Medicaid & CBHP Rules
To access the text of the Secretary of State's (SOS)
official online version of the Department's rules, click on the links below.
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Children's Basic Health Plan
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10 CCR 2505-3
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300 - Enrollment Fees and Co-payments
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50 - Definitions
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400 - Enrollment
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100 - Eligibility
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500 - Financial Management
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200 - Benefits Package
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600 - Appeals Process
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Medical Assistance
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10 CCR 2505-10
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8.011.1 General Exclusions From Coverage
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8.062 Social Security Medicare Benefits |
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8.012 Providers Prohibited From Collecting Payment From Recipients
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8.063 Medical Assistance Estate Recovery
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8.013 Out-of-State Medical Care
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8.064 Data Provision and Claims Requirements (Eff. 03/30/2009)
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8.014 Non Emergent Medical Transportation
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8.065 Recovery of Medical Assistance Overpayments
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8.040 Recoveries From Providers |
8.066 Health Insurance Buy-In |
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8.041 Claims Reimbursement and Status |
8.070 Mis-Utilization, Fraud, or Abuse |
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8.042 Utilization of a Cash System of Accounting |
8.075 Client Over Utilization Program |
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8.043 Timely Filing Requirements |
8.076 Program Integrity (Eff. 12/30/2008)
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8.049 Reconsideration/Appeal of Adverse Administrative Action |
8.079 Quality Improvement (Eff. 05/30/2009) |
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8.050 Provider Appeals |
8.080 Medicaid Eligibility Quality Control |
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8.057 Recipient Appeals |
8.090 Medicaid Claims Processing and Third Party Liability Quality Control |
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8.058 Request for Prior Authorization |
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| 8.061 Use Of Other Resources In The Provision Of Medical Assistance Benefits |
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8.100 Medical Assistance Eligibility
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8.180 Medical Identification Cards and Duration of Eligibility |
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8.130 Provider Participation |
8.190 Acute Medical Benefits Determination
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8.170 State Identification Number
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8.201 Treatment of Oral Medical Conditions for Adult Clients
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8.220 Competitive Procurement and Selective Contracting, Including Global Fee Payment Programs
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8.205 Medicaid Managed Care Program
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8.221 General Provisions |
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8.209 Medicaid Managed Care Grievance and Appeal Processes |
8.280 Early And Periodic Screening, Diagnosis And Treatment (Eff. 10-01-2007)
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8.212 Community Mental Health Services |
8.290 School Health Services
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8.300 Hospital Services
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8.392 Financing of the Single Entry Point System |
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8.390 Long Term Care Single Entry Point System |
8.393 Function of a Single Entry Point Agency |
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8.400 Long Term Care |
8.443 Nursing Facility Reimbursement |
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8.401 Level of Care Screening Guidelines |
8.444 through 8.446 Repealed, Effective June 30, 2005 |
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8.402 Admission Procedures for Long Term Care |
8.448 Repealed, Effective May 30, 2006 |
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8.403 Long Term Care - Services to the Developmentally Disabled |
8.461 Repealed, Effective May 30, 2006 |
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8.404 Admission Criteria: Programs for the Developmentally Disabled |
8.470 Hospital Back Up Level of Care |
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8.405 Admission Procedures: Programs for the Developmentally Disabled |
8.481 Medical Review/Independent Professional Review |
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8.406 Nursing Facility Care - Levels of Care |
8.482 Resident Income and Possessions |
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8.408 Levels of Care Defined - Skilled Nursing Care |
8.484 Home Care Allowance - REPEALED |
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8.409 Levels of Care Defined - Intermediate Nursing Care |
8.485 Home and Community Based Services for the Elderly, Blind and Disabled (HCBS-EBD) General Provisions |
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8.415 Role of Counties and Nursing Facilities |
8.486 HCBS-EBD Case Management Functions |
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8.420 Requirements and Provisions for Participation by Colorado Nursing Facilities |
8.487 HCBS-EBD Provider Agencies
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8.421 Responsibility of County Department Concerning Participation |
8.488 Electronic Monitoring |
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8.422 Visits to Recipients by Social Services Personnel, Privacy for Conferences with Recipients |
8.489 Personal Care
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8.423 Visits to Recipients by the Colorado Long Term Care Ombudsman and Designated Representatives |
8.490 Homemaker Services
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8.424 Periodic Visits - Nursing Home Records to be Made Available |
8.491 Adult Day Services |
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8.425 Repealed, Effective June 30,2005 |
8.492 Respite Care |
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8.430 Medicaid Certification of New Nursing Facilities or Additional Beds |
8.493 Home Modification |
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8.435 Enforcement Remedies |
8.494 Non-Medical Transportation |
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8.440 Nursing Facility Benefits |
8.495 Alternative Care Facilities (Eff. 03/30/2009) |
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8.441 Nursing Facility Cost Reporting
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8.496 Home and Community Based Services for Persons Living with AIDS (HCBS-PLWA) General Provisions |
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8.442 Submission of Cost Reporting Information
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8.500 Home and Community Based Services for the Developmentally Disabled (HCB-DD) Waiver |
8.530 Denial, Termination, or Reduction In Services |
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8.500.90 Supported Living Services Waiver (SLS)
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8.540 Private Duty Nursing Services |
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8.503 Children's Extensive Support Waiver Program (CES) |
8.550 Hospice Benefit |
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8.504 Home and Community Based Services Pediatric Hospice Waiver (Eff. 12/30/2007) |
8.551 Consumer Directed Attendant Support |
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8.506 Children's Home and Community Based Services Waiver Program |
8.552 In Home Support Services |
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8.508 Children's Habilitation Residential Program |
8.553 Community Transition Services |
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8.509 Home and Community Based Services for Persons With Mental Illness (HCBS-MI) |
8.560 Clinic Services - Certified Health Agencies |
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8.510 Consumer Directed Attendant Support Services (Eff. 12/30/2007) |
8.561 Requirements For Certification |
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8.515.00 Home and Community Based Services For People with Brain Injury (HCBS-BI) |
8.562 Requirements For Participation |
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8.516.00 Environmental Modification |
8.563 Benefits And Limitations |
| 8.518 Consumer Directed Care For The Elderly |
8.564 Billing Procedures |
| 8.519 Home and Community Based Services For Children With Autism Waiver |
8.565 Reimbursement |
| 8.520 Home Health Services |
8.566 Appeals |
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8.525 Services Requirements |
8.567 Certified Health Agency/Physician Relationship |
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8.526 Provider Agency Requirements |
8.570 Ambulatory Surgery Centers |
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8.527 Prior Authorization
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8.571 Clinic Services-Ambulatory Surgery Center, Physician Prior Authorization |
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8.528 Reimbursement |
8.580 Oxygen And Oxygen Equipment |
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8.529 Post-Payment Review |
8.585 Oxygen, Oxygen Equipment, And Supplies |
| 8.590 Durable Medical Equipment And Disposable Medical Supplies |
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8.660 Laboratory and X-Ray
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8.700 Federally Qualified Health Centers |
8.748 Prenatal Plus Program
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8.715 Breast and Cervical Cancer Program |
8.749 Nurse Home Visitor Program |
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8.726 Teen Pregnancy Prevention Pilot Program |
8.750 Community Mental Health Centers/Clinics
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8.730 Family Planning Services |
8.754 Client Co-Payment |
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8.740 Rural Health Clinics |
8.760 Targeted Case Management Services |
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8.745 Special Connections |
8.765 Services for Clients in Psychiatric Residential Treatment Facilities or Residing in Therapeutic Residential Child Care Centers |
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8.746 Outpatient Substance Abuse Treatment |
8.766 Residential Treatment Center Reimbursement |
| 8.747 Screening, Brief Intervention And Referral to Treatment Services |
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8.800 Pharmaceuticals
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8.900 Colorado Indigent Care Program (CICP)
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8.940 Old Age Pension Health Care Program and Old Age Pension Health Care Supplemental Program
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8.930 Comprehensive Primary and Preventive Care Grant Program
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8.950 Primary Care Fund
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8.1000 Medicare Modernization Act - Low-Income Subsidy Eligibility
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8.2000 Hospital Provider Fee Collection and Disbursement
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