Committee advances bill to align Medicaid third‑party liability with federal requirements

House lawmakers advanced House Bill 25-1033, which sponsors said updates state Medicaid third‑party liability rules to match federal direction in the Consolidated Appropriations Act of 2022.

Representative Leader, the bill sponsor, told the committee the measure would add two technical requirements so the Department of Health Care Policy and Financing (HCPF) complies with Centers for Medicare & Medicaid Services (CMS) guidance: allowing certain reimbursement requests even when a Medicaid prior authorization denial is present, and requiring commercial payers to respond to information requests within 60 days.

David Smith, a HCPF staffer with 15 years’ experience working on third‑party liability, testified that the changes are technical but would materially support state efforts to “pay and chase” reimbursements when Medicaid identifies another liable payer after it has paid a claim. Smith explained that the department already cross‑checks commercial eligibility and uses business rules to accept or reject claims, and that the proposed changes would facilitate recovery where coverage is later identified.

Representative Leader said the bill will keep Colorado in compliance with federal requirements and that the bill carries no fiscal note. The committee moved the bill to the Committee of the Whole with a favorable recommendation by roll call; the clerk announced the motion passed and that the bill “passes 130.”

Sponsors and witnesses emphasized this was a technical compliance effort rather than a policy overhaul, and the Department of Health Care Policy and Financing will use the statutory authority to pursue reimbursements from other payers as part of ongoing operations.