{"data":{"id":"us-co/c.r.s.-25.5-1-128","jurisdiction":"us-co","citation":"C.R.S. § 25.5-1-128","heading":"Provider payments - compliance with state fiscal requirements - rules - definitions.","body":"(1) (a) Notwithstanding any provision of law to the contrary, when the state department has regulatory authority over a program and when the provider has already signed a state department-approved provider application to provide a service or to bill the state department or its authorized contractor for a service, the state department-approved provider application shall serve to fulfill the requirements of a commitment voucher and the fiscal requirements of section 24-30-202 (1), C.R.S.\n\n(b) The executive director may promulgate rules to exempt a provider who provides services through a program as described in subsection (1)(a) of this section for any program the state department is authorized by law to administer, including but not limited to:\n\n(I) The \"Colorado Medical Assistance Act\", articles 4 to 6 of this title;\n\n(II) The \"Children's Basic Health Plan Act\", article 8 of this title;\n\n(III) Repealed.\n\n(IV) The school health services program authorized by section 25.5-5-318;\n\n(V) Programs that are funded through the primary care fund, created in section 24-22-117 (2)(b), C.R.S.; and\n\n(VI) The state-funded old age pension health and medical care program pursuant to article 2 of this title.\n\n(1.5) The state department shall maintain a list of enrolled school-based health centers and school-linked health-care services providers. The state department shall develop the list based on grant enrollment data pursuant to section 25-20.5-503 that is provided to the state department by the department of public health and environment. The state department shall establish a process for identifying claims for services provided in these settings.\n\n(2) As used in this section, unless the context otherwise requires, \"provider\" means a health-care provider; a mental health-care provider; a pharmacist; a home health agency; a general hospital, birth center, or community clinic licensed or certified by the department of public health and environment pursuant to section 25-1.5-103 (1)(a)(I) or (1)(a)(II); a federally qualified health center, as defined in the federal \"Social Security Act\", 42 U.S.C. sec 1395x (aa)(4); a rural health clinic, as defined in the federal \"Social Security Act\", 42 U.S.C. sec. 1395x (aa)(2); a health maintenance organization issued a certificate of authority pursuant to section 10-16-402; a school district as defined in section 25.5-5-318 (1)(a); or any other entity that provides health care, health-care coordination, outreach, enrollment, or administrative support services to members through fee-for-service, a managed care entity, a behavioral health organization, a medical home, or any system of care that coordinates health care or services as defined and authorized through rules promulgated by the state board or by the executive director.","path":["Title 25.5 - HEALTH CARE POLICY AND FINANCING","Article 1 - Department of Health Care Policy and Financing","Part 1 - GENERAL PROVISIONS"],"source_url":"https://olls.info/crs/crs2026-title-25.5.htm","current_through":"Colorado Revised Statutes 2026","vintage":"","retrieved_at":"2026-09-14T18:37:45Z","sha256":"06306aca3ae2077f86f5715872b01bcd024833aa7ab81afcf69372e99e520758","source_id":"us-co","stale":false,"prev":"us-co/c.r.s.-25.5-1-127","next":"us-co/c.r.s.-25.5-1-129"},"notice":"GroundRules: Original legal text. Not legal advice."}