HB 24-1086

House Bill 24-1086 in Colorado ensures that the Department of Health Care Policy and Financing must enter into a direct contract with Denver Health's managed care organization (MCO) from July 1, 2025, until June 30, 2032. This means Denver Health will continue to manage Medicaid services under specific conditions set by the department. The bill also requires Denver Health to work with other designated entities if they are assigned to handle behavioral health care. Additionally, it restricts Denver Health from paying Medicaid providers more than standard rates unless a quality agreement is in place. The governor signed this bill into law on April 4, 2024, and it took effect immediately on the same day.

Official Summary

Current law requires the department of health care policy and financing (department) to offer to enter into a direct contract with the managed care organization (MCO) operated by or under the control of the Denver health and hospital authority (Denver health) until Denver health ceases to operate a medicaid managed care program or until June 30, 2025. The act removes the option for the department to enter into a direct contract until June 30, 2025, and instead requires the department to enter into the contract from July 1, 2025, until June 30, 2032, as long as the MCO meets all MCO criteria required by the department. If the department designates a managed care entity (MCE) other than the MCO operated by Denver health to manage behavioral health-care services, the act requires Denver health to collaborate with the MCE during the term of the contract. The act prohibits the MCO from reimbursing contracted medicaid providers at rates that are higher than the department's medicaid fee for service rates unless the provider enters into a quality incentive agreement with the MCO. For the 2023-24 state fiscal year, the department distributed money appropriated for a supplemental state payment to Denver health. The act authorizes the department to continually distribute any money appropriated for payment to Denver health. APPROVED by Governor April 4, 2024 EFFECTIVE April 4, 2024(Note: This summary applies to this bill as enacted.)

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