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Program Rules and Regulations

To access the text of the Secretary of State's (SOS)
official online version of the Department's rules, click on the links below.

 

 

 

 Children's Basic Health Plan

 

 10 CCR 2505-3

 

 50-600

 

 300 - Enrollment Fees and Co-payments

 

 50 - Definitions

 

 400 - Enrollment

 

 100 - Eligibility

 

 500 - Financial Management

 

 200 - Benefits Package

 

 600 - Appeals Process

 

 

 

 

 

 Medical Assistance

 

 10 CCR 2505-10

 

 8.000 - 8.099

 

 

 8.011.1 General Exclusions From Coverage 

 

 8.062 Social Security Medicare Benefits

 

 8.012 Providers Prohibited From Collecting Payment From Recipients

  

 8.063 Medical Assistance Estate Recovery

 

 8.013 Out-of-State Medical Care
 

 

 8.064 Data Provision and Claims Requirements (Eff. 03/30/2009)

 

 8.014 Non Emergent Medical Transportation
 

 

 8.065 Recovery of Medical Assistance Overpayments

 

 8.040 Recoveries From Providers

 

 8.066 Health Insurance Buy-In

 

 8.041 Claims Reimbursement and Status 

 

 8.070 Mis-Utilization, Fraud, or Abuse

 

 8.042 Utilization of a Cash System of Accounting

 8.075 Client Over Utilization Program

 

 8.043 Timely Filing Requirements

 

 8.076 Program Integrity (Eff. 12/30/2008)

 

 8.049 Reconsideration/Appeal of Adverse Administrative Action

 

 8.079 Quality Improvement (Eff. 05/30/2009)
 
 

 8.050 Provider Appeals

 

 8.080 Medicaid Eligibility Quality Control

 

 8.057 Recipient Appeals


 

 8.090 Medicaid Claims Processing and Third Party Liability Quality Control

 

 8.058 Request for Prior Authorization

 

 
 8.061 Use Of Other Resources In The Provision Of Medical Assistance Benefits


 

 

 

 

 8.100 - 8.199

 

 

 8.100 Medical Assistance Eligibility

  

 8.180  Medical Identification Cards and Duration of Eligibility

  8.130 Provider Participation

 8.190 Acute Medical Benefits Determination

 

  8.170  State Identification Number

 

 

 

 

 8.200 - 8.299

 

 

 8.201 Treatment of Oral Medical Conditions for Adult Clients

 

 8.220 Competitive Procurement and Selective Contracting, Including Global Fee Payment Programs  

 

 8.205 Medicaid Managed Care Program


  

 8.221 General Provisions


 

 8.209 Medicaid Managed Care Grievance and Appeal Processes

 

 8.280 Early And Periodic Screening, Diagnosis And Treatment (Eff. 10-01-2007)

  

8.212 Community Mental Health Services


 

 8.290 School Health Services

 

 

 

 8.300 - 8.399

 

 

 8.300 Hospital Services


 

 8.392 Financing of the Single Entry Point System

  8.390  Long Term Care Single Entry Point System


 
 

  8.393 Function of a Single Entry Point Agency


 

 

 

 

 8.400 - 8.499

 

 

 8.400 Long Term Care


 

 8.443 Nursing Facility Reimbursement


 

 8.401 Level of Care Screening Guidelines



 

 8.444 through 8.446 Repealed, Effective June 30, 2005


 
 

 8.402 Admission Procedures for Long Term Care

 

 8.448 Repealed, Effective May 30, 2006


 

 8.403 Long Term Care - Services to the Developmentally Disabled

 

 8.461 Repealed, Effective May 30, 2006


 

 8.404 Admission Criteria: Programs for the Developmentally Disabled

 8.470 Hospital Back Up Level of Care


 

 8.405 Admission Procedures: Programs for the Developmentally Disabled

 

 8.481 Medical Review/Independent Professional Review

 8.406 Nursing Facility Care - Levels of Care


 8.482 Resident Income and Possessions 


 

 8.408 Levels of Care Defined - Skilled Nursing Care

 

 8.484 Home Care Allowance - REPEALED


 

 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


 8.415 Role of Counties and Nursing Facilities

 8.486 HCBS-EBD Case Management Functions


 8.420 Requirements and Provisions for Participation by Colorado Nursing Facilities

 8.487 HCBS-EBD Provider Agencies
 

 

 8.421 Responsibility of County Department Concerning Participation

 8.488 Electronic Monitoring


 

 8.422 Visits to Recipients by Social Services Personnel, Privacy for Conferences with Recipients

 

 8.489 Personal Care 

 

 

 8.423 Visits to Recipients by the Colorado Long Term Care Ombudsman and Designated Representatives

 

 8.490 Homemaker Services

 

 

 8.424 Periodic Visits - Nursing Home Records to be Made Available


 

 8.491 Adult Day Services



 

 8.425 Repealed, Effective June 30,2005


  8.492 Respite Care


 

 8.430 Medicaid Certification of New Nursing Facilities or Additional Beds


 

  8.493 Home Modification



 

 8.435 Enforcement Remedies



 

  8.494 Non-Medical Transportation



 8.440 Nursing Facility Benefits


 

  8.495 Alternative Care Facilities (Eff. 03/30/2009)


 8.441 Nursing Facility Cost Reporting





 

  8.496 Home and Community Based Services for Persons Living with AIDS (HCBS-PLWA) General Provisions



 8.442 Submission of Cost Reporting Information

 

  

 

 

 

 8.500 - 8.599

 

 

 8.500 Home and Community Based Services for the Developmentally Disabled (HCB-DD) Waiver


 8.530 Denial, Termination, or Reduction In Services


 8.500.90 Supported Living Services Waiver (SLS)

 

  8.540 Private Duty Nursing Services


 

 8.503 Children's Extensive Support Waiver Program (CES)

 

  8.550 Hospice Benefit


 8.504 Home and Community Based Services Pediatric Hospice Waiver (Eff. 12/30/2007)


 

  8.551 Consumer Directed Attendant Support


 8.506 Children's Home and Community Based Services Waiver Program

 

  8.552 In Home Support Services 


 

 8.508 Children's Habilitation Residential Program


 

  8.553 Community Transition Services


 

   8.555 Colorado Choice Transitions (CCT), A Money Follows the Person Demonstration
 

 8.509 Home and Community Based Services for Persons With Mental Illness (HCBS-MI)


 

  8.560 Clinic Services - Certified Health Agencies

 
 

 8.510 Consumer Directed Attendant Support Services (Eff. 12/30/2007)


  8.561 Requirements For Certification



 

 8.515.00 Home and Community Based Services For People with Brain Injury (HCBS-BI) 


 

  8.562 Requirements For Participation



 

 8.516.00 Environmental Modification


 

 8.563 Benefits And Limitations


 8.517 Home and Community Based Services For Persons with Spinal Cord Injury
 
 
 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



 

 8.525 Services Requirements



 

 8.567 Certified Health Agency/Physician Relationship


 

  8.526 Provider Agency Requirements



 8.570 Ambulatory Surgery Centers


 
 

 8.527 Prior Authorization

 
 

 

 8.571 Clinic Services-Ambulatory Surgery Center, Physician Prior Authorization


 

  8.528 Reimbursement


 8.580 Oxygen And Oxygen Equipment


 

  8.529 Post-Payment Review



 

 8.585 Oxygen, Oxygen Equipment, And Supplies


 
   8.590 Durable Medical Equipment And Disposable Medical Supplies

 

 

 

8.600 - 8.699

 

 8.660 Laboratory and X-Ray

 

 

 

 8.700 - 8.799

 

 

 8.700 Federally Qualified Health Centers

 

 8.748 Prenatal Plus Program
 

 

 8.715 Breast and Cervical Cancer Program

 

 8.749 Nurse Home Visitor Program


 

 8.726 Teen Pregnancy Prevention Pilot Program


 

8.750 Community Mental Health Centers/Clinics

 

 8.730 Family Planning Services


 

 8.754 Client Co-Payment


 8.740 Rural Health Clinics


 

  8.760 Targeted Case Management Services


 8.745 Special Connections




  8.765 Services for Clients in Psychiatric Residential Treatment Facilities or Residing in Therapeutic Residential Child Care Centers


 

 8.746 Outpatient Substance Abuse Treatment

 

 8.766 Residential Treatment Center Reimbursement


 8.747 Screening, Brief Intervention And Referral to Treatment Services


 

 

 

8.800 - 8.899

 

 8.800 Pharmaceuticals

 

 

 

8.900 - 8.999

 

 

 8.900 Colorado Indigent Care Program (CICP)

 

 

8.940 Old Age Pension Health Care Program and Old Age Pension Health Care Supplemental Program

 

 

8.930 Comprehensive Primary and Preventive Care Grant Program

 

 8.950 Primary Care Fund

 

 

 

 

 8.1000 - 8.1099

 

 8.1000 Medicare Modernization Act - Low-Income Subsidy Eligibility

 

 

 

 

8.2000

 

8.2000 Hospital Provider Fee Collection and Disbursement