPERATIONAL STANDARDS . NOTHING IN THIS SUBSECTION (13) LIMITS24
PROVIDER PARTICIPATION OR IMPOSES TRIP CAPS.25
(14) THE TRANSPORTATION BROKER, OR THE STATE DEPARTMENT26
IF THERE IS NO TRANSPORTATION BROKER , SHALL NOT RESTRICT THE27
HB26-1328-12-
NUMBER OF VEHICLES A TRANSPORTATION PROVIDER CAN UTILIZE OR1
RESTRICT THE AREAS WHERE OR TYPES OF SERVICES A TRANSPORTATION2
PROVIDER OPERATES.3
(15) A TRANSPORTATION BROKER SHALL PROVIDE THEIR TRIP4
ASSIGNMENT RULES AND PROCEDURES TO THE STATE DEPARTMENT FOR5
APPROVAL. UPON APPROVAL, THE STATE DEPARTMENT SHALL MAKE THE6
TRANSPORTATION BROKER TRIP ASSIGNMENT RULES AND PROCEDURES7
PUBLICLY AVAILABLE ON THE STATE DEPARTMENT'S WEBSITE.8
(16) TRANSPORTATION PROVIDERS HAVE SOLE AUTHORITY OVER9
DRIVER SCHEDULING, VEHICLE DISPATCHING, AND DRIVER MANAGEMENT.10
(17) NEMT DRIVERS AND VEHICLES MUST MEET SAFETY ,11
LICENSING, AND PROGRAM COMPLIANCE REQUIREMENTS . NEMT TRIPS12
CONDUCTED BY NONCOMPLIANT DRIVERS OR VEHICLES ARE NOT ELIGIBLE13
FOR REIMBURSEMENT.14
(18) T O ENSURE CONTINUITY OF CARE , TRANSPORTATION15
PROVIDERS MAY BILL THE STATE DEPARTMENT DIRECTLY FOR COMPLIANT16
TRANSPORTATION SERVICES PROVIDED TO MEMBERS DURING THE17
IMPLEMENTATION OF A BROKERED NEMT PROGRAM IN A REGION OR IN18
THE EVENT OF TRANSPORTATION BROKER TERMINATION. DIRECT BILLING19
OUTSIDE OF THESE CIRCUMSTANCES IS NOT PERMITTED.20
SECTION 4. In Colorado Revised Statutes, add 25.5-1-804 as21
follows:22
25.5-1-804. Medicaid member eligibility and verification.23
(1) T HE TRANSPORTATION BROKER , OR A TRANSPORTATION24
PROVIDER IF THERE IS NO BROKER , SHALL ENSURE DURING SCHEDULING25
THAT INDIVIDUALS WHO SIGN UP TO RECEIVE TRANSPORTATION SERVICES26
ARE MEMBERS WHO ARE ELIGIBLE TO RECEIVE NONEMERGENCY MEDICAL27
HB26-1328-13-
TRANSPORTATION SERVICES.1
(2) T HE MEMBER ELIGIBILITY VERIFICATION PROCESS MUST2
PROTECT MEMBER PRIVACY . MEMBER ELIGIBILITY VERIFICATION MUST3
NOT REQUIRE DISPLAYING A MEMBER IDENTIFICATION CARD ON CAMERA4
OR THE VIDEO RECORDING OF MEMBERS FOR BILLING OR PAYMENT5
PURPOSES. NOTHING IN THIS SUBSECTION (2) PROHIBITS THE USE OF VIDEO6
RECORDING FOR DRIVER OR MEMBER SAFETY, OPERATIONAL MONITORING,7
OR COMPLAINT RESOLUTION PURPOSES.8
(3) I F A TRANSPORTATION PROVIDER PROVIDES SCHEDULED9
TRANSPORTATION SERVICES IN GOOD FAITH BASED ON INFORMATION10
PROVIDED BY A TRANSPORTATION BROKER OR THE STATE DEPARTMENT ,11
THE STATE DEPARTMENT SHALL NOT DENY PAYMENT SOLELY BECAUSE THE12
BROKER OR THE STATE DEPARTMENT LATER DETERMINES THAT THE13
MEMBER'S ELIGIBILITY OR TRIP INFORMATION WAS INACCURATE, IF:14
(a) THE PROVIDER HAD NO KNOWLEDGE OF THE INACCURACY AT15
THE TIME OF SERVICE; AND16
(b) T HE PROVIDER FOLLOWED ALL APPLICABLE RULES ,17
PROCEDURES, AND DOCUMENTATION REQUIREMENTS FOR CLAIM18
SUBMISSION.19
(4) NOTHING IN THIS SECTION ALTERS OR SUPERSEDES FEDERAL20
MEDICAID REQUIREMENTS. IF IT IS LATER DETERMINED THAT A MEMBER21
WAS NOT ELIGIBLE FOR MEDICAID AT THE TIME OF SERVICE , THE STATE22
DEPARTMENT MAY BE REQUIRED TO ADJUST OR RETRACT PAYMENT, EVEN23
IF THE PROVIDER RENDERED SERVICES IN GOOD FAITH.24
(5) T HE STATE DEPARTMENT SHALL PROVIDE TRANSPORTATION25
PROVIDERS WITH ACCESS TO ELIGIBILITY VERIFICATION TOOLS VIA THE26
TRANSPORTATION BROKER OR OTHER AUTHORIZED SYSTEMS TO REDUCE27
HB26-1328-14-
THE LIKELIHOOD OF INELIGIBLE TRIPS.1
SECTION 5. In Colorado Revised Statutes, add 25.5-1-805 as2
follows:3
25.5-1-805. Nonemergency medical transportation provider4
and broker audits - reporting.5
(1) THE STATE DEPARTMENT SHALL ENSURE A RANDOM GROUP OF6
TRANSPORTATION PROVIDERS ARE AUDITED EVERY YEAR . AUDITS MUST7
INCLUDE A REVIEW OF:8
(a) THE NUMBER OF CLAIMS FOR SERVICES RENDERED SUBMITTED9
BY THE TRANSPORTATION PROVIDER;10
(b) TRANSPORTATION PROVIDER POLICIES AND PROCEDURES;11
(c) DRIVER CREDENTIALS;12
(d) VEHICLE CREDENTIALS; AND13
(e) T HE TRANSPORTATION PROVIDER 'S COMPLIANCE WITH14
TRANSPORTATION BROKER AND STATE DEPARTMENT POLICIES AND15
PROCEDURES.16
(2) THE STATE DEPARTMENT SHALL AUDIT EACH TRANSPORTATION17
BROKER ANNUALLY . THE STATE DEPARTMENT MAY DESIGNATE A18
THIRD-PARTY SERVICE PROVIDER TO CONDUCT AN AUDIT ON ITS BEHALF.19
AN AUDIT OF A TRANSPORTATION BROKER MUST INCLUDE, AT MINIMUM,20
A REVIEW OF:21
(a) THE TRANSPORTATION BROKER'S POLICIES AND PROCEDURES;22
(b) THE NUMBER OF TRIPS ASSIGNED TO EACH TRANSPORTATION23
PROVIDER;24
(c) T HE TRANSPORTATION BROKER 'S COMPLIANCE WITH THE25
PROHIBITION ON TRIP CAPS ESTABLISHED PURSUANT TO SECTION26
25.5-1-802 (10)(b);27
HB26-1328-15-
(d) T HE TRANSPORTATION BROKER 'S COMPLIANCE WITH THE1
PROHIBITION ON CONFLICTS OF INTEREST ESTABLISHED IN SECTION2
25.5-1-803 (14);3
(e) T HE TRANSPORTATION BROKER 'S COMPLIANCE WITH THE4
DRIVER, VEHICLE , AND TRANSPORTATION PROVIDER CREDENTIALING5
REQUIREMENTS ESTABLISHED BY THE STATE DEPARTMENT IN6
COLLABORATION WITH THE BOARD PURSUANT TO SECTION 25.5-1-8027
(10)(a); AND8
(f) MEMBER REQUESTS FOR SPECIFIC TRANSPORTATION PROVIDERS.9
(3) THE STATE DEPARTMENT SHALL MAKE THE AUDIT REPORTS OF10
TRANSPORTATION PROVIDERS AND TRANSPORTATION BROKERS PUBLICLY11
AVAILABLE IN A MANNER THAT ENSURES REASONABLE ACCESS. THE STATE12
DEPARTMENT SHALL GIVE THE TRANSPORTATION BROKER AND13
TRANSPORTATION PROVIDERS THE OPPORTUNITY TO REVIEW, RESPOND TO,14
AND SEEK CORRECTION OF FACTUAL ERRORS PRIOR TO MAKING THE15
TRANSPORTATION BROKER'S AND TRANSPORTATION PROVIDERS ' AUDITS16
PUBLICLY AVAILABLE . THE STATE DEPARTMENT MAY REDACT17
CONFIDENTIAL OR SENSITIVE INFORMATION IN THE PUBLICLY AVAILABLE18
AUDITS TO PROTECT MEMBER PRIVACY.19
SECTION 6. In Colorado Revised Statutes, add 25.5-1-806 as20
follows:21
25.5-1-806. Nonemergency medical transportation - fiscal22
efficiency - rules.23
(1) T O ENSURE THE STATE DEPARTMENT OPERATES THE NEMT24
SERVICES PROGRAM AS FISCALLY EFFICIENTLY AS POSSIBLE , THE STATE25
DEPARTMENT SHALL:26
(a) CATEGORIZE ALL NEMT EXPENDITURES AS MEDICAL SERVICES27
HB26-1328-16-
FOR ELIGIBLE POPULATIONS;1
(b) IMPLEMENT CHANGES TO THE NEMT SERVICES PROGRAM AS2
SOON AS POSSIBLE TO OBTAIN THE MEDICAL SERVICES FEDERAL MATCH3
RATE FOR NEMT BY:4
(I) USING A TRANSPORTATION BROKER AND ENSURING THE BROKER5
COMPLIES WITH 42 CFR 440.170 (a) AND ALL OTHER FEDERAL6
REQUIREMENTS; OR7
(II) USING AN ALTERNATIVE ALLOWED UNDER FEDERAL LAW TO8
CLAIM NEMT EXPENDITURES AS MEDICAL SERVICES FOR FEDERAL9
REIMBURSEMENT PURPOSES;10
(c) ISSUE PUBLIC NOTICE AND AMEND THE MEDICAID STATE PLAN11
AS REQUIRED BY THIS SECTION; AND12
(d) PROVIDE THE COLORADO HEALTHCARE AFFORDABILITY AND13
SUSTAINABILITY ENTERPRISE BOARD WITH INFORMATION NO LESS14
FREQUENTLY THAN QUARTERLY REGARDING ANY STATE SAVINGS THAT15
RESULT FROM THE RECATEGORIZATION OF NEMT EXPENDITURES AS16
MEDICAL SERVICES , RATHER THAN ADMINISTRATIVE SERVICES , FOR17
ELIGIBLE POPULATIONS.18
(2) THE STATE DEPARTMENT MAY ADOPT RULES TO IMPLEMENT19
THIS SECTION.20
SECTION 7. In Colorado Revised Statutes, 25.5-5-102, amend21
(1)(m); and add (1)(n) as follows:22
25.5-5-102. Basic services for the categorically needy -23
mandated services.24
(1) Subject to the provisions of subsection (2) of this section and25
section 25.5-4-104, the program for the categorically needy must include26
the following services as mandated and defined by federal law:27
HB26-1328-17-
(m) Federally qualified health centers; AND1
(n) TRANSPORTATION SERVICES.2
SECTION 8. In Colorado Revised Statutes, 25.5-5-202, amend3
(1) introductory portion; and repeal (2) as follows:4
25.5-5-202. Basic services for the categorically needy - optional5
services - repeal.6
(1) Subject to the provisions of subsection (2) of this section, The7
following are services for which federal financial participation is8
available and that Colorado has selected to provide as optional services9
under the medical assistance program:10
(2) In addition to the services described in subsection (1) of this11
section and subject to continued federal financial participation, Colorado12
has selected to provide transportation services as an administrative cost.13
SECTION 9. Effective date. This act takes effect July 1, 2026.14
SECTION 10. 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
HB26-1328-18-