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Medicaid Eligibility for Inmates

The Department has examined Senate Bill 08-006, concerning Medicaid eligibility for inmates and the ability to cover individuals residing in the State's Community Corrections programs.  The areas investigated and the Department's subsequent actions are detailed below:


1.      Senate Bill 08-006 authorized the Department to suspend Medicaid eligibility for those individuals who become inmates of a public institution.  The Department's current Medicaid regulations require an individual's eligibility to be terminated when he or she becomes an inmate of a public institution.


The Department has researched policies implemented in other states and by other federal agencies since that time, but was unable to locate a complete policy that could easily be adopted or duplicated.  The Department discovered that several states had abandoned efforts to develop a comprehensive policy after encountering substantial difficulties.  The Department has made a concerted effort to incorporate guidance provided by the Centers for Medicare and Medicaid Services (CMS) and other sources in order to develop a unique policy which can be implemented by the Department's eligibility technicians and within the Colorado Benefits Management System (CBMS).


Department Action:  The Department has prepared a proposed policy and is seeking CMS and stakeholder input.  (Go to Documents and Research, view May 28, 2009 Department Letter to CMS)



2.      Determine if individuals residing in the State's Community Corrections are considered inmates of a public institution for the purposes of a Medicaid eligibility analysis.  The Department is researching this issue and will provide addition information and/or an explanation as to why CMS should or should not consider Medicaid clients residing in the Community Corrections program as incarcerated individuals. 


Department Action:  A proposed change in policy has been sent to CMS.  (Go to Documents and Research, view Letter to CMS and Responses Concerning Community Corrections)



3.      Review and, if necessary, propose a change to state regulations that specify individuals are not eligible to receive discounted services under available CICP funds if those individuals are being held or confined involuntarily under governmental control in State or federal prisons, jails, detention facilities or other penal facilities.  This includes those individuals residing in detention centers awaiting trial, at a wilderness camp, residing in half-way houses who have not been released on parole, and those persons in the custody of a law enforcement agency temporarily released for the sole purpose of receiving health care.


Department Action:  Following the resolution to items above, the Department will develop a proposed policy for stakeholder review. 



If you have any questions regarding the information on this page please contact

Chris Underwood at 303-866-4766 or