§ 25.5-4-416 — Providers - medical equipment and supplies - requirements

(1)
As used in this section, unless the context otherwise requires, provider means a
person or entity that delivers disposable medical supplies or durable medical
equipment products or services directly to a member.

(2) On and after January 1, 2007, the state board rules for the payment for
disposable medical supplies and durable medical equipment, including but not
limited to prosthetic and orthotic devices, shall prohibit a provider from being
reimbursed unless the provider:

(a) (I) Has one or more physical locations within the state of Colorado or
within fifty miles of a border of Colorado with a street address, a local business
telephone number, an inventory, and a sufficient staff to service or repair products;
except that the requirements of this paragraph (a) shall not apply to durable
medical equipment or disposable medical supplies that are medically necessary
and cannot be purchased from a provider meeting the requirements of this
paragraph (a);

(II) Complies with all state and local licensing, insurance, and regulatory
requirements for operating the provider's business;

(III) Is responsible for the delivery of and instructing the member on the
proper use of the equipment; and

(IV) Provides repairs, replacements, or adjustments to the provider's
products pursuant to rules of the state board; or

(b) Contracts with a provider who meets the criteria established in paragraph
(a) of this subsection (2).

(3) The provisions of this section shall apply to fee-for-service and primary
care physician program recipients.

Legislative History

Source: L. 2006: Entire section added, p. 525, � 1, effective August 7. L. 2024: (1) and (2)(a)(III) amended, (SB 24-176), ch. 152, p. 642, � 38, effective August 7.