Article 5
Colorado Medical Assistance Act - Services and Programs

Sections

25.5‑5‑101
Mandatory provisions - eligible groups - rules - repeal
25.5‑5‑102
Basic services for the categorically needy - mandated services
25.5‑5‑103
Mandated programs with special state provisions - rules
25.5‑5‑104
Qualified medicare beneficiaries
25.5‑5‑105
Qualified disabled and working individuals
25.5‑5‑201
Optional provisions - optional groups - rules - repeal
25.5‑5‑202
Basic services for the categorically needy - optional services
25.5‑5‑203
Optional programs with special state provisions - repeal
25.5‑5‑204
Presumptive eligibility - pregnant person - children - long-term care - state plan
25.5‑5‑204.5
Continuous eligibility - children
25.5‑5‑206
Medicaid buy-in program - disabled children - disabled adults - federal authorization - rules
25.5‑5‑207
Adult dental benefit - adult dental fund - creation - legislative declaration
25.5‑5‑208
Additional services - training - grants - screening, brief intervention, and referral
25.5‑5‑301
Clinic services
25.5‑5‑302
Clinic services - children and pregnant women - utilization of certain providers
25.5‑5‑303
Private-duty nursing
25.5‑5‑304
Hospice care
25.5‑5‑305
Pediatric hospice care - legislative declaration - federal authorization - rules - fund
25.5‑5‑307
Child mental health treatment and family support program
25.5‑5‑308
Breast and cervical cancer prevention and treatment program - creation - legislative declaration - definitions - funds - repeal
25.5‑5‑309
Pregnant women - needs assessment - referral to treatment program - definition
25.5‑5‑310
Treatment program for high-risk pregnant and parenting women - cooperation with private entities - definition
25.5‑5‑311
Treatment program for high-risk pregnant and parenting women - data collection
25.5‑5‑312
Treatment program for high-risk pregnant and parenting women - extended coverage - federal approval
25.5‑5‑314
Substance use disorder treatment for Native Americans - federal approval
25.5‑5‑315
Acceptance of gifts, grants, and donations - Native American substance abuse treatment cash fund
25.5‑5‑316
Legislative declaration - state department - disease management programs authorization - report
25.5‑5‑318
Health services - provision by school districts - repeal
25.5‑5‑319
Family planning pilot program - rules - federal waiver - repeal
25.5‑5‑320
Telemedicine - reimbursement - disclosure statement - rules - definition
25.5‑5‑321
Telemedicine - home health care - home health telemedicine cash fund - rules - repeal
25.5‑5‑321.5
Telehealth - interim therapeutic restorations - reimbursement - definitions
25.5‑5‑322
Over-the-counter medications - rules
25.5‑5‑323
Complex rehabilitation technology - no prior authorization - metrics - report - rules - legislative declaration - definitions
25.5‑5‑324
Nonemergency medical transportation - urgent and secure transportation need - report - repeal
25.5‑5‑325
Residential and inpatient substance use disorder treatment - medical detoxification services - federal approval - performance review report
25.5‑5‑326
Access to clinical trials - definitions
25.5‑5‑327
Eligible peer support services - reimbursement - definitions
25.5‑5‑328
Secure transportation for behavioral health crises - benefit - funding
25.5‑5‑329
Family planning services - federal authorization - rules - definitions
25.5‑5‑330
Screening for perinatal mood and anxiety disorder
25.5‑5‑331
Federally qualified health center - clinical pharmacy services - reimbursement - rules
25.5‑5‑332
Therapy using equine movement - federal authorization - definition
25.5‑5‑333
Primary care and behavioral health statewide integration grant program - creation - report - definition - repeal
25.5‑5‑334
Community health worker services - federal authorization - reporting - rules - definition
25.5‑5‑335
Continuous medical coverage for children and adults feasibility study - federal authorization - rules - report - definition
25.5‑5‑336
Prohibition on using the body mass index or ideal body weight - medical necessity criteria
25.5‑5‑401
Short title
25.5‑5‑402
Statewide managed care system - rules - definitions - repeal
25.5‑5‑403
Definitions
25.5‑5‑406.1
Required features of statewide managed care system
25.5‑5‑408
Capitation payments - availability of base data - adjustments - rate calculation - capitation payment proposal - preference - assignment of medicaid recipients - definition
25.5‑5‑410
Data collection for managed care programs
25.5‑5‑412
Program of all-inclusive care for the elderly - services - eligibility - legislative declaration - rules - definitions
25.5‑5‑414
Telemedicine - legislative intent
25.5‑5‑415
Medicaid payment reform and innovation pilot program - legislative declaration - creation - selection of payment projects - report - rules
25.5‑5‑418
Primary care provider sustainability fund - creation - use of fund
25.5‑5‑419
Accountable care collaborative - reporting - rules
25.5‑5‑420
Advancing care for exceptional kids
25.5‑5‑421
Parity reporting - state department - public input
25.5‑5‑422
Medication-assisted treatment - limitations on MCEs - definition
25.5‑5‑423
Independent review organization - review denial of residential and inpatient substance use disorder treatment claims - contract
25.5‑5‑424
Residential and inpatient substance use disorder treatment - MCE standardized utilization management process - medical necessity - report
25.5‑5‑425
Audit of MCE denials for residential and inpatient substance use disorder treatment authorization - report
25.5‑5‑500.3
Authorization to bill third party
25.5‑5‑501
Providers - drug reimbursement
25.5‑5‑502
Unused medications - reuse - rules - definition
25.5‑5‑503
Prescription drug benefits - authorization - dual-eligible participation
25.5‑5‑504
Providers of pharmaceutical services
25.5‑5‑505
Prescribed drugs - mail order - rules
25.5‑5‑506
Prescribed drugs - utilization review
25.5‑5‑507
Prescription drug information and technical assistance program - rules
25.5‑5‑509
Substance use disorder - prescription drugs - opiate antagonist
25.5‑5‑510
Pharmacy reimbursement - substance use disorder - injections
25.5‑5‑511
Reimbursement for pharmacists’ services - legislative declaration
25.5‑5‑512
Pharmacy benefit - mental health and substance use disorders - legislative declaration
25.5‑5‑513
Pharmacy benefits - prescription drugs - rebates - analysis
25.5‑5‑514
Prescription drugs used for treatment or prevention of HIV - prohibition on utilization management - definition
25.5‑5‑515
Pharmacy reimbursement - vaccine administration to children - legislative declaration
25.5‑5‑516
Serious mental illness - prescribed drugs
25.5‑5‑801
Legislative declaration
25.5‑5‑802
Definitions
25.5‑5‑803
High-fidelity wraparound services for children and youth - federal approval - reporting
25.5‑5‑804
Integrated funding pilot
Green check means up to date. Up to date

Current through Fall 2024

Art. 5’s source at colorado​.gov