The act limits the benefits pregnant women and children with a certain family household income and citizen or immigration status are eligible for under the state medical assistance program and the medical assistance program. Eligible pregnant women and children are subject to the following limitations on benefits:Beginning July 1, 2026, there is an annual cap on dental services in the amount of $1,100;Beginning January 1, 2027, behavioral health services offered must be provided on a fee-for-service basis only;Beginning January 1, 2027, services offered through the accountable care collaborative are no longer covered; andBeginning January 1, 2027, managed care services through the medical assistance program are no longer covered. Beginning January 1, 2027, children under 19 years old whose family household income does not exceed 260% of the federal poverty line, adjusted for family size, and who are not eligible for the medical assistance program due to their immigration status, are not eligible for home- and community-based services, community first choice, long-term home health, private duty nursing, hospice care, and nursing home care unless those children already receive those services on or before December 31, 2026. Beginning January 1, 2027, the act caps enrollment of children in the state medical assistance program at 25,000 children if either enrollment exceeds 25,000 or the expenditures for a fiscal quarter exceeds one-quarter of the appropriation for state medical assistance plus 5% to account for seasonality fluctuations. If one of the conditions is met, the enrollment cap begins on the first day of the month following 60 days after the department of health care policy and financing (state department) determines that the condition was met. The act repeals provisions requiring the state department to develop an outreach and enrollment strategy for enrolling eligible groups into new coverage options and repeals the state children's basic health plan. The act appropriates $3,378,166 from the general fund to the state department to implement the act and reduces appropriations to the state department by $14,202,723 if certain conditions are met.(Note: This summary applies to this bill as enacted.)
Under current law, if a defendant is found incompetent to proceed and the defendant will not be restored to competency in the foreseeable future, the court is required to dismiss charges against the defendant and the defendant, in limited circumstances, may be referred for certification for short-term treatment through a civil court process. The act maintains the requirement for the court to dismiss the charges against a defendant if the defendant's highest charged offense is among certain misdemeanor offenses, and the act maintains certification for short-term treatment as an option for the defendant. However, if the defendant is unrestorable or the defendant has reached the statutory maximum time permitted to be restored, the act authorizes the district attorney or county attorney (prosecution) to notify the court that the prosecution seeks civil commitment or an enhanced protective placement of a defendant if the prosecution can prove by clear and convincing evidence that the defendant:Has a mental disability or developmental disability;Committed an act that, in the absence of any mental disability or developmental disability, would constitute homicide, a crime of violence, or a felony that constitutes unlawful sexual behavior, and the act is or was charged in a criminal case in Colorado in which competency was raised; and Poses a substantial risk of serious harm to others. If the prosecution seeks civil commitment or an enhanced protective placement, the court is required to stay the order dismissing the defendant's case, set a trial within 91 days after the date the written notice was filed, and order the department of human services (CDHS) to identify an appropriate provider and placement for the defendant in the event a civil commitment or enhanced protective placement is granted. The defendant may stipulate that the court order a civil commitment or enhanced protective placement. If the court finds the prosecution has not met its burden, the court is required to deny the prosecution's request to civilly commit the defendant or order an enhanced protective placement of the defendant; except that the court may consider whether to order other civil proceedings. If the court finds the prosecution has met its burden, the court is required to order the civil commitment or enhanced protective placement of the defendant, place the defendant and issue any related orders, transfer jurisdiction of the civil commitment or enhanced protective placement to an appropriate civil court with jurisdiction, and dismiss the defendant's criminal case. When the court orders the civil commitment or enhanced protective placement, the court shall make a finding of the defendant's primary diagnosis that constitutes the mental disability or developmental disability. The court shall order the defendant civilly committed to the legal custody of CDHS unless the defendant's primary diagnosis is an intellectual and developmental disability (IDD) or a neurocognitive disorder, in which case, the court shall order an enhanced protective placement and legal custody of the defendant to the department of health care policy and financing (HCPF). If CDHS proposes placing the defendant into inpatient care, the court shall order, without further court review, that the defendant be placed into inpatient care at the discretion of CDHS if the court ordered a civil commitment or that the defendant be placed into inpatient care at the discretion of HCPF if the court ordered an enhanced protective placement. If CDHS has not identified an appropriate provider that is willing to accept placement of the defendant, the court shall set a review hearing within 35 days after the order for civil commitment or enhanced protective placement and order CDHS, in consultation with the behavioral health administration (BHA), to identify at least one appropriate provider. Upon receiving jurisdiction of a civil commitment or enhanced protective placement, the act requires the civil court to supervise the civil commitment or enhanced protective placement by notifying the county attorney, appointing an attorney to represent the respondent, and setting a review hearing. At the hearing, the respondent has the right to request modification of the terms of the civil commitment or enhanced protective placement and the right to periodic review, including whether the respondent qualifies for termination of the civil commitment or enhanced protective placement. The court is required to ensure the respondent is placed in the least-restrictive setting adequate to protect the victims and community. If the respondent is not placed into inpatient care at the discretion of CDHS, or if CDHS proposes to move the respondent into or out of inpatient care, the court shall, prior to modifying the civil commitment or enhanced protective placement to change the respondent's provider or placement, review the appropriateness of the proposed provider or placement. The provider charged with the physical care and custody of the respondent is required to submit a report to the court and the parties annually by the date the respondent was civilly committed or ordered into enhanced protective placement unless a substantially similar examination was ordered by the court within the previous 12 months. The act requires the court to terminate the respondent's civil commitment or enhanced protective placement if the respondent no longer poses a substantial risk of serious harm to others or the respondent does not have the applicable disorder or disability that is likely to cause the respondent to be a danger to the respondent's self or a danger to others and the respondent has demonstrated sufficient capacity and willingness to conform their conduct to the requirements of the law. If the respondent does not meet the criteria for termination, the respondent is not entitled to another termination trial within one year after the conclusion of the previous trial. The court shall convert a civil commitment to an enhanced protective placement if the respondent does not meet the criteria for termination but the respondent has a mental health disorder that is an IDD or a neurocognitive disorder, without having any other mental health disorder that is not an IDD or a neurocognitive disorder and that substantially contributes to whether the respondent is a danger to the respondent's self or a danger to others, or is gravely disabled. If the defendant does not meet the criteria for termination and has co-occurring mental health disorders that include an IDD or a neurocognitive disorder, the court may, upon the recommendation of CDHS, convert the civil commitment to an enhanced protective placement. The court shall convert an enhanced protective placement to a civil commitment if the respondent does not meet the criteria for termination and the respondent no longer has an IDD or a neurocognitive disorder that substantially contributes to whether the respondent is a danger to the respondent's self or a danger to others, or is gravely disabled. If the defendant does not meet the criteria for termination and has co-occurring mental health disorders that do not include an IDD or a neurocognitive disorder, the court may, upon the recommendation of CDHS, convert the enhanced protective placement to a civil commitment. Under current law, an emergency mental health hold (M1 hold) may be initiated against a person for not more than 72 hours if the person appears to have a mental health disorder and, as a result of the mental health disorder, appears to be a danger to the person's self or others, or appears to be gravely disabled. A person detained for an M1 hold and transported to an emergency medical services facility or facility designated by the commissioner (facility) of the BHA is required to receive an evaluation as soon as possible after the person presents to the facility. The act authorizes a person who has an M1 hold initiated against them while in confinement to receive an evaluation at the person's place of confinement rather than being transported to a facility. If the person is released from confinement while under an M1 hold, the person responsible for the confinement is required to coordinate with the BHA to transfer the person to a facility. Under current law, if a person under an M1 hold meets the criteria for certification for short-term treatment, the person may be certified for not more than 3 months. Rather than requiring an M1 hold as a prerequisite to short-term certification or certification for long-term care and treatment, the act authorizes a person to be certified if the person:Has been advised of the availability of, but has not accepted, voluntary treatment or with consideration of all reasonably available information, is believed will not remain in voluntary treatment; and By clear and convincing evidence, has a mental health disorder and, as a result of the mental health disorder, the person is a danger to the person's self, a danger to others, or gravely disabled. A person may not be certified for short-term treatment or long-term care and treatment if the person has an IDD or neurocognitive disorder without any other mental health disorder that is not an IDD or neurocognitive disorder and that substantially contributes to whether the respondent is a danger to the respondent's self or a danger to others, or is gravely disabled. If a respondent is certified, the court shall order CDHS to provide care coordination and make diligent efforts to find a provider for the respondent that is willing to hold the certification. The respondent may be certified for long-term care and treatment if the respondent continues to meet the criteria and standards for certification for short-term treatment. The certification terminates when the professional person in charge of the respondent's treatment and the BHA determine the respondent no longer meets the criteria for certification. To terminate a short-term treatment certification less than 30 days after the initial certification, two professional persons are required to individually consult and review the respondent's case and agree that the respondent no longer meets the criteria for certification. A court may order the short-term or long-term protective placement of a person:Who, by clear and convincing evidence, has a neurocognitive disorder;When reasonable grounds exist to believe that the person will not remain in a voluntary treatment program; andWho, by clear and convincing evidence, is a danger to the person's self, a danger to others. The act aligns the provisions for short-term and long-term protective placement with certifications for short-term treatment and long-term care and treatment. No later than October 1, 2027, the act requires CDHS to construct and operate an outpatient treatment facility for adults with behavioral health needs, including adults who are found incompetent to proceed and unlikely to be restored to competency. To implement the act, for the 2025-26 state fiscal year, the act appropriates to CDHS $535,934 from the general fund and $4,777,898 from the capital construction fund. To implement the act, the act makes the following appropriations for state fiscal year 2026-27:$17,802,360 to CDHS from the general fund, of which $242,323 is reappropriated to the department of law and $52,644 to the office of information technology;To the judicial department, $26,296 from the judicial department information technology cash fund and $5,401,437 from the general fund, of which $1,719,409 is for use by the office of state public defender and specified independent agencies;$842,808 to HCPF from the general fund; and$150,000 to the department of law from the general fund.(Note: This summary applies to this bill as enacted.)
The act requires the nonemergency medical transportation broker (broker) to establish the transportation community advisory board (TCAB) and requires the state department of health care policy and financing (state department) to collaborate with the TCAB prior to establishing rules and processes for the safety and oversight of nonmedical transportation services and nonemergency medical transportation (NEMT) services. The act requires, in collaboration with the TCAB, certain rules for NEMT the state department must adopt. The state department may impose trip caps or market-share restrictions on a transportation provider (provider) as part of corrective action plan. The act requires providers to use vehicles equipped with 2-way video cameras and a video recording system when transporting members. The act establishes how the broker must roll out their implementation and requires the broker to provide all providers with software, a communication toolkit, training, and technical assistance to facilitate NEMT services. The broker may encourage medicaid members (members) to book transportation services at least 2 days before their requested transportation date, and the broker shall accept and make reasonable efforts to fulfill same-day and next-day transportation requests. The act requires providers, only after all service regions have been implemented, to accommodate member requests for preferred or alternate drivers when operationally feasible. The act requires the broker, and, if there is no broker, the providers to verify that individuals using the transportation services are eligible members during the scheduling of transportation services. The act prohibits the broker from operating, owning, or controlling a provider in Colorado. The act requires the broker to provide their trip assignment rules and procedures to the state department for approval and for publication on the state department's website. The act allows a transportation network company to provide NEMT services when a provider is unavailable. The state department shall ensure all transportation providers, drivers, and vehicles are credentialed, and services provided by noncredentialed drivers or in noncredentialed vehicles are not eligible for reimbursement. The act prohibits the state department from denying payment of services to providers if the provider provides scheduled transportation services in good faith based on the information provided by the broker or if the provider had no knowledge of an inaccuracy and the provider followed all applicable rules and procedures. Subject to available appropriations, the act requires the state department to audit providers and audit the broker annually. The act requires the state department to categorize all NEMT expenditures as medical services and make changes to the NEMT program as necessary to obtain medical services federal match rates for NEMT services. The act also eliminates the requirement that the state department provide transportation services as an administrative cost. The act reduces appropriations to the state department from the general fund by $76,639 and from the healthcare affordability and sustainability hospital provider fee cash fund by $20,941,853.(Note: This summary applies to this bill as enacted.)
The act prohibits the department of health care policy and financing (department) from making a wage enhancement supplemental payment to an eligible nursing home provider regardless of when the services were provided. The act reduces the 2025-26 state fiscal year appropriation to the department for medical and long-term care services for medicaid eligible individuals by $4,359,961.(Note: This summary applies to this bill as enacted.)
The act establishes information disclosure requirements for a licensed facility that offers on-site and residential services for individuals with dementia and dementia-related conditions, including Alzheimer's disease ('dementia care facility' or 'facility'). The act requires the department of public health and environment (department), in consultation with the state long-term care ombudsman or the ombudsman's designee, to create a dementia care services information form (form) by July 1, 2027. The form must include certain specified fields for the disclosure of information regarding a dementia care facility's dementia care services, including the facility's:Dementia training requirements for staff that are in addition to statutory training requirements;Guidelines for using restraints;Security features and procedures for addressing the needs of residents with dementia; andCriteria and processes to determine placement, transfer, or discharge of residents living with dementia. The department may review and update the form to ensure that it facilitates the disclosure of the required information. After creating or updating the form, the department must provide the form to every dementia care facility in the state. A dementia care facility must complete the form with responsive, accurate, and complete information regarding the facility's dementia care services. Beginning October 1, 2027, every dementia care facility shall:Provide its completed form to every individual who contacts the facility seeking dementia care services;Review and update the form when the facility's information changes to ensure the information on the form is current, complete, and correct;Publish the facility's current completed form on the facility's website; andMaintain on the facility's premises and have available for inspection a copy of the facility's current completed form, and produce the form upon request by the department during a survey or inspection of the facility. The act requires the department to issue a citation to a facility that fails to maintain on its premises and have available for inspection its completed form or that fails to produce the form upon request by the department during a survey or inspection. The department may adopt rules, as necessary, to implement the act's requirements concerning the form; except that the rules adopted by the department must not exceed applicable national standards. The department may use money from the assisted living residence improvement cash fund for the purposes of creating the form and adopting related rules.(Note: This summary applies to this bill as enacted.)
Current law requires the department of public health and environment (CDPHE) to consider certain criteria as a basis for distributing grants from the nursing home penalty cash fund (fund). The act strikes these criteria and instead requires CDPHE to distribute such grants in accordance with priorities and allowable uses identified by the centers for medicare and medicaid services within the federal department of health and human services (centers). Current law requires the nursing home innovations grant board (board) to make recommendations for the approval of grants from the fund. The act requires such recommendations to be consistent with the processes for grant cycles of, and priorities and allowable uses identified by, the centers. Current law requires CDPHE and the department of health care policy and financing, with the board's assistance, to jointly submit an annual report to the governor and certain legislative committees of reference regarding the expenditure of money in the fund. The act changes the due date of the report from October 1 to January 1. In current law, the term 'benefit residents of nursing facilities' is defined to mean that a grant has a direct impact on the residents of nursing facilities or has an indirect impact on the residents through education of nursing facility staff. The act amends this definition to include training, as well as education, of nursing facility staff. Current law states that a governmental entity may not apply for or receive a grant from the fund unless the entity is a facility that is owned or operated by a governmental agency and licensed as a nursing care facility. The act removes this restriction.(Note: This summary applies to this bill as enacted.)
The bill requires a transportation broker to contract with at least 5 transportation providers to provide nonemergency transportation services to medicaid members.A transportation provider must meet certain requirements before providing transportation services.The bill requires that medicaid members be able to preapprove nonemergency medical transportation services and choose a preferred transportation provider to receive nonemergency transportation services through.(Note: This summary applies to this bill as introduced.)
The bill establishes regulations for the sale, transfer, or distribution of compounded weight-loss medication, which custom-made medications that, is defined in the bill as a drug that is: Created by combining, mixing, or altering other drugs or drug substances; Intended to be used by humans for obesity or weight management and contains an active ingredient that is named in a drug approved by the federal food and drug administration (FDA); and A glucagon-like peptide-1 receptor agonist drug, known as a 'GLP-1' drug. Unlike mass-produced medications, a compound weight-loss medication is not subject to approval by the federal food and drug administration (FDA). A person may not sell, transfer, or distribute a compounded weight-loss medication unless the person confirms that the medication: FDA. Is made from bulk drug substances and drugs that are approved by the FDA when such approval is required; Was manufactured in compliance with FDA processes; Contains bulk drug substances that are pharmaceutical grade and are accompanied by a certificate of analysis containing information that is material to the safety and efficacy of the bulk drug substances; Was manufactured at a facility that is registered with the FDA and passed an FDA inspection within the previous 2 years; and Is verified for purity and accurate dosage. Labels for compounded weight-loss medications must list all active and inactive ingredients, the quantity of those ingredients, and the ingredients' country of origin. There must also be a warning on the label stating that the compounded weight-loss medication has not been FDA-approved, has inadequate evidence of safety or efficacy, and has known and unknown side effects. A person must also provide certain disclosures to a patient when prescribing compounded weight-loss medications. The bill prohibits the use of false or misleading claims, including unsubstantiated claims, when advertising or promoting compounded weight-loss medications. A person that sells, transfers, or distributes compounded weight-lost medication must keep records related to the compounded weight-loss medication for at least 2 years after the date of expiration of the compounded weight-loss medication and make those records available for inspection by the state board of pharmacy. The state board of pharmacy may issue fines of up to $1,000 per dose of compounded weight-loss medications that are sold or distributed in violation of the bill and may revoke a pharmacy or business license for violations. The attorney general has authority to enforce this bill as a deceptive trade practice under the 'Colorado Consumer Protection Act'. The bill establishes that a person engages in a deceptive trade practice when the person : Makes a false or misleading claim about a compounded weight-loss medication when advertising or promoting the medication; Distributes a compounded weight-loss medication when not legally authorized to distribute or transfer the drug used in the compounded weight-loss medication; Makes a materially false or misleading representation that the compounded weight-loss medication is approved by the FDA when the medication is not approved by the FDA; or Makes a materially false, misleading, or unverified claim regarding the efficacy, safety, performance, outcomes, or benefits of the compounded weight-loss medication. The attorney general has exclusive authority to enforce the bill as a deceptive trade practice under the 'Colorado Consumer Protection Act'. There is no private right of action for a violation of the bill, and the provisions of the bill may only be enforced by the attorney general. The bill does not apply to certain facilities or in certain circumstances, including: The administration of a compounded weight-loss medication by a practitioner at certain hospitals, clinics, and other health facilities licensed by the department of public health and environment; Long term care facilities; Assisted living residences; Home care agencies; The program of all-inclusive care for the elderly or PACE program; Adult day care facilities; or The compounding of drugs for animal use.(Note: Italicized words indicate new material added to the original summary; dashes through words indicate deletions from the original summary.)(Note: This summary applies to the reengrossed version of this bill as introduced in the second house.)
The bill requires an individual being discharged from a nursing facility to be presumptively eligible for long-term services and supports under medicaid.The bill requires the department of health care policy and financing (state department) to determine presumptive eligibility and requires county departments of human or social services (county departments) to set up the long-term services and supports for an individual being discharged from a nursing facility prior to the individual's discharge date.The state department is required to submit an annual report to the state auditor and post the report on the state department's website detailing information about the individuals discharged from a nursing facility and the associated presumptive eligibility determinations.The bill establishes remedial measures against a county department if the county department fails to set up long-term services and supports for the individual. The bill establishes remedial measures against a nursing facility that fails to discharge an individual on the discharge date due to a failure within the nursing facility's control or fails to cooperate in good faith with the state department to ensure long-term care services and supports are in place for the individual.(Note: This summary applies to this bill as introduced.)
