Tort and Casualty

The Tort and Casualty Unit in the Benefits Coordination section of the Department recovers money from a legally responsible third party when the Department 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.

By law, you or your representative must provide the Department written notice within fifteen (15) days after the filing of an action or claim against a third party.   Section 25.5-4-301(6), C.R.S.


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 the Department of a claim on behalf of a Health First Colorado member, the Department must also receive:

  • A Letter of Representation

- Injured party's name
- Health First Colorado ID or Social Security Number (Members call 1-800-221-3943 for ID#)
- Date of birth
- Date of incident or accident
- Type of incident or accident
- Nature of the injuries

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 and Financing
Attention: Benefits Coordination Department
1570 Grant Street
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.  Sections 25.5-4-301(5) & (6), C.R.S.

See the Tort and Casualty Presentation for more information or contact:

Deborah Sorenson
Phone: 303-866-3109
Fax: 303-866-3552

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