HB 26-1235

HB 26-1235 is a Colorado bill that updates Medicaid by requiring transportation brokers to provide information about their contracts with medical transport providers starting December 1, 2026. It also changes some terms and requirements for reimbursement of treatment services in jails, prohibits certain payment reductions for outpatient therapy, mandates home-based service agencies to report financial data starting January 1, 2027, and requires the state department to publish information on community engagement efforts. This bill affects Medicaid members, healthcare providers, and transportation companies that work with Medicaid patients. Since it has been signed into law, these changes will be implemented as specified in the legislation.

Official Summary

On or before December 1, 2026, and annually thereafter, the act requires each transportation broker that administers nonemergency medical transportation to medicaid members to submit certain information to the department of health care policy and financing (state department) regarding transportation providers that the transportation broker contracts with. Beginning January 1, 2027, the state department is required to include this information in its annual 'SMART Act' presentation.     The act changes the term 'qualified alien' to 'qualified noncitizen' to align with federal requirements.     If the state department plans to implement, apply, or enforce new multiple procedure payment reductions for outpatient therapy services, the act requires the state department to provide notice to the impacted providers of the changes at least 6 months prior to implementing the changes and to hold at least one stakeholder meeting to discuss the payment reductions.     The act requires the state department to reimburse a provider who is licensed and authorized to prescribe, dispense, compound, or administer medication-assisted treatment in a jail setting.     The act requires the medical services board to adopt rules before January 1, 2027, to comply with federal community engagement requirements and requires the state department make available on its website data on the community engagement requirements and their impact on medical assistance enrollment.     The act requires the state department to collect direct care service cost to administrative cost ratio information from home- and community-based service provider agencies and submit a report to the general assembly detailing the information collected.     The act repeals the state medical assistance and services advisory council.(Note: This summary applies to this bill as enacted.)

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