Colorado § 25.5-5-331 Federally qualified health center - reimbursement - rules

Colorado Statutes

§ 25.5-5-331 — Federally qualified health center - reimbursement - rules

Colorado·Title 25.5 Health·Art. Colorado Medical Assistance Act -

(1)Costs associated with services provided by clinical pharmacists through a federally qualified health center, as defined in the federal Social Security Act, 42 U.S.C. sec. 1395x (aa)(4), are considered allowable costs for the purpose of a federally qualified health center's cost report and must be included in the calculation of the reimbursement rate for a patient visit at a federally qualified health center.

(2)(a) A federally qualified health center, as defined in the federal Social Security Act, 42 U.S.C. sec. 1395x (aa)(4), may establish a separate subsidiary company for the purpose of providing fee-for-service services outside of the federally qualified health center's standard cost report if:

(I)The subsidiary is providing fee-for-service services that have historical

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(1)
Costs associated with services provided by clinical pharmacists through a federally
qualified health center, as defined in the federal Social Security Act, 42 U.S.C.
sec. 1395x (aa)(4), are considered allowable costs for the purpose of a federally
qualified health center's cost report and must be included in the calculation of the
reimbursement rate for a patient visit at a federally qualified health center.

(2) (a) A federally qualified health center, as defined in the federal Social
Security Act, 42 U.S.C. sec. 1395x (aa)(4), may establish a separate subsidiary
company for the purpose of providing fee-for-service services outside of the
federally qualified health center's standard cost report if:

(I) The subsidiary is providing fee-for-service services that have historically
been provided and reimbursed on a fee-for-service basis; and

(II) The state department determines that the subsidiary's reimbursements
would be budget neutral.

(b) Upon receiving any necessary federal authorization, the state department
shall reimburse a subsidiary company, as described in subsection (2)(a) of this
section, on a fee-for-service basis for services that are eligible for fee-for-service
reimbursement.

(c) A subsidiary that receives reimbursement pursuant to this section may
pass through money received from the reimbursement directly to the federally
qualified health center operating as the subsidiary's parent corporation.

(d) (I) The state department shall exclude all costs associated with a
subsidiary company established pursuant to this subsection (2) from the calculation
of a federally qualified health center's reimbursement rates.

(II) The state department shall require a federally qualified health center
that establishes a separate subsidiary company pursuant to this subsection (2) to
include the costs associated with the subsidiary in its cost report that is necessary
to calculate reimbursement rates.

(3) The state department shall promulgate rules to implement the provisions
of this section.

Colorado § 25.5-5-331 (Federally qualified health center - reimbursement - rules) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

Legislative History

Source: L. 2021: Entire section added, (HB 21-1275), ch. 470, p. 3379, � 2, effective September 7. L. 2025: Entire section amended, (HB 25-1288), ch. 260, p. 1332, � 3, effective May 27.