The Tort and Casualty Unit in the Third-Party Liability and Recoveries section of the Colorado Department of Health Care Policy & Financing (HCPF) recovers money from a legally responsible third party when HCPF has paid claims on behalf of a Health First Colorado (Colorado's Medicaid Program) member. These circumstances commonly include payments, awards, or settlements from auto, homeowners' and malpractice insurance carriers intended to compensate the members for their injuries. Health First Colorado has an automatic lien by statute in these circumstances. We are required by state and federal law to take all reasonable measures to identify parties and to seek reimbursement from those legally responsible parties.
Health First Colorado Members
To report an incident or accident, submit a Case Information Form or letter which includes the following information:
- Injured party's name
- Health First Colorado ID or Social Security Number
- Date of birth
- Date of incident or accident
- Type of incident or accident
- Nature of the injuries
- Contact information of the insurance company and claim number
- Contact information for your attorney
- If you have received a Medical Services Questionnaire (MSQ)
Attorneys
To notify HCPF of a claim on behalf of a Health First Colorado member, HCPF must also receive:
- A Letter of Representation
- Injured party's name
- Health First Colorado ID or Social Security Number
- Date of birth
- Date of incident or accident
- Type of incident or accident
- Nature of the injuries
- An Authorization Form (HIPAA-compliant authorization)
- Email Address (due to COVID19, staff do not have the ability to fax or mail, while working from home)
Insurance Company Representatives
When providing notice of a Health First Colorado member's claim, include the information described above for members on company letterhead.
Mail or Fax to:
Colorado Department of Health Care Policy & Financing
Attention: Third-Party Liability and Recoveries section
303 E. 17th Avenue
Denver, CO 80203
Fax number: 303-866-3552
Note: Under Colorado State Law, failure to comply with providing notice of an action within fifteen (15) days or failure by a party to a judgment award or settlement to satisfy Health First Colorado's lien shall make the recipient, legal guardian, executor, administrator, attorney, or other representative liable for the entire amount of medical assistance furnished to or on behalf of the recipient for the injuries that gave rise to the action or claim.
For more information, or if you have submitted a written request for Health First Colorado lien information, you can check the status of a lien or ask questions concerning our process by submitting an email to: Tort.Casualty@state.co.us
Your email must include:
- Health First Colorado member name
- Health First Colorado ID#
- Date of Incident
- Your name
- Your contact information
- Your question