MedicaidAdministrativeMedium impact
Health First Colorado (Colorado's Medicaid Program) News and Updates (B2400516 - 11/2024)
Colorado Medicaid·CO·Provider Bulletin
Effective date
Jan 1, 2025
We identified it
Jun 20, 2026
Summary
Colorado Medicaid (Health First Colorado) has updated multiple policies including claim submission limits, billing restrictions, coverage expansion for undocumented children/pregnant individuals, and DRA compliance requirements. Key changes affect claim processing, member billing rules, and prior authorization processes.
Action Required
By November 1, 2024: Submit DRA Declaration and compliance documentation to HCPF_DRAAct2005@state.co.us if your practice receives $5M+ annually in Medicaid payments. Immediately: Ensure claims with over 50 detail lines are submitted via EDI batch process only, not the Provider Web Portal. By January 1, 2025: Prepare for increased patient volume from newly eligible undocumented children and pregnant individuals - no billing changes required for these members.