MedicaidPrior AuthHigh impact
Health First Colorado (Colorado's Medicaid Program) News and Updates (B2600534 - 02/2026)
Colorado Medicaid·CO·Provider Bulletin
Effective date
Jan 1, 2026
We identified it
Jun 20, 2026
Summary
Colorado Medicaid (Health First Colorado) has implemented significant changes to prior authorization processes, reducing pend response times from 10 business days to 7 calendar days and eliminating multiple pends on the same PAR. Additionally, there are updates to timely filing rules, EDI vendor transitions, and specific requirements for home health documentation.
Action Required
Immediately: Update prior authorization workflows to respond to pends within 7 calendar days instead of 10 business days. Ensure all required documentation is included with initial PAR submissions as additional pends will not be granted. For expedited PARs, include all documentation upfront as no pends are allowed. Home health agencies must update Plan of Care documentation to include comprehensive details of amount, frequency, duration, and specific duties for each visit. Billing teams should verify clearinghouse vendors are aware of ongoing EDI transitions with Edifecs.