April 26, 2017

SB 17-004: Allowing Nonenrolled Medicaid Providers to Charge for Services

On January 11, 2017, Sen. Jake Tate and Rep. Cole Wist introduced SB 17-004, “Concerning Access by Medicaid Recipients to Nonenrolled Medical Providers.”

Under current law, recipients of services under the Colorado medical assistance program (medicaid) are not responsible for the cost of services by a medical provider or the cost remaining after payment by medicaid or another private insurer, regardless of whether the medical provider is enrolled in the medicaid program, unless the medical services provided are nonreimbursable by medicaid. The bill amends the statute so that the prohibition on charging medicaid recipients for medical services applies only if the medical provider is enrolled in medicaid.

Prior to providing medical services to a medicaid recipient, a nonenrolled provider must enter into a written agreement with the recipient as specified in the bill. If the requirements are met, the medicaid recipient would be responsible for the cost of the medical services.

The bill was introduced in the Senate and assigned to the Health & Human Services Committee. It is scheduled to be heard in committee on January 26, 2017, at 1:30 p.m.

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