§ 25.5-6-1303 — Complementary and integrative health - rules

Colorado § 25.5-6-1303

• Jurisdiction: Colorado
• Title 25.5: Health
• Art.: Colorado Medical Assistance Act -

Text

(1) (a) The
general assembly authorizes the state department to continue operations of a
program that would allow an eligible person with a disability to receive
complementary or integrative health to the extent authorized by federal waiver. The
state department may seek any federal waivers that may be necessary to
implement this part 13.

(b) Subject to available funds, it is the intent of the general assembly that
the state department enroll every eligible person that applies for the waiver and
that an eligible person is not placed on a waiting list for services.

(2) (a) The purpose of the program is to expand the choice of therapies
available to eligible persons with disabilities and to produce an overall cost savings
for the state compared to the estimated expenditures that would have otherwise
been spent for the same persons absent the program.

(b) In order to qualify and to remain eligible for the program authorized by
this section, a person must:

(I) Be diagnosed with a primary condition of a spinal cord injury, multiple
sclerosis, a brain injury, spina bifida, muscular dystrophy, or cerebral palsy, with the
total inability for independent ambulation directly resulting from one of these
diagnoses;

(II) Be willing to participate in the program;

(III) Demonstrate a current need, as further defined in rule by the state
board, for complementary or integrative health; and

(IV) Be eligible for medicaid, including but not limited to persons who meet
the functional level of care and financial criteria described in rules promulgated by
the state board relating to long-term care services.

(c) Repealed.

(d) The program is available to all eligible individuals in Colorado.

(3) The state department shall develop the accountability requirements for
the program necessary to safeguard the use of public money and to promote
effective and efficient service delivery.

(4) The state board shall adopt rules as necessary for the implementation
and administration of the program.

(5) to (7) Repealed.

(8) (a) No later than January 2024, the state department shall submit a
report to the senate health and human services committee, the house of
representatives public and behavioral health and human services committee, and
the house of representatives health and insurance committee, or any successor
committees, as part of its State Measurement for Accountable, Responsive, and
Transparent (SMART) Government Act presentation required by section 2-7-203.
At a minimum, the report must identify:

(I) A reimbursement system with a goal to incentivize and increase
transportation provider participation;

(II) How the state department will ensure compliance with applicable federal
laws and waiver requirements;

(III) A system of common reporting to ensure a member does not exceed the
medicaid benefit in a multi-provider scenario; and

(IV) Best practices based on what other states have done to allow
transportation network companies to provide nonmedical transportation services
for individuals receiving services, including but not limited to, reimbursement rates;
driver compensation; and integration with programs that provide nonmedical
transportation services.

(b) In developing the report, the state department shall engage in a
stakeholder process that includes individuals with intellectual and developmental
disabilities and their families, individuals with disabilities, and transportation
network companies. The report may be developed in conjunction with the reporting
requirement in sections 25.5-6-307 (6), 25.5-6-409 (6), 25.5-6-606 (9), and 25.5-6-704 (8).

(c) (I) Upon completion of the report described in subsection (8)(a) of this
section, the state department shall analyze and review each operational
transportation network company, as defined in section 40-10.1-602 (3). The state
department shall verify each transportation network company's viability to ensure
the health, safety, welfare, cost effectiveness, and capability in expanding
nonmedical transportation services for individuals receiving services pursuant to
this section and comply with all rules promulgated pursuant to subsection (8)(e)(I)
of this section.

(II) No later than July 1, 2024, the state department shall authorize verified
transportation network companies to provide nonmedical transportation services if
the state department finds the transportation network company viable under
federal requirements and within budgetary constraints.

(III) For the purposes of this subsection (8)(c), verify means a
transportation network company meets all requirements resulting from the report
described in subsection (8)(a) of this section.

(d) The state department may seek any necessary federal authorization for
the implementation of this subsection (8).

(e) (I) The state department shall promulgate any necessary rules to ensure
transportation network companies comply with federal and state oversight
requirements and shall include all relevant stakeholders, including medicaid
members, transportation network companies, current providers and drivers for
nonmedical transportation services, and other parties interested in developing the
requirements.

(II) Pursuant to section 40-10.1-105 (1)(l), transportation network companies
are not subject to regulation by the public utilities commission when providing
nonmedical transportation services pursuant to this section and are instead subject
to rules promulgated by the state department pursuant to this subsection (8)(e).

(f) This subsection (8) does not apply to a provider authorized to provide
transportation services pursuant to part 8 of article 1 of title 25.5 prior to August
10, 2022.

Legislative History

Source: L. 2009: Entire part added, (HB 09-1047), ch. 395, p. 2129, � 1, effective August 5. L. 2015: (1), (2)(a), (2)(b)(III), (5), and (7) amended and (6) repealed, (SB 15-011), ch. 333, p. 1355, � 3, effective June 5. L. 2019: IP(5) amended, (SB 19-197), ch. 335, p. 3089, � 1, effective May 29. L. 2021: (1)(a) and (2)(b) amended and (2)(c) and (2)(d) added, (SB 21-038), ch. 404, p. 2684, � 1, effective September 7. L. 2022: (8) added, (HB 22-1114), ch. 396, p. 2821, � 6, effective August 10. L. 2024: (5)(c), (8)(a)(III), and (8)(e)(I) amended, (SB 24-176), ch. 152, p. 671, � 93, effective August 7. L. 2025: (1)(a), (2)(a), IP(2)(b), (2)(b)(II), (2)(b)(III), (2)(d), (3), and (4) amended and (2)(c), (5), and (7) repealed, (SB 25-226), ch. 219, p. 1007, � 4, effective August 6.