MedicaidPrior AuthHigh impact
Health First Colorado (Colorado's Medicaid Program) News and Updates (B2600538 - 05/2026)
Colorado Medicaid·CO · Pediatrics, Physical Therapy, Occupational Therapy·Provider Bulletin
Effective date
May 18, 2026
We identified it
Jun 20, 2026
Summary
Colorado Medicaid (Health First Colorado) has implemented multiple critical changes including stricter prior authorization timeframes (reduced from 10 business days to 7 calendar days), mandatory license verification with claim denials starting May 18, 2026, and required prior authorizations for all pediatric long-term home health services with full enforcement beginning June 1, 2026.
Action Required
By May 18, 2026: Verify all provider licenses are current in the Provider Web Portal using Provider Maintenance Request - expired licenses will cause claim denials with EOB 3385. By June 1, 2026: Ensure all pediatric long-term home health services (PT, OT, ST, RN/LPN, CNA) have approved PARs through Atrezzo portal - services without PARs will be denied. Immediately: Update PAR submission processes to respond within 7 calendar days instead of 10 business days, and ensure expedited PARs include all documentation upfront as pends are not allowed.