MedicaidPrior AuthHigh impact
Health First Colorado (Colorado's Medicaid Program) News and Updates (B2600537 - 04/2026)
Colorado Medicaid·CO·Provider Bulletin
Effective date
Jan 1, 2026
We identified it
Jun 20, 2026
Summary
Colorado Medicaid has implemented significant prior authorization changes including reducing pend response times from 10 business days to 7 calendar days, eliminating additional pends on the same request, and prohibiting pends on expedited requests. Provider revalidation processes have also been updated with new reenrollment options.
Action Required
Immediately: Update prior authorization workflows to respond to Colorado Medicaid pends within 7 calendar days (reduced from 10 business days). Ensure all required documentation is submitted with initial PAR requests as additional pends will not be allowed. For expedited requests, submit complete documentation upfront as no pends are permitted. Verify provider revalidation status using the weekly updated Provider Revalidation Dates Spreadsheet as claims will deny if past revalidation date. Trading partners must prepare for EDI platform transition to Edifecs planned for summer 2026.