MedicaidAdministrativeHigh impact
Health First Colorado (Colorado's Medicaid Program) News and Updates (B2500526 - 08/2025)
Colorado Medicaid·CO·Provider Bulletin
Effective date
Aug 1, 2025
We identified it
Jun 20, 2026
Summary
Colorado Medicaid is implementing multiple system transitions affecting EDI processing, pharmacy benefits, and prior authorization requirements. Key changes include EDI vendor transition to Cotiviti in 2026, pharmacy benefit management moving to MedImpact in October 2025/February 2026, and resumption of prior authorization requirements for long-term home health nursing services effective August 1, 2025.
Action Required
Immediately: Ensure clearinghouses are aware of upcoming EDI transition to Cotiviti (late summer 2026). By October 2025: Update pharmacy contact information when MedImpact transitions occur. For home health agencies: Submit Skilled Care Acuity Assessment referrals to Telligen before submitting PARs for RN/CNA services. Attend ColoradoPAR training sessions scheduled throughout August 2025.