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.
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.
