Colo. Rev. Stat. § 25.5-1-128

Current through 11/5/2024 election
Section 25.5-1-128 - [Effective 7/1/2025] Provider payments - compliance with state fiscal requirements - rules - definitions
(1)
(a) Notwithstanding any provision of law to the contrary, when the state department has regulatory authority over a program and when the provider has already signed a state department-approved provider application to provide a service or to bill the state department or its authorized contractor for a service, the state department-approved provider application shall serve to fulfill the requirements of a commitment voucher and the fiscal requirements of section 24-30-202 (1), C.R.S.
(b) The executive director may promulgate rules to exempt a provider who provides services through a program as described in subsection (1)(a) of this section for any program the state department is authorized by law to administer, including, but not limited to:
(I) The "Colorado Medical Assistance Act", articles 4 to 6 of this title;
(II) The "Children's Basic Health Plan Act", article 8 of this title;
(III)[Repealed by 2024 amendment.]
(IV) The school health services program authorized by section 25.5-5-318;
(V) Programs that are funded through the primary care fund, created in section 24-22-117 (2)(b), C.R.S.; and
(VI) The state-funded old age pension health and medical care program pursuant to article 2 of this title.
(1.5) The state department shall maintain a list of enrolled school-based health centers and school-linked health-care services providers. The state department shall develop the list based on grant enrollment data pursuant to section 25-20.5-503 that is provided to the state department by the department of public health and environment. The state department shall establish a process for identifying claims for services provided in these settings.
(2) As used in this section, unless the context otherwise requires, "provider" means a health-care provider; a mental health-care provider; a pharmacist; a home health agency; a general hospital, birth center, or community clinic licensed or certified by the department of public health and environment pursuant to section 25-1.5-103 (1)(a)(I) or (1)(a)(II); a federally qualified health center, as defined in the federal "Social Security Act", 42 U.S.C. sec 1395x (aa)(4); a rural health clinic, as defined in the federal "Social Security Act", 42 U.S.C. sec. 1395x (aa)(2); a health maintenance organization issued a certificate of authority pursuant to section 10-16-402; a school district as defined in section 25.5-5-318 (1)(a); or any other entity that provides health care, health-care coordination, outreach, enrollment, or administrative support services to members through fee-for-service, , a managed care entity, a behavioral health organization, a medical home, or any system of care that coordinates health care or services as defined and authorized through rules promulgated by the state board or by the executive director.

C.R.S. § 25.5-1-128

Amended by 2024 Ch. 404,§ 4, eff. 8/7/2024.
Amended by 2024 Ch. 152,§ 8, eff. 8/7/2024.
Amended by 2024 Ch. 76,§ 21, eff. 7/1/2025.
L. 2012: Entire section added, (HB 12-1054), ch. 14, p. 36, § 1, effective March 15.
2024 Ch. 404, was passed without a safety clause. See Colo. Const. art. V, § 1(3).
2024 Ch. 152, was passed without a safety clause. See Colo. Const. art. V, § 1(3).
2024 Ch. 76, was passed without a safety clause. See Colo. Const. art. V, § 1(3).
This section is set out more than once due to postponed, multiple, or conflicting amendments.