Operation of Denver Health & Hospital Authority

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 act 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 from July 1, 2025, until June 30, 2032, as long as the MCO meets all MCO criteria required by the department.

If the department designates a managed care entity (MCE) other than the MCO operated by Denver health to manage behavioral health-care services, the act requires Denver health to collaborate with the MCE during the term of the contract.

The act 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.

For the 2023-24 state fiscal year, the department distributed money appropriated for a supplemental state payment to Denver health. The act authorizes the department to continually distribute any money appropriated for payment to Denver health.

APPROVED by Governor April 4, 2024

EFFECTIVE April 4, 2024
(Note: This summary applies to this bill as enacted.)