HB 1328

HOUSE BILL 26-1328
BY REPRESENTATIVE(S) Stewart K. and Winter T., Bacon, Barron,
Boesenecker, Brown, Carter, Clifford, Duran, Gonzalez R., Hamrick,
Jackson, Johnson, Lieder, Lukens, Nguyen, Paschal, Phillips, Rutinel,
Rydin, Story, McCluskie, English, Lindsay, Sirota;
also SENATOR(S) Mullica and Kirkmeyer, Amabile, Ball, Benavidez,
Bridges, Bright, Catlin, Cutter, Daugherty, Exum, Gonzales J., Hinrichsen,
Jodeh, Kipp, Lindstedt, Marchman, Pelton B., Pelton R., Roberts,
Rodriguez, Snyder, Wallace.
CONCERNING NONEMERGENCY MEDICAL TRANSPORTATION FOR MEDICAID
     MEMBERS, AND, IN CONNECTION THEREWITH, MAKING AND REDUCING
     AN APPROPRIATION.
Be it enacted by the General Assembly ofthe State of Colorado:
       SECTION 1. In Colorado Revised Statutes, 25.5-1-801, amend the
introductory portion, (1 ), (3 ), and (4); and add (6) and (7) as follows:
        25.5-1-801. Definitions.
        As used in this section PART 8, unless the context otherwise requires:
Capital letters or bold & italic numbers indicate new material added to existing law; dashes
through words or numbers indicate deletions from existing law and such material is not part of
the act.
       (1) "Nonemergency medical transportation" OR "NEMT" means
transportation to or from medically necessary nonemergency treatment.
       (3)    "Transportation broker" means an entity designated by
CONTRACTED WITH the department of health care policy and financing to
administer nonemergency medical transportation for medicaid members.
       (4) (a) "Transportation provider" means an individual or ENTITY,
INCLUDING, BUT NOT LIMITED TO, A NONPROFIT, PUBLIC, OR business entity,
othe1 than a t1 ansportation b1 oke1, that:
       W (I) Provides transportation services TO MEDICAID MEMBERS; or
       th} (II) Arranges the facilitation of transportation services FOR
MEDICAID MEMBERS by an individual.
       (b)     "TRANSPORTATION        PROVIDER"   DOES   NOT    INCLUDE   A
TRANSPORTATION BROKER OR A TRANSPORTATION NETWORK COMPANY AS
DEFINED IN SECTION 40-10.1-602.
       ( 6) "TRANSPORTATION COMMUNITY ADVISORY BOARD" OR "BOARD"
MEANS THE TRANSPORTATION COMMUNITY ADVISORY BOARD DESCRIBED IN
SECTION 25.5-1-802 (4).
       (7) "TRIP CAPS" MEANS NUMERICAL LIMITS ON THE NUMBER OF TRIPS
A TRANSPORTATION PROVIDER IS ASSIGNED AND MAY ACCEPT WITHIN A
SPECIFIED PERIOD OF TIME THAT ARE NOT BASED ON TRANSPORTATION
PROVIDER     CAPACITY,      PERFORMANCE,      SAFETY,    OR    COMPLIANCE
CONSIDER.ATIONS.
       SECTION 2. In Colorado Revised Statutes, amend 25.5-1-802 as
follows:
    25.5-1-802. Medicaid transportation services - transportation
community advisory board - safety and oversight - rules.
       (1) The state department shall collaborate with stakeholde1s,
including, but not limited to, disability and eonsume1 adv oeates, PACE
prnvide1s ope1ating pmsuant to section 25.5-5-412, transportation brnkers,
and transportation pm Viders, THE TRANSPORTATION COMMUNITY ADVISORY
PAGE 2-HOUSE BILL 26-1328
BOARD to establish rules and processes for the safety and oversight of
nonmedical transportation services and nonemergency medical
transportation services provided to medicaid members pursuant to articles
4 to 6 of this title 25.5. The mies and processes must.
        (a) Ensute the safccy ofpassengets,
        (b) Protect passenget access to trnnsportation set vices, and
       (c) Establish dt i~ et and vehicle t equh ements that minimize financial
and administI ati ve bm dens fut tt ansportation pt o videt s, dh ect support
professionals as defined in section 25.5-6-406, long-tetm cate dhect cate
wmkets, independent contrnctms, and employees providing trnnsportation
set vlCCS.
         (2) To the extent possible, the state department shall use existing
o vet sight procedm es to ensut e compliance with the t equh ements as
desct ibed in subsection ( 1) of this section.
       (3) If a providet of trnnsportation set vices aheady complies with
trnnsportation safccy standards established by anothet state departnrent
which meet ot exceed the mies and processes established pmsuant to
subsection ( 1) of this section, demonstt ating such compliance to the state
department is sufficient to ~etify compliance with the tequhements of this
section.
        (4) THE TRANSPORTATION BROKER SHALL ESTABLISH THE
TRANSPORTATION COMMUNITY ADVISORY BOARD, WHICH IS COMPOSED OF
REPRESENTATIVES OF A CROSS-SECTION OF NEMT STAKEHOLDERS,
INCLUDING     MEMBERS,     TRANSPORTATION        PROVIDERS,    HEALTH-CARE
TREATMENT PROVIDERS, AND DISABILITY ADVOCATES.  THE BOARD
MEMBERSHIP MUST INCLUDE:
        (a) MEDICAID MEMBERS FROM BOTH RURAL AND URBAN AREAS WHO
UTILIZE NEMT SERVICES;
        (b) BEHAVIORAL HEALTH, PRIMARY CARE, AND OTHER TREATMENT
PROVIDERS SERVING MEDICAID MEMBERS;
        (c) NEMT PROVIDERS REPRESENTING:
PAGE 3-HOUSE BILL 26-1328
      (I) RURAL AND URBAN SERVICE AREAS; AND
      (II) LARGE, MEDIUM, AND SMALL PROVIDER ORGANIZATIONS;
      (d)     NEl\tlT PROVIDERS WITH EXPERIENCE IN MANAGEMENT,
DISPATCH, DRIVING, AND COMPLIANCE;
      (e)     CONSUMER AND DISABILITY ADVOCATES REPRESENTING
POPULATIONS WITH DIVERSE MOBILITY, HEALTH, AND ACCESS NEEDS; AND
      (f) HOSPITAL AND HEALTH SYSTEM REPRESENTATIVES, INCLUDING
ENTITIES INVOLVED IN DISCHARGE PLANNING AND CARE TRANSITIONS FOR
MEMBERS;
      (g)     A REPRESENTATIVE FROM THE STATE DEPARTMENT WITH
KNOWLEDGE AND SPECIALIZATION IN NEMT; AND
      (h)     A    NONPROFIT OR PUBLIC TRANSPORTATION       PROVIDER
REPRESENTING BOTH RURAL AND URBAN SERVICE AREAS.
      (5) (a)      To ENSURE THAT THE COMPOSITION OF THE BOARD
REPRESENTS ACTIVE TRANSPORTATION PROVIDERS, FORTY PERCENT OF
BOARD MEMBERS MUST BE PROVIDERS WITH DIRECT NEMT OPERATIONAL
EXPERIENCE,       INCLUDING   MANAGEMENT,    DISPATCH,   DRIVING,   OR
COMPLIANCE.
      (b) THE BOARD SHALL ELECT A CHAIR FROM AMONG ITS MEMBERS.
      (c)       WHEN   APPOINTING   OR   APPROVING   NEMT   PROVIDER
REPRESENTATIVES TO THE BOARD, THE TRANSPORTATION BROKER AND THE
STATE DEPARTMENT SHALL ENSURE EQUITABLE REPRESENTATION AMONG:
      (I) FOR-PROFIT TRANSPORTATION PROVIDERS;
      (II) NONPROFIT TRANSPORTATION PROVIDERS; AND
      (Ill)     PUBLIC TRANSPORTATION PROVIDERS, INCLUDING LOCAL
GOVERNMENT OR PUBLIC TRANSIT AGENCIES.
      (6) BOARD MEMBERS SERVE TWO-YEAR TERMS. BOARD MEMBERS
PAGE 4-HOUSE BILL 26-1328
SERVE WITHOUT COMPENSATION AND WITHOUT REIMBURSEMENT FOR
EXPENSES.
      (7) THE BOARD CHAIR AND STATE DEPARTMENT SHALL CIRCULATE
MEETING AGENDAS TO THE BOARD MEMBERS AT LEAST TEN DAYS IN
ADVANCE OF MEETINGS. THE BOARD SHALL DOCUMENT MEETING MINUTES
AND APPROVE MEETING MINUTES WITHIN FIFTEEN BUSINESS DAYS AFTER
EACH MEETING. THE BOARD MUST GIVE BOARD MEMBERS THE OPPORTUNITY
TO SUBMIT WRITTEN RECOMMENDATIONS OR COMMENTS TO THE BOARD
PRIOR TO BOARD ACTION OR ADVICE.
      (8)   THE BOARD IS AN ADVISORY BODY. THE BOARD DOES NOT
REPLACEORLIMITTHESTATEDEPARTMENT'SCOLLABORATIONWITHNEMT
PROVIDERS WHEN DEVELOPING RULES, PROCESSES, OR POLICIES.
      (9) THE BOARD SHALL PROVIDE RECOMMENDATIONS TO THE STATE
DEPARTMENT ABOUT THE STATE DEPARTMENT'S RULES, PROCESSES, AND
POLICIES THAT GOVERN NEMT. FINAL DECISIONS REGARDING RULES,
PROCESSES, AND POLICIES REMAIN THE RESPONSIBILITY OF THE STATE
DEPARTMENT.
      (10) THE STATE DEPARTMENT, IN COLLABORATION WITH THE BOARD,
SHALL ADOPT RULES THAT:
      (a) ESTABLISH DRIVER, VEHICLE, AND TRANSPORTATION PROVIDER
CREDENTIALING REQUIREMENTS;
      (b) PROHIBIT TRIP CAPS, MARKET-SHARE RESTRICTIONS, OR OTHER
POLICIES THAT LIMIT TRANSPORTATION PROVIDER PARTICIPATION IN THE
MARKET, EXCEPT AS ALLOWED PURSUANT TO SUBSECTION (11) OF THIS
SECTION;
      (c) REQUIRE THE STATE DEPARTMENT TO HOST MEETINGS WITH THE
BOARD NO LESS THAN QUARTERLY TO REVIEW PROGRAM PERFORMANCE,
IDENTIFY AND ADDRESS PROGRAM CHALLENGES, DISCUSS PROGRESS TOWARD
PROGRAM GOALS, AND IDENTIFY OPPORTUNITIES TO ENHANCE EFFICIENCY
AND OUTCOMES OF THE PROGRAM;
      (d) REQUIRE REASONABLE ACCOMMODATION OF MEMBER REQUESTS
FOR AN ALTERNATE OR SPECIFIC TRANSPORTATION PROVIDER WHEN
PAGE 5-HOUSE BILL 26-1328
OPERA TIGNALL Y FEASIBLE;
         (e)    CREATE A PROCESS FOR MEMBERS AND TRANSPORTATION
PROVIDERS TO FILE CONCERNS WITH THE STATE DEPARTMENT AND FOR THE
STATE DEPARTMENT TO REPORT TO THE BOARD THE NUMBER OF CONCERNS
FILED;
         (f)
           ESTABLISH PROCESSES FOR CLAIM SUBMISSION FROM
TRANSPORTATION PROVIDERS AND PAYMENT OF TRANSPORTATION
PROVIDERS;
         (g)     ESTABLISH POLICIES REGARDING THE STORAGE, ACCESS,
RETENTION, AND DELETION OF VIDEO RECORDINGS OF MEMBERS MADE
DURING NONEMERGENCY MEDICAL TRANSPORTATION. THE POLICIES MUST
NOT PROHIBIT THE USE OF VIDEO RECORDING FOR SAFETY OR DRIVER
ACCOUNTABILITY PURPOSES;
         (h)    DEVELOP BILLING PROCEDURES AND REQUIREMENTS FOR THE
PAYMENT OF TRANSPORTATION PROVIDERS;
         (i)    DEVELOP A PROCESS FOR TRANSPORTATION PROVIDERS TO
RESOLVE  BILLING   ISSUES   WITH   THE   STATE   DEPARTMENT   OR
TRANSPORTATION BROKER;
         (j)    ESTABLISH POLICIES AND PROCEDURES TO VERIFY MEMBER
ELIGIBILITY PRIOR TO A MEMBER RECEIVING TRANSPORTATION SERVICES;
         (k) ESTABLISH POLICIES REQUIRING TRANSPORTATION PROVIDERS OR
THE TRANSPORTATION BROKER, OR BOTH, TO UTILIZE A DIGITAL DISPATCH
S0FTWARESYSTEMTHATAUTOMATICALLYREC0RDSPICK-UPANDDROP-0FF
ADDRESSES, GPS COORDINATES, TIMES OF PICK-UP AND DROP-OFF, ROUTES
DRIVEN, MILES DRIVEN, AND THE DRIVER AND VEHICLE THAT PERFORMED
THE TRIP; AND
         (l) ESTABLISH THAT MEMBERS HAVE A RIGHT TO RECEIVE NEMT
SERVICES THAT ARE ACCESSIBLE AND APPROPRIATE TO THEIR INDIVIDUAL
MEDICAL AND FUNCTIONAL NEEDS, INCLUDING MOBILITY AND
COMMUNICATION ACCOMMODATIONS.
         (11)     THE STATE DEPARTMENT MAY IMPOSE TRIP CAPS OR
PAGE 6-HOUSE BILL 26-1328
MARKET-SHARE RESTRICTIONS ON A TRANSPORTATION PROVIDER AS
CORRECTIVE ACTION AS PART OF A CORRECTIVE ACTION PLAN BASED ON A
TRANSPORTATION PROVIDER'S DOCUMENTED MATERIAL PERFORMANCE
DEFICIENCIES THAT ARE SUPPORTED BY OBJECTIVE MEASURABLE CRITERIA
APPLIED ON AN INDIVIDUALIZED, PROPORTIONAL, AND TIME-LIMITED BASIS
FOLLOWING PRIOR WRITTEN NOTICE OF THE DEFICIENCIES AND A
MEANINGFUL OPPORTUNITY TO CURE.
      (12) THESTATEDEPARTMENTSHALLENSUREALLTRANSPORTATION
PROVIDERS, DRIVERS, AND VEHICLES ARE CREDENTIALED IN A MANNER
SUFFICIENT TO PROTECT MEMBER SAFETY AND ENSURE PROGRAM INTEGRITY.
THE   STATE   DEPARTMENT    SHALL    ESTABLISH   REQUIREMENTS     FOR
TRANSPORTATION PROVIDER, DRIVER, AND VEHICLE CREDENTIALING
THROUGH CONTRACT OR PROGRAM POLICY. THE TRANSPORTATION BROKER
SHALL VERIFY COMPLIANCE WITH CREDENTIALING REQUIREMENTS.
      ( 13) SERVICES PROVIDED BY NON COMPLIANT OR NON CREDENTIALED
DRIVERS OR IN NONCOMPLIANT OR NONCREDENTIALED VEHICLES ARE NOT
ELIGIBLE FOR REIMBURSEMENT.
      (14)    FOR   THE    PRIMARY   PURPOSE     OF   SAFETY,   DRIVER
ACCOUNTABILITY, AND FRAUD PREVENTION, TRANSPORTATION PROVIDERS
SHALL USE VEHICLES EQUIPPED WITH TWO-WAY VIDEO DASH CAMERAS AND
A VIDEO RECORDING SYSTEM WHEN TRANSPORTING MEMBERS. THE VIDEO
DASH CAMERA AND VIDEO RECORDING SYSTEM MUST CAPTURE VISUAL
DOCUMENTATION OF TRIPS, INCLUDING IMAGES OF PICK-UP AND DROP-OFF
OF A MEMBER. THE POLICIES REGARDING THE USE OF VIDEO RECORDING
DURING   TRANSPORTATION     SERVICES   ESTABLISHED     PURSUANT    TO
SUBSECTION (I0)(g) OF THIS SECTION MUST ADDRESS MEMBER PRIVACY,
OPERATIONAL FEASIBILITY, AND COMPLIANCE WITH APPLICABLE FEDERAL
AND STATE LAWS AND RELATED REGULATORY STANDARDS, INCLUDING
MEDICAID REQUIREMENTS. VIDEO RECORDINGS OF MEMBERS ARE NOT
REQUIRED FOR BILLING PURPOSES, BUT MAY BE USED FOR AUDITING
PURPOSES. THIS SUBSECTION (14) DOES NOT APPLY TO TRANSPORTATION
PROVIDERS OPERATING FLEETS OF FIVE OR FEWER VEHICLES.
      (15) THE DATA COLLECTED PURSUANT TO SUBSECTION (I0)(k) OF
THIS SECTION MUST ONLY BE MADE AVAILABLE TO THE STATE DEPARTMENT
OR THE TRANSPORTATION BROKER IN DIGITAL FORMAT.
PAGE 7-HOUSE BILL 26-1328
      (16) THE STATE DEPARTMENT SHALL, IN ACCORDANCE WITH THE
"STATE ADMINISTRATIVE PROCEDURE ACT", ARTICLE 4 OF TITLE 24,
PROVIDE ADVANCED NOTICE AND THE OPPORTUNITY FOR PUBLIC COMMENT
PRIOR TO THE IMPLEMENTATION OF AN NEMT RULE CHANGE.
      (17)    THE     STATE   DEPARTMENT      SHALL    ESTABLISH   BILLING
PROCEDURES, DOCUMENTATION REQUIREMENTS, AND PAYMENT STANDARDS
FOR TRANSPORTATION PROVIDERS PURSUANT TO SUBSECTION ( 10)(f) OF THIS
SECTION. THE PROCEDURES MUST BE CONSISTENT WITH STATE AND FEDERAL
MEDICAID REQUIREMENTS AND MUST NOT REQUIRE PAYMENT FOR CLAIMS
THAT DO NOT MEET APPLICABLE PROGRAM INTEGRITY, DOCUMENTATION, OR
ELIGIBILITY STANDARDS. THE PROCEDURES MUST ESTABLISH:
      (a) REQUIRED CLAIM FORMATS AND SUPPORTING DOCUMENTS;
      (b) CLAIM DENIAL CRITERIA; AND
      (c) REIMBURSEMENT REQUIREMENTS.
      (18) THE STATE DEPARTMENT MAY ISSUE INTERIM OPERATIONAL
GUIDANCE TO CLARIFY PROCEDURES, IMPROVE ADMINISTRATIVE EFFICIENCY,
OR PROVIDE TECHNICAL INSTRUCTIONS TO TRANSPORTATION PROVIDERS.
INTERIM    GUIDANCE    MUST    NOT     SUBSTANTIVELY    CHANGE     BILLING,
DOCUMENTATION, OR PAYMENT STANDARDS IDENTIFIED IN THE PROCEDURES
ADOPTED PURSUANT TO SUBSECTION (17) OF THIS SECTION, EXCEPT AS
NECESSARY TO ADDRESS PROGRAM INTEGRITY RISKS, INCLUDING FRAUD,
WASTE, OR ABUSE, OR TO ENSURE COMPLIANCE WITH STATE OR FEDERAL
LAW. IN INSTANCES OF FRAUD, WASTE, OR ABUSE OF NEMT SERVICES, THE
STATE DEPARTMENT MAY PROVIDE IMMEDIATE INTERIM OPERATIONAL
GUIDANCEIFTHESTATEDEPARTMENTJNCLUDESTHEJUSTIFICATIONFORTHE
INTERIM OPERATIONAL GUIDANCE IN THE GUIDANCE AND PROVIDES
REASONABLE    ADVANCED        NOTICE    TO   AFFECTED   TRANSPORTATION
PROVIDERS, UNLESS IMMEDIATE ACTION IS REQUIRED TO PREVENT ONGOING
FRAUD.IFTHESTATEDEPARTMENTTAKESIMMEDIATEACTION, THEACTIONS
MUST BE:
      (a) LIMITED IN SCOPE AND DURATION;
      (b) INCLUDE PROMPT WRITTEN NOTICE EXPLAINING THE CHANGE;
PAGE 8-HOUSE BILL 26-1328
      (c) APPLIED PROSPECTIVELY TO THE EXTENT PERMITTED BY STATE
AND FEDERAL LAW AND MUST NOT ALTER CLAIMS SUBMITTED PRIOR TO THE
EFFECTIVE DATE OF THE fNTERIM OPERATIONAL GUIDANCE, EXCEPT AS
REQUIRED TO ADDRESS FRAUD, WASTE, OR ABUSE.
      (19)   THE STATE DEPARTMENT SHALL NOTIFY TRANSPORTATION
PROVIDERS OF NEW BILLING OR DOCUMENTATION REQUIREMENTS OR
SUBSTANTIVE CHANGES, WHETHER ISSUED BY RULE OR BY INTERIM
GUIDANCE, AT LEAST THIRTY DAYS BEFORE THE CHANGES BECOME
EFFECTIVE. FORMS, TEMPLATES, OR DOCUMENTATION THAT WAS VALID
PRIOR TO THE EFFECTIVE DATE OF A NEW RULE CONTINUES TO BE VALID
THROUGH ITS EXPIRATION OR UNTIL THE END OF THE NOTICE PERIOD,
WHICHEVER IS LATER.
      (20) NOTHING fN THIS SECTION ENTITLES A PROVIDER TO PAYMENT
OR LIMITS THE STATE DEPARTMENT'S AUTHORITY TO DENY, RECOUP, OR
ADJUST CLAIMS IN ACCORDANCE WITH STATE OR FEDERAL LAW.
      (21) MATIERS OUTSIDE THE SCOPE OF THE BOARD OR THAT CANNOT
BE RESOLVED AMONG BOARD MEMBERS MUST BE DIRECTED TO THE STATE
DEPARTMENT.
       SECTION 3. In Colorado Revised Statutes, add 25.5-1-804 as
follows:
      25.5-1-804. State nonemergency transportation broker -
transportation providers - repeal.
      (1) (a)    THE STATE DEPARTMENT MAY CONTRACT WITH A
TRANSPORTATION BROKER.
      (b)    A TRANSPORTATION BROKER SHALL CREATE A PUBLICLY
AVAILABLE CONTINGENCY PLAN TO ENSURE UNINTERRUPTED NEMT
SERVICES IN THE EVENT THE TRANSPORTATION BROKER EXPERIENCES
SYSTEM OUTAGES OR IS OTHERWISE UNABLE TO PERFORM REQUIRED
FUNCTIONS. THE TRANSPORTATION BROKER SHALL SHARE THE CONTINGENCY
PLAN WITH TRANSPORTATION PROVIDERS.
      (c) IFTHESTATEDEPARTMENTCONTRACTS WITH A TRANSPORTATION
BROKER, THE STATE DEPARTMENT SHALL DESIGNATE REGIONS WITHIN THE
PAGE 9-HOUSE BILL 26-1328
STATE FOR IMPLEMENTATION OF A BROKERED NEMT PROGRAM.
         (2) THE TRANSPORTATION BROKER SHALL IMPLEMENT A BROKERED
NEMT PROGRAM ON A PHASED BASIS, ONE REGION AT A TIME, AND SHALL
NOT BEGIN IMPLEMENTATION IN A SUBSEQUENT REGION UNTIL THE PROGRAM
IS FULLY IMPLEMENTED IN THE PRIOR REGION. FOR PURPOSES OF THIS
SECTION, A PROGRAM IS FULLY IMPLEMENTED IN A REGION WHEN:
         (a)   TECHNOLOGY    SYSTEMS   FOR   SCHEDULING,   ELIGIBILITY
VERIFICATION, TRIP ASSIGNMENT, PROVIDER PAYMENT, AND CUSTOMER
SUPPORT ARE FULLY OPERATIONAL;
         (b) TRANSPORTATION PROVIDERS IN THE REGION ARE PROVIDED A
REASONABLE OPPORTUNITY TO COMPLETE THE BROKER ONBOARDING
PROCESS, INCLUDING PROVIDER TRAINING, SYSTEM ACCESS, AND REQUIRED
VEHICLE AND DRIVER VERIFICATION;
         (c) A SUFFICIENT NETWORK OF TRANSPORTATION PROVIDERS IS
AVAILABLE TO MEET MEMBERS' MEDICAL NEEDS AND ENSURE TIMELY
ACCESS TO NEMT SERVICES; AND
         (d) THE STATE DEPARTMENT HAS VERIFIEDTHATPROVIDERPAYMENT
PROCESSES AND CUSTOMER SUPPORT FUNCTIONS OPERATE EFFECTIVELY.
         (3) THE STATE DEPARTMENT AND TRANSPORTATION BROKER SHALL
PROVIDE TIMELY NOTICE AND TECHNICAL ASSISTANCE TO TRANSPORTATION
PROVIDERS REGARDING THE ONBOARDING PROCESS. PROVIDERS MAY
CONTINUE TO COMPLETE ONBOARDING DURING THE IMPLEMENTATION
PERIOD.
         (4) FOR TRIPS ORIGINATING IN REGIONS THAT HAVE NOT YET BEEN
DESIGNATED BY THE STATE DEPARTMENT FOR IMPLEMENTATION OF A
BROKERED NEMT PROGRAM, TRANSPORTATION PROVIDERS MAY CONTINUE
TO PROVIDE TRANSPORTATION SERVICES AND BILL THE STATE DEPARTMENT
DIRECTLY. ONCE A REGION HAS BEEN DESIGNATED FOR IMPLEMENTATION OF
A BROKERED NEMT PROGRAM, TRANSPORTATION SERVICES PROVIDED TO
MEMBERS IN THAT REGION MUST BE SCHEDULED AND AUTHORIZED THROUGH
THE TRANSPORTATION BROKER IN ACCORDANCE WITH STATE DEPARTMENT
RULES.
PAGE IO-HOUSE BILL 26-1328
      (5)     NOTHING IN THIS SECTION LIMITS MEMBER ACCESS TO
TRANSPORTATION       SERVICES   OR   CREATES   SERVICE    GAPS   DURING
IMPLEMENTATION OF A BROKERED PROGRAM.
      (6)     TRANSPORTATION PROVIDERS MAY COMMUNICATE WITH
MEMBERS     REGARDING TRANSPORTATION       SERVICES,     INCLUDING TRIP
SCHEDULING, SERVICEDELIVERY,ANDOPERATIONALQUESTIONS. THE STATE
DEPARTMENT AND BOARD SHALL DEVELOP POLICIES REGARDING WHEN AND
HOW TRANSPORTATION PROVIDERS CAN COMMUNICATE WITH MEMBERS.
      (7)    THE STATE DEPARTMENT SHALL DEVELOP AND PROVIDE
TRANSPORTATION PROVIDERS A PROVIDER COMMUNICATION TOOLKIT TO
ASSIST TRANSPORTATION PROVIDERS IN DISCUSSING THE TRANSITION TO
TRANSPORTATION BROKER CONTROL OR OTHER PROGRAM CHANGES. THE
PROVIDER COMMUNICATION TOOLKIT MUST INCLUDE TALKING POINTS,
SCRIPTS,    AND   GUIDANCE TO   ENSURE   ACCURATE AND       CONSISTENT
INFORMATION IS COMMUNICATED TO MEMBERS. THE STATE DEPARTMENT
SHALL MAKE THE PROVIDER COMMUNICATION TOOLKIT AVAILABLE TO
TRANSPORTATION PROVIDERS AT LEAST NINETY DAYS PRIOR TO THE
IMPLEMENTATION OF A BROKERED NEMT PROGRAM IN THE REGION IN
WHICH THE PROVIDER OPERATES.
      (8) AT LEAST NINETY DAYS PRIOR TO THE IMPLEMENTATION OF A
BROKERED NEMT PROGRAM IN A REGION, THE TRANSPORTATION BROKER,
IN COORDINATION WITH THE STATE DEPARTMENT, SHALL PROVIDE TRAINING
AND TECHNICAL SUPPORT TO TRANSPORTATION PROVIDERS THAT PROVIDE
SERVICES IN THE REGION. THE STATE DEPARTMENT MAY EXTEND THE
NINETY-DAY PERIOD AS NEEDED BASED ON PROVIDER READINESS OR DELAYS
IN MATERIALS OR INSTRUCTION. THE TRANSPORTATION BROKER SHALL
PROVIDE TRAINING AND TECHNICAL SUPPORT TO TRANSPORTATION
PROVIDERS, WITH SUPPORT AND OVERSIGHT BY THE STATE DEPARTMENT.
      (9)     THE    TRANSPORTATION    BROKER    SHALL    PROVIDE   ALL
TRANSPORTATION PROVIDERS IN A BROKERED NEMT PROGRAM REGION
WITH SOFTWARE TO FACILITATE NEMT SERVICES. THE TRANSPORTATION
BROKER SHALL NOT REQUIRE TRANSPORTATION PROVIDERS TO PAY THE COST
OF SOFTWARE LICENSING, IMPLEMENTATION, MAINTENANCE, UPGRADES, OR
TRAINING.
      ( 10) THE TRANSPORTATION BROKER MAY ENCOURAGE A MEMBER TO
PAGE 11-HOUSE BILL 26-1328
SCHEDULE TRANSPORTATION SERVICES AT LEAST TWO DAYS PRIOR TO THEIR
REQUESTED TRANSPORTATION DATE. THE TRANSPORTATION BROKER SHALL
ACCEPT AND MAKE REASONABLE EFFORTS TO FULFILL SAME-DAY AND
NEXT-DAY TRANSPORTATION REQUESTS, INCLUDING REQUESTS FOR URGENT
MEDICAL AND BEHAVIORAL HEALTH OUTPATIENT, SPECIALTY, AND HOSP ITAL
VISITS; TIME-SENSITIVE IN-STATE AND OUT-OF-STATE TRANSFERS; AND
DISCHARGES FROM HEALTH-CARE FACILITIES, WHEN FEASIBLE, AND SHALL
NOT REQUIRE ADV AN CED NOTICE THAT WOULD UNREASONABLY LIMIT
ACCESS TO MEDICALLY NECESSARY SERVICES. THE TRANSPORTATION
BROKER SHALL ALLOW MEMBERS TO SCHEDULE SINGLE AND RECURRING
TRANSPORTATION SERVICES. THE TRANSPORTATION BROKER SHALL ALLOW
MEMBERS, PRIOR TO THE REQUESTED TRANSPORTATION SERVICES, TO
REQUEST A TRANSPORTATION PROVIDER OR REQUEST A DIFFERENT
TRANSPORTATION PROVIDER. THE TRANSPORTATION BROKER SHALL NOT
DIRECT MEMBERS AWAY FROM THEIR PREFERRED TRANSPORTATION
PROVIDER. THE TRANSPORTATION BROKER SHALL DOCUMENT AND RETAIN
ALL PROVIDER PREFERENCE REQUESTS        FOR AUDIT PURPOSES. THE
TRANSPORTATION BROKER MAY ONLY PROVIDE MEMBERS THE OPTION TO
REQUEST A SPECIFIC PROVIDER AFTER ALL SERVICE REGIONS HA VE BEEN
IMPLEMENTED. THE PROHIBITION ON DIRECTING MEMBERS A WAY FROM
PREFERRED TRANSPORTATION PROVIDERS DOES NOT APPLY WHEN THE
PROVIDER IS SUBJECT TO TRIP CAPS OR MARKET-SHARE RESTRICTIONS AS
PART OF A CORRECTIVE ACTION PLAN PURSUANT TO SECTION 25.5-1-802
(11 ).
         ( 11) A TRANSPORTATION BROKER, ORA TRANSPORTATION PROVIDER
IF THERE IS NO TRANSPORTATION BROKER, SHALL VERIFY A MEMBER'S
ELIGIBILITY FORNEMT SERVICES IMMEDIATELY UPON A MEMBER'S REQUEST
FOR NEMT TRANSPORTATION SERVICES USING REAL-TIME ACCESS TO THE
STATE DEPARTMENT'S ELIGIBILITY SYSTEM. IF VERIFICATION CANNOT BE
COMPLETED DUE TO SYSTEM ISSUES OR INCOMPLETE INFORMATION, THE
TRANSPORTATION BROKER SHALL NOTIFY THE MEMBER AND THE STATE
DEPARTMENT AS SOON AS PRACTICABLE AND TAKE ACTION TO RESOLVE THE
ISSUE PROMPTLY. ONCE ELIGIBILITY IS VERIFIED, THE MEMBER IS
IMMEDIATELY ELIGIBLE TO SCHEDULE TRIPS, IN ACCORDANCE WITH
PROGRAM RULES.
         (12)   THE   TRANSPORTATION   BROKER   SHALL   ENSURE   ALL
TRANSPORTATION PROVIDERS MEET THE CREDENTIALING REQUIREMENTS
ESTABLISHED BY STATE DEPARTMENT RULE. NOTHING IN THIS SUBSECTION
PAGE 12-HOUSE BILL 26-1328
(12) PROHIBITS A TRANSPORTATION BROKER FROM IMPOSING ADDITIONAL
CREDENTIALING, TRAINING, OR SAFETY REQUIREMENTS NECESSARY TO
ENSURE MEMBER SAFETY, PROGRAM INTEGRITY, OR QUALITY OF SERVICE.
      (13) (a) THE TRANSPORTATION BROKER SHALL NOT OPERATE, OWN,
OR CONTROL AN NEMT TRANSPORTATION PROVIDER THAT OPERATES IN
COLORADO. THE TRANSPORTATION BROKER SHALL MAINTAIN POLICIES
CONCERNING PREVENTING CONFLICTS OF INTEREST AND ENSURE THAT TRIP
ASSIGNMENTS ARE MADE CONSISTENT WITH SAFETY, COMPLIANCE, AND
OPERATIONAL STANDARDS. NOTHING IN THIS SUBSECTION (13) LIMITS
PROVIDER PARTICIPATION OR IMPOSES TRIP CAPS.
      (b) A TRANSPORTATION BROKER THAT ENTERED INTO A CONTRACT
WITH THE STATE DEPARTMENT PRIOR TO JANUARY 1, 2026, TO PROVIDE
TRANSPORTATION SERVICES AS A TRANSPORTATION PROVIDER MAY
CONTINUE PROVIDING TRANSPORTATION SERVICES AS A TRANSPORTATION
PROVIDER UNTIL SEPTEMBER 1, 2026. A TRANSPORTATION BROKER WHO HAS
CONTRACTEDWITHTHESTATEDEPARTMENTTOPROVIDETRANSPORTATION
SERVICES AS A TRANSPORTATION PROVIDER AND WHOSE CONTRACT IS
EXECUTED, AMENDED, OR RENEWED ON OR AFTER JANUARY 1, 2026, SHALL
NOT OPERATE, OWN OR CONTROL AN NEMT TRANSPORTATION PROVIDER
THAT OPERATES IN COLORADO PURSUANT TO SUBSECTION (13)(a) OF THIS
SECTION.
      (c)  SUBSECTION (13)(b) OF THIS SECTION AND THIS SUBSECTION
(13)(c) ARE REPEALED, EFFECTIVE JANUARY 1, 2027.
      (14) THE TRANSPORTATION BROKER, OR THE STATE DEPARTMENT IF
THERE IS NO TRANSPORTATION BROKER, SHALL NOT RESTRICT THE NUMBER
OF VEHICLES A TRANSPORTATION PROVIDER CAN UTILIZE OR RESTRICT THE
AREAS WHERE OR TYPES OF SERVICES A TRANSPORTATION PROVIDER
OPERATES.
      (15)   A TRANSPORTATION BROKER SHALL PROVIDE THEIR TRIP
ASSIGNMENT RULES AND PROCEDURES TO THE STATE DEPARTMENT FOR
APPROVAL. UPON APPROVAL, THE STATE DEPARTMENT SHALL MAKE THE
TRANSPORTATION BROKER TRIP ASSIGNMENT RULES AND PROCEDURES
PUBLICLY AVAILABLE ON THE STATE DEPARTMENT'S WEBSITE.
      (16)   TRANSPORTATION PROVIDERS HAVE SOLE AUTHORITY OVER
PAGE 13-HOUSE BILL 26-1328
DRIVER SCHEDULING, VEHICLE DISPATCHING, AND DRIVER MANAGEMENT.
      ( 17) NEMT DRIVERS AND VEHICLES MUST MEET SAFETY, LICENSING,
AND PROGRAM COMPLIANCE REQUIREMENTS. NEMT TRIPS CONDUCTED BY
NONCOMPLIANT DRIVERS OR VEHICLES ARE NOT ELIGIBLE FOR
REIMBURSEMENT.
      ( 18) TO ENSURE CONTINUITY OF CARE, TRANSPORTATION PROVIDERS
MAY   BILL    THE   STATE   DEPARTMENT    DIRECTLY   FOR    COMPLIANT
TRANSPORTATION      SERVICES   PROVIDED   TO   MEMBERS     DURING   THE
IMPLEMENTATION OF A BROKERED NEMT PROGRAM IN A REGION OR IN THE
EVENT OF TRANSPORTATION BROKER TERMINATION. DIRECT BILLING
OUTSIDE OF THESE CIRCUMSTANCES IS NOT PERMITTED.
      (19)   (a) TRANSPORTATION NETWORK COMPANIES, AS DEFINED IN
SECTION 40-10.1-602, MAY PROVIDE NEMT SERVICES IF:
      (I)    THE TRANSPORTATION PROVIDER ORIGINALLY ASSIGNED TO
COMPLETE A TRIP IS UNABLE TO FULFILL THE ASSIGNMENT AND NO OTHER
ENROLLED TRANSPORTATION PROVIDER IS AVAILABLE TO COMPLETE THE
TRIP WITHIN THE TIME FRAME NECESSARY TO ENSURE THE MEMBER ARRIVES
AT THEIR APPOINTMENT; OR
      (II) NO TRANSPORTATION PROVIDER IS AVAILABLE TO SERVE THE
MEMBER IN THE MEMBER'S COUNTY OR SERVICE AREA AT THE TIME THE TRIP
IS REQUESTED.
      (b)    EACH USE OF A TRANSPORTATION NETWORK COMPANY IN
ACCORDANCE WITH THIS SUBSECTION MUST BE DOCUMENTED BY THE
TRANSPORTATION BROKER IN WRITING OR AN ELECTRONIC RECORDS,
INCLUDING THE REASON FOR USING THE TRANSPORTATION NETWORK
COMPANY, THE REASON A TRANSPORTATION PROVIDER WAS UNABLE TO
COMPLETE THE TRIP, AND THE DATE AND TIME OF THE REQUEST. THE
TRANSPORTATION BROKER SHALL MAKE THE DOCUMENTATION AVAILABLE
TO THE STATE DEPARTMENT OR ITS DESIGNEE UPON REQUEST FOR AUDIT
PURPOSES.
      (c) THE TRANSPORTATION NETWORK COMPANY PROVIDING NEMT
SERVICES MUST MEET THE DRIVER, VEHICLE, SAFETY, AND CREDENTIALING
REQUIREMENTS ESTABLISHED BY THE STATE DEPARTMENT FOR
PAGE 14-HOUSE BILL 26-1328
TRANSPORTATION NETWORK COMPANIES PARTICIPATING IN THE NEMT
PROGRAM, AS APPLICABLE.
      (20) ALICENSEDAMBULANCESERVICEPROVIDERISNOTSUBJECTTO
THE REQUIREMENTS OF THIS SECTION.
       SECTION 4. In Colorado Revised Statutes, add 25.5-1-805 as
follows:
      25.5-1-805. Medicaid member eligibility and verification.
      (1)   THE TRANSPORTATION BROKER, OR A TRANSPORTATION
PROVIDER IF THERE IS NO BROKER, SHALL ENSURE DURING SCHEDULING THAT
INDIVIDUALS WHO SIGN UP TO RECEIVE TRANSPORTATION SERVICES ARE
MEMBERS WHO ARE ELIGIBLE TO RECEIVE NONEMERGENCY MEDICAL
TRANSPORTATION SERVICES.
      (2) THEMEMBERELIGIBILITYVERIFICATIONPROCESSMUSTPROTECT
MEMBER PRIVACY. MEMBER ELIGIBILITY VERIFICATION MUST NOT REQUIRE
DISPLAYING A MEMBER IDENTIFICATION CARD ON CAMERA OR THE VIDEO
RECORDING OF MEMBERS FOR ROUTINE BILLING PURPOSES. NOTHING IN THIS
SUBSECTION (2) PROHIBITS THE USE OF VIDEO RECORDING FOR DRIVER OR
MEMBER SAFETY, OPERATIONAL MONITORING, OR COMPLAINT RESOLUTION
PURPOSES. THE STATE DEPARTMENT MAY REQUEST VIDEO RECORDINGS FOR
PROGRAM INTEGRITY REVIEW WITHOUT ADVANCED NOTICE TO THE
TRANSPORTATION PROVIDER, PROVIDED THAT REQUESTS ARE NARROWLY
TAILORED TO SPECIFIC ISSUES UNDER REVIEW. THE USE OF VIDEO
RECORDINGS    MUST      COMPLY    WITH   APPLICABLE    PRIVACY    AND
CONFIDENTIALITY REQUIREMENTS. TRANSPORTATION PROVIDERS ARE NOT
REQUIRED TO RETAIN OR PRODUCE VIDEO RECORDINGS BEYOND THE
STANDARD    RETENTION    PERIOD   ESTABLISHED   IN   THEIR   OPERATING
PROCEDURES. ABSENCE OF VIDEO RECORDINGS OUTSIDE A RETENTION
PERIOD DOES NOT CONSTITUTE NONCOMPLIANCE, AND ADVERSE ACTION
SHALL NOT BE TAKEN AGAINST A TRANSPORTATION PROVIDER ON THIS BASIS.
      (3)   IF A TRANSPORTATION PROVIDER PROVIDES SCHEDULED
TRANSPORTATION SERVICES IN GOOD FAITH BASED ON INFORMATION
PROVIDED BY A TRANSPORTATIONBROKERORTHESTATEDEPARTMENT, THE
STATE DEPARTMENT SHALL NOT DENY PAYMENT SOLELY BECAUSE THE
PAGE 15-HOUSE BILL 26-1328
BROKER OR THE STATE DEPARTMENT LATER DETERMINES THAT THE
MEMBER'S ELIGIBILITY OR TRIP INFORMATION WAS INACCURATE, IF:
       (a) THE PROVIDER HAD NO KNOWLEDGE OF THE INACCURACY AT THE
TIME OF SERVICE; AND
       (b) THE PROVIDER FOLLOWED ALL APPLICABLE RULES, PROCEDURES,
AND DOCUMENTATION REQUIREMENTS FOR CLAIM SUBMISSION.
       (4)   NOTHING IN THIS SECTION ALTERS OR SUPERSEDES FEDERAL
MEDICAID REQUIREMENTS. IF IT IS LATER DETERMINED THAT A MEMBER WAS
NOT ELIGIBLE FOR MEDICAID AT THE TIME OF SERVICE, THE STATE
DEPARTMENTMAYBEREQUIREDTOADJUSTORRETRACTPAYMENT,EVENIF
THE PROVIDER RENDERED SERVICES IN GOOD FAITH.
      (5)    THE STATE DEPARTMENT SHALL PROVIDE TRANSPORTATION
PROVIDERS WITH ACCESS TO ELIGIBILITY VERIFICATION TOOLS VIA THE
TRANSPORTATION BROKER OR OTHER AUTHORIZED SYSTEMS TO REDUCE THE
LIKELIHOOD OF INELIGIBLE TRIPS.
       SECTION 5.      In Colorado Revised Statutes, add 25.5-1-806 as
follows:
      25.5-1-806. Nonemergency medical transportation provider and
broker audits - reporting.
      (1)    THE STATE DEPARTMENT SHALL, SUBJECT TO AVAILABLE
APPROPRIATIONS,    AUDIT   TRANSPORTATION     PROVIDERS   TO   ENSURE
REIMBURSEMENT IS MADE ONLY FOR TRIPS PERFORMED BY CREDENTIALED
DRIVERS OPERATING CREDENTIALED VEHICLES PURSUANT TO THE RULES
ADOPTED PURSUANT TO SECTION 25 .5-1-802.
      (2)     THE STATE DEPARTMENT MAY USE DATA ANALYTICS,
COMPLAINTS BY MEMBERS, AND OTHER PROGRAM INTEGRITY INDICATORS TO
PRIORITIZE WHICH TRANSPORTATION PROVIDERS TO AUDIT. THE STATE
DEPARTMENT IS NOT REQUIRED TO ANNUALLY PERFORM AUDITS BUT MUST
PERFORM AUDITS AS RESOURCES ALLOW. AN AUDIT OF A TRANSPORTATION
PROVIDER MAY INCLUDE A REVIEW OF THE FOLLOWING, AS THEY RELATE TO
THE PROVIDER:
PAGE 16-HOUSE BILL 26-1328
      (a) CLAIMS SUBMITTED;
      (b) THE PROVIDER'S POLICIES AND PROCEDURES;
      (c) DRIVER AND VEHICLE CREDENTIALS;
      (d)    COMPLIANCE   WITH   STATE     DEPARTMENT AND     BROKER
REQUIREMENTS;
      (e) TRIP RECORDS;
      ( f) MEMBER GRIEVANCES, COMPLAINTS, AND INCIDENTS, INCLUDING
THEIR RESOLUTION; OR
      (g) OTHER DATA NECESSARY TO EVALUATE SAFETY, TIMELINESS,
AND QUALITY OF THE SERVICES PROVIDED BY THE PROVIDER.
      (3)   THE STATE DEPARTMENT SHALL, SUBJECT TO AVAILABLE
APPROPRIATIONS, CONDUCT AUDITS OF EACH TRANSPORTATION BROKER AT
LEAST ANNUALLY. THE DEPARTMENT MAY USE THIRD-PARTY CONTRACTORS
TO CONDUCT AUDITS OF TRANSPORTATION BROKERS. AN AUDIT OF A
TRANSPORTATION BROKER MAY INCLUDE A REVIEW OF THE BROKER'S:
      (a) POLICIES AND PROCEDURES;
      (b)   TRIP DISTRIBUTION AMONG TRANSPORTATION PROVIDERS,
INCLUDING ANALYSIS BY GEOGRAPHY AND TRIP TYPE;
      (c) COMPLIANCE WITH PROHIBITIONS ON TRIP CAPS ESTABLISHED IN
STATE DEPARTMENT RULE;
      (d)    COMPLIANCE   WITH   DRIVER,    VEHICLE,   AND   PROVIDER
CREDENTIALING REQUIREMENTS ESTAB LI SHED IN STATE DEPARTMENT RULE;
AND
      (e) RESPONSETOMEMBERREQUESTSFORSPECIFICTRANSPORTATION
PROVIDERS, INCLUDING WHETHER THEY WERE HONORED AND, IF NOT, THE
REASON FOR DENIAL.
      SECTION 6. In Colorado Revised Statutes, 25.5-5-102, amend
PAGE 17-HOUSE BILL 26-1328
(l)(m); and add (l)(n), (3), (4), (5), and (6) as follows:
       25.5-5-102. Basic services for the categorically needy- mandated
services.
       (1) Subject to the provisions of subsection (2) of this section and
section 25.5-4-104, the program for the categorically needy must include
the following services as mandated and defined by federal law:
       (m) Federally qualified health centers; AND
      (n) NONEMERGENCY MEDICAL TRANSPORTATION SERVICES, AS
REQUIRED BY 42    u.s.c.
                  SEC. 1396a (a)(4)(A).
       (3)   THE STATE DEPARTMENT SHALL CLASSIFY NONEMERGENCY
MEDICAL TRANSPORTATION EXPENDITURES AS MEDICAL SERVICES FOR ALL
ELIGIBLE POPULATIONS AND SERVICES.
       ( 4) THE STATE DEPARTMENT SHALL, TO THE EXTENT PERMITTED BY
FEDERAL LAW, ENSURE THAT ALL ELIGIBLE NONEMERGENCY MEDICAL
TRANSPORTATION EXPENDITURES CLASSIFIED AS MEDICAL SERVICES RECEIVE
AVAILABLE FEDERAL FINANCIAL PARTICIPATION.
       (5) ON NOVEMBER 1, 2026, AND NOVEMBER 1, 2027, THE STATE
DEPARTMENT SHALL SUBMIT A REPORT TO THE JOINT BUDGET COMMITTEE
AND THE COLORADO HEALTHCARE AFFORDABILITY AND SUSTAINABILITY
ENTERPRISE BOARD ABOUT STATE SA VINOS EXPECTED OR RECEIVED AS A
RESULT OF CLASSIFYING NONEMERGENCY MEDICAL TRANSPORTATION AS A
MEDICAL SERVICE. THE REPORT MUST INCLUDE, AT A MINIMUM:
       (a)     THE   TOTAL     AMOUNT      OF   NONEMERGENCY     MEDICAL
TRANSPORTATION EXPENDITURES CLASSIFIED AS MEDICAL SERVICES;
       (b) THE FEDERAL FINANCIAL PARTICIPATION AS A RESULT OF THE
CLASSIFICATION;
       (c) A DESCRIPTION OF ACTIONS TAKEN TO IMPLEMENT SUBSECTION
(3) OF THIS SECTION, INCLUDING STATE PLAN AMENDMENTS, WAIVERS, OR
PROGRAM CHANGES;
PAGE 18-HOUSE BILL 26-1328
       (d)   IDENTIFICATION OF REMAINING NONEMERGENCY MEDICAL
TRANSPORTATION EXPENDITURES NOT YET CLASSIFIED AS MEDICAL SERVICES
AND THE BARRIERS TO THE CLASSIFICATION; AND
       (e)    RECOMMENDATIONS  FOR   ADDITIONAL     STATUTORY      OR
ADMINISTRATIVE CHANGES NECESSARY TO MAXIMIZE FEDERAL FINANCIAL
PARTICIPATION.
       (6) SUBSECTION ( 5) OF THIS SECTION REPEALS, EFFECTIVE JANUARY
1, 2028.
       SECTION 7. In Colorado Revised Statutes, 25.5-5-202, amend (1)
introductory portion; and repeal (2) as follows:
       25.5-5-202. Basic services for the categorically needy - optional
services - repeal.
       (1) Subject to the provisions of subsection (2) of this section, The
following are services for which federal financial participation is available
and that Colorado has selected to provide as optional services under the
medical assistance program:
       (2) In addition to the set vices described in subsection (I) of this
section and subject to continued federal financial participation, Color ado
has selected to provide transportation set vices as an administ1ative cost.
       SECTION 8. Appropriation - adjustments to 2026 long bill.
(1) Except as provided in subsection (3) of this section, to implement this
act, appropriations made in the annual general appropriation act for the
2026-27 state fiscal year to the department of health care policy and
financing for medical and long-term care services for Medicaid eligible
individuals are adjusted as follows:
      (a) The general fund appropriation is decreased by $76,639, which
is subject to the "(M)" notation as defined in the annual general
appropriation act for the same fiscal year; and
       (b) The appropriation from the healthcare affordability and
sustainability hospital provider fee cash fund created in section
25.5-4-402.4 (5)(a), C.R.S., is decreased by $20,941,853.
PAGE 19-HOUSE BILL 26-1328
       (2) The decrease of the appropriations in subsection (1) of this
section is based on the assumption that the anticipated amount of federal
funds received for the 2025-26 state fiscal year by the department of health
care policy and financing for medical and long-term care services for
Medicaid eligible individuals will increase by $21,018,492.
       (3) Subsection (1) of this section does not require a reduction of an
appropriation in the annual general appropriation act to the department of
health care policy and financing for the 2026-27 state fiscal year for medical
and long-term care services for Medicaid eligible individuals if:
      (a) The amount of the general fund appropriation made is less than
the amount of the adjustment required in subsection (l)(a) of this section;
       (b) The amount of the appropriation from the healthcare
affordability and sustainability hospital provider fee cash fund is less than
the amount of the adjustment required in subsection (l)(b) of this section;
or
        (c) The annual general appropriation act for the 2026-27 state fiscal
year does not include an appropriation to the department of health care
policy and financing for medical and long-term care services for Medicaid
eligible individuals.
       SECTION 9. Effective date. This act takes effect July 1, 2026;
except that section 8 of this act takes effect only if the annual general
appropriation act for the 2026-27 state fiscal year becomes law, in which
case section 8 takes effect upon the effective date of this act or of the annual
general appropriation act for state fiscal year 2026-27. whichever is later.
       SECTION 10. Safety clause. The general assembly finds,
determines, and declares that this act is necessary for the immediate
preservation of the public peace, health, or safety or for appropriations for
PAGE 20-HOUSE BILL 26-1328
the support and maintenance of the departments of the state and state
institutions.
Jul~
SPEAKER OF THE HOUSE  PRESIDENT OF
OF REPRESENTATIVES  THE SENATE
v~
Vanessa Reilly
               ~  Esther van Mourik
CHIEF CLERK OF THE HOUSE  SECRETARY OF
OF REPRESENTATIVES  THE SENATE
      APPROVED 0V1      T\tnKSc-lhl '3~ 4h- ~  o...+   l2!'30f»-
                                (D te and Time)
PAGE 21-HOUSE BILL 26-1328