HB21-1187 Summary

• Establishes a new case management system (Part 17, Article 6, Title 25.5) to provide conflict-free case management services for individuals eligible for long-term services and supports under Colorado Medicaid.

• Requires the state department to establish defined service areas statewide and designate case management agencies through competitive solicitation by December 31, 2022, with implementation timeline development by December 31, 2021.

• Defines five key system outcomes: federal compliance, quality, simplicity, stability, and accountability, with case management services separated from direct service provision to ensure conflict-free operations.

• Creates comprehensive definitions and procedures for case management agencies, person-centered support plans, eligibility determinations, service coordination, records confidentiality, and dispute resolution.

• Takes effect July 1, 2024, replacing and consolidating prior single-entry-point case management provisions while maintaining federal compliance with 42 CFR 441.301(c)(1)(vi) conflict-free case management requirements.