Department 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
 170 - Presumptive Eligibility  600 - Appeals Process
 200 - Benefits Package  

 

Medical Assistance

10 CCR 2505-10
 8.000 - 8.099  8.061 Use Of Other Resources In The Provision Of Medical Assistance Benefits                                   
 8.010 Medical Assistance Benefit Coverage Standards  8.062 Social Security Medicare Benefits
 8.011.1 General Exclusions From Coverage  8.063 Medical Assistance Estate Recovery
 8.012 Providers Prohibited From Collecting Payment From Recipients  8.064 Data Provision and Claims Requirements (Eff. 03/30/2009)
 8.013 Out-of-State Medical Care  8.065 Recovery of Medical Assistance Overpayments
 8.014 Non Emergent Medical Transportation  8.066 Health Insurance Buy-In
 8.015 Electronic Health Record Inentive Payment Program  8.070 Mis-Utilization, Fraud, or Abuse
 8.016 Alternative Benefit Plan  8.075 Client Over Utilization Program
 8.017 Habilitative Services  8.076 Program Integrity (Eff. 12/30/2008)
 8.040 Recoveries From Providers  8.079 Quality Improvement (Eff. 05/30/2009)
 8.041 Claims Reimbursement and Status  8.080 Medicaid Eligibility Quality Control
 8.042 Utilization of a Cash System of Accounting  8.090 Medicaid Claims Processing and Third Party Liability Quality Control
 8.043 Timely Filing Requirements  
 8.049 Reconsideration/Appeal of Adverse Administrative Action  
 8.050 Provider Appeals  
 8.057 Recipient Appeals  
 8.058 Request for Prior Authorization  

 

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  
 8.200 Physician Services                                                                        8.220 Competitive Procurement and Selective Contracting, Including Global Fee Payment Programs
 8.201 Dental Services  8.221 General Provisions
 8.205 Medicaid Managed Care Program  8.280 Early And Periodic Screening, Diagnosis And Treatment (Eff. 10-01-2007) 
 8.209 Medicaid Managed Care Grievance and Appeal Processes  8.290 School Health Services
 8.212 Community Behavioral Health Services  8.295 School-Based Health Center Benefit Coverage Standard
 8.215 Community Mental Health Services Program Capitation Rate Setting  

 

8.300 - 8.399  
 8.300 Hospital Services                              8.392 Financing of the Single Entry Point System
 8.310 Dialysis Treatment Centers  8.393 Functions of a Single Entry Point Agency
 8.300 Hospital Services  8.394 Accountability Mechanisms for Single Entry Point Agencies
 8.390 Long Term Care Single Entry Point System  

 

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
 8.407 Special Provision Concerning Clients Eligible for Social Security Age - 72 Benefits (Prouty)  8.483 Adult Foster Care - REPEALED
 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 - REPEALED effective March 30, 2014 
 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  8.540 Private Duty Nursing Services
 8.500.90 Supported Living Services Waiver (SLS)  8.550 Hospice Benefit
 8.503 Children's Extensive Support Waiver Program (CES)  8.551 Consumer Directed Attendant Support - REPEALED effective February 1, 2014
 8.504 Home and Community Based Services Pediatric Hospice Waiver (Eff. 12/30/2007)  8.552 In Home Support Services
 8.506 Children's Home and Community Based Services Waiver Program  8.553 Community Transition Services
 8.508 Children's Habilitation Residential Program  8.555 Colorado Choice Transitions (CCT), A Money Follows the Person Demonstration
 8.509 Home and Community Based Services for Community Mental Health Supports (HCBS-CMHS)  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 Persons with Brain Injury (HCBS-BI)  8.562 Requirements For Participation
   8.563 Benefits And Limitations
 8.517 Home and Community Based Services For Persons with Spinal Cord Injury  8.564 Billing Procedures
 8.518 Consumer Directed Care For The Elderly  8.565 Reimbursement
 8.519 Home and Community Based Services For Children With Autism Waiver  8.566 Appeals
 8.520 Home Health Services  8.567 Certified Health Agency/Physician Relationship
 8.525 Services Requirements  8.570 Ambulatory Surgery Centers
 8.526 Provider Agency Requirements  8.571 Clinic Services-Ambulatory Surgery Center, Physician Prior Authorization
 8.527 Prior Authorization  8.580 Oxygen And Oxygen Equipment
 8.528 Reimbursement  8.585 Oxygen, Oxygen Equipment, And Supplies
 8.529 Post-Payment Review  8.590 Durable Medical Equipment And Disposable Medical Supplies
 8.530 Denial, Termination, or Reduction In Services  

 

8.600 - 8.699  
 8.600 Services for Individuals with Intellectual and Developmental Disabilities  8.609 Program Services and Supports
 8.601 Administrative Services  8.610 Facility Based Adult Day Habilitation Services and Supports
 8.602 Service Agencies  8.611 Transportation
 8.603 Program Approval by the Department  8.612 Supports Intensity Scale Assessment and Support Levels
 8.604 Due Process and Confidentiality  8.613 Family Support Services (FSS) Program
 8.605 Dispute Resolution Procedures  8.614 Gastrosyomy Services
 8.606 Confidentiality  8.660 Laboratory and X-Ray
 8.607 Case Management Services   
 8.608  Service and Support Planning, Supporting People with Challenging Behavior, and Protections  

 

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 (Effective August 30, 2007)
 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 Residential Child Care Facilities
 8.746 Outpatient Substance Abuse Treatment  8.766 Residential Treatment Center Reimbursement - REPEALED effective November 30, 2011
 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
 8.930 Comprehensive Primary and Preventive Care Grant Program - REPEALED effective August 12, 2011  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