Current law requires the department of health care policy and financing (department) to offer to enter into a direct contract with the managed care organization (MCO) operated by or under the control of the Denver health and hospital authority (Denver health) until Denver health ceases to operate a medicaid managed care program or until June 30, 2025. The bill removes the option for the department to enter into a direct contract until June 30, 2025, and instead requires the department to enter into the contract
until Denver health ceases to operate a managed care program from July 1, 2025, until June 30, 2032, as long as the MCO meets all MCO criteria required by the department .
The bill prohibits the MCO from reimbursing contracted medicaid providers at rates that are higher than the department's medicaid fee for service rates unless the provider enters into a quality incentive agreement with the MCO.
The bill requires the MCO's contract to provide physical and behavioral health-care services to the population it serves.
For the 2023-24 state fiscal year, the department distributed money appropriated for a supplemental state payment to Denver health. The bill authorizes the department to continually distribute any money appropriated for payment to Denver health.
(Note: Italicized words indicate new material added to the original summary; dashes through words indicate deletions from the original summary.)
(Note: This summary applies to the reengrossed version of this bill as introduced in the second house.)