MedicaidAdministrativeMedium impact
Health First Colorado (Colorado's Medicaid Program) News and Updates (B2100460 - 03/2021)
Colorado Medicaid·CO·Provider Bulletin
Effective date
Mar 1, 2021
We identified it
Jun 20, 2026
Summary
Health First Colorado (Colorado Medicaid) has updated billing policies requiring Medicare Advantage plans to be billed in Medicare fields rather than TPL fields, and eliminated co-pays for COVID-19 related visits including vaccine administration, testing, and treatment. Additional guidance provided on member billing restrictions and Recovery Audit Contractor reviews.
Action Required
Immediately: Update billing system to ensure Medicare Advantage plans (HMO/PPO) are billed in Medicare fields, not Third-Party Liability fields for Health First Colorado members. Stop collecting co-pays from Health First Colorado members for COVID-19 vaccine administration, diagnostic testing, and treatment visits. Review member billing practices to ensure compliance with restrictions on TPL co-pays, deductibles, and collection agency referrals.