It is the intent of the general assembly that medicaid be the last resort for payment for medically necessary goods and services furnished to recipients and that all other sources of payment are primary to medical assistance provided by medicaid. Source: L. 2008: Entire section added, p. 1771, § 2, effective June 2.
The state department shall implement and maintain a system for reducing medical services coding errors in medicaid claims submitted to the state department for reimbursement. The system shall include automatic, prepayment review of medicaid claims through the use of nationally recognized correct coding methods in the medicaid management information system, in accordance with 42 U.S.C. […]
The general assembly finds and declares that: Colorado’s medicaid program provides critical medical services to the state’s poorest and most vulnerable residents; Funding for these services is provided through a financial partnership between Colorado and the federal government; For the 2015-16 state budget year, the general assembly appropriated $8,891,000,000 for Colorado’s medicaid program, of which […]
Except as provided in section 25.5-4-302 and subparagraph (III) of this paragraph (a), no recipient or estate of the recipient shall be liable for the cost or the cost remaining after payment by medicaid, medicare, or a private insurer of medical benefits authorized by Title XIX of the social security act, by this title, or […]
The general assembly hereby finds, determines, and declares that the cost of providing medical assistance to qualified recipients throughout the state has increased significantly in recent years; that such increasing costs have created an increased burden on state revenues while reducing the amount of such revenues available for other state programs; that recovering some of […]
At any time prescribed by the department of revenue, but not less frequently than annually, the state department may certify to the department of revenue information regarding any person who: Is obligated to the state agency responsible for administering medical assistance in this state for medical support based on medical assistance provided to the obligor’s […]
No later than October 1, 2017, and no later than October 1 each year thereafter, the attorney general shall submit a written report to the state department for inclusion in a single, comprehensive report to the general assembly concerning medicaid fraud pursuant to section 25.5-1-115.5. The attorney general shall provide information relating to medicaid provider […]
This section and sections 25.5-4-304 to 25.5-4-310 shall be known and may be cited as the “Colorado Medicaid False Claims Act”. Source: L. 2010: Entire section added, (SB 10-167), ch. 296, p. 1379, § 10, effective May 26. Cross references: For the legislative declaration in SB 10-167, see section 1 of chapter 296, Session Laws […]
As used in sections 25.5-4-303.5 to 25.5-4-309, unless the context otherwise requires: “Claim” means a request or demand for money or property, whether under a contract or otherwise, and regardless of whether the state has title to the money or property, under the “Colorado Medical Assistance Act” that is: Presented to an officer, employee, or […]
Except as otherwise provided in subsection (2) of this section, a person is liable to the state for a civil penalty of not less than five thousand five hundred dollars and not more than eleven thousand dollars; except that these upper and lower limits on liability shall automatically increase to equal the civil penalty allowed […]
Responsibility of attorney general. The attorney general shall diligently investigate a violation under section 25.5-4-305. If the attorney general finds that a person has violated or is violating section 25.5-4-305, the attorney general may bring a civil action under this section against the person. Actions by private persons. A relator may bring a civil action […]
A civil action under section 25.5-4-306 (1) or (2) may not be brought after the later of: More than six years after the date on which the violation of section 25.5-4-305 is committed; or More than three years after the date when facts material to the right of action are known or reasonably should have […]
An action under section 25.5-4-306 may be brought in any judicial district in which the defendant or, in the case of multiple defendants, any one defendant can be found, resides, or transacts business or in which an act proscribed by section 25.5-4-305 occurred. A summons as required by the Colorado rules of civil procedure shall […]
General. Whenever the attorney general has reason to believe that a person may be in possession, custody, or control of documentary material or information relevant to a false medicaid claims law investigation, the attorney general may, before commencing a civil proceeding under section 25.5-4-306 or other false medicaid claims law or making an election under […]
Notwithstanding section 24-1-136 (11)(a)(I), on or before January 15, 2012, and on or before each January 15 thereafter, the attorney general shall submit a written report to the health and human services committees of the senate and the house of representatives, or any successor committees, and to the joint budget committee of the general assembly […]
