C.R.S. Section 25.5-1-128
Provider payments

  • compliance with state fiscal requirements
  • definitions
  • rules

(1)

Intentionally left blank —Ed.

(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 paragraph (a) of this subsection (1) 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)

The “Colorado Indigent Care Program”, part 1 of article 3 of this title;

(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.

(2)

As used in this section, unless the context otherwise provides, “provider” means a health-care provider, a mental health-care provider, a pharmacist, a home health agency, a general provider as defined in section 25.5-3-103 (3), 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 recipients through fee-for-service, the primary care physician program, 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.

Source: Section 25.5-1-128 — Provider payments - compliance with state fiscal requirements - definitions - rules, https://leg.­colorado.­gov/sites/default/files/images/olls/crs2023-title-25.­5.­pdf (accessed Oct. 20, 2023).

25.5‑1‑101
Short title 25.5‑1‑102
Legislative declaration 25.5‑1‑103
Definitions 25.5‑1‑104
Department of health care policy and financing created - executive director - powers, duties, and functions - report 25.5‑1‑105
Transfer of functions 25.5‑1‑105.5
Chief medical officer - qualifications 25.5‑1‑107
Final agency action - administrative law judge - authority of executive director 25.5‑1‑108
Executive director - rules 25.5‑1‑109
Department of health care policy and financing cash fund 25.5‑1‑109.5
Clinical standards - development 25.5‑1‑114
Grants-in-aid - county supervision 25.5‑1‑114.5
Medicaid fraud detection - request for information 25.5‑1‑115
Locating violators - recoveries 25.5‑1‑115.5
Medical assistance fraud - report 25.5‑1‑116
Records confidential - authorization to obtain records of assets - release of location information to law enforcement agencies - outstanding felony arrest warrants 25.5‑1‑117
County departments - district departments 25.5‑1‑118
Duties of county departments 25.5‑1‑119
County staff 25.5‑1‑120
Appropriations 25.5‑1‑121
County expenditures - advancements - procedures 25.5‑1‑122
County appropriation increases - limitations 25.5‑1‑123
Medical homes for children - legislative declaration - duties of the department 25.5‑1‑124
Early intervention payment system - participation by state department - rules - definitions 25.5‑1‑126
Discounted prices for durable medical equipment and supplies 25.5‑1‑127
Third-party benefit denials information 25.5‑1‑128
Provider payments - compliance with state fiscal requirements - definitions - rules 25.5‑1‑129
State department proposal - state option for health-care coverage - report to general assembly - waiver authorization - legislative declaration 25.5‑1‑130
Improving access to behavioral health services for individuals at risk of entering the criminal or juvenile justice system - duties of the state department 25.5‑1‑131
Insurance ombudsman - consumer advocate - duties 25.5‑1‑132
Report of medicaid reimbursement rates paid to community mental health center providers and independent providers - definition 25.5‑1‑133
Access to behavioral health services for individuals under twenty-one years of age - rules - report - repeal 25.5‑1‑134
Prescription benefits - department and pharmacy benefit manager - contracts - audit - rules 25.5‑1‑201
Programs to be administered by the department of health care policy and financing 25.5‑1‑203
Prescription drug information and technical assistance program - expansion 25.5‑1‑204
Advisory committee to oversee the all-payer health claims database - creation - members - duties - legislative declaration - rules - report 25.5‑1‑204.5
All-payer health claims database scholarship grant program - creation - definitions 25.5‑1‑204.7
All-payer health claims database - creation of tool for review of data included in the database - definitions 25.5‑1‑205
Providing for the efficient provision of health care through state-supervised cooperative action - rules 25.5‑1‑206
School-based substance abuse prevention and intervention program - creation - reporting - legislative declaration - definitions 25.5‑1‑207
Rural provider access and affordability stimulus grant program - advisory committee - fund - reporting - rules - definitions - repeal 25.5‑1‑301
Medical services board - creation 25.5‑1‑302
Medical services board - organization 25.5‑1‑303
Powers and duties of the board - scope of authority - rules 25.5‑1‑601
Legislative declaration 25.5‑1‑602
Commission created - composition - terms of office 25.5‑1‑603
Duties of commission - reporting 25.5‑1‑701
Definitions 25.5‑1‑702
Hospitals - public community meeting requirement - rules 25.5‑1‑703
Hospitals - community health needs assessments - community benefit implementation plans - reports - rules 25.5‑1‑704
Hospital community investment compliance - rules 25.5‑1‑801
Definitions 25.5‑1‑802
Medicaid transportation services - safety and oversight - rules 25.5‑1‑901
Legislative declaration 25.5‑1‑902
Definitions 25.5‑1‑903
Failure to comply with hospital price transparency laws - prohibiting collection of debt - penalty 25.5‑1‑904
Transparency - hospitals - standard charges - shoppable services - enforcement 25.5‑1‑1001
Hospital collaborative agreements - review of proposed collaborative agreements - immunity - legislative declaration - definitions - rules
Green check means up to date. Up to date

Current through Fall 2024

§ 25.5-1-128’s source at colorado​.gov