CO HB1096

Prohibits the Department of Health Care Policy and Financing from denying Medicaid members the ability to purchase primary care services or enter into direct primary care agreements with providers who charge periodic fees rather than billing through insurance

Requires Medicaid members using direct primary care to sign an acknowledgment that the provider only participates in Medicaid as an ordering, prescribing, and referring provider; does not accept Medicaid payment for services; and that the member cannot seek Medicaid reimbursement for those services

Mandates direct primary care providers serving Medicaid members enroll in the Colorado Medical Assistance Program as ordering, prescribing, or referring providers to ensure prescriptions and referrals are properly processed

Preserves Medicaid members' right to continue receiving primary care from traditional Medicaid-enrolled providers while also using direct primary care services

Directs the Department of Health Care Policy and Financing to seek any necessary federal authorization for implementation; effective date of August 12, 2026