Code of Colorado Regulations 1305 - Department of Health Care Policy and Financing
Code of Colorado Regulations — 1305: Department of Health Care Policy and Financing
Status
CCR 1305 was the title for regulations concerning the Department of Health Care Policy and Financing in Colorado.
These regulations have been repealed and are no longer in effect.
Current Regulations
The Department now issues its administrative rules under 10 CCR 2505, which governs Health First Colorado (Medicaid), Children’s Basic Health Plan (CHP+), and related programs.
These rules cover program operations, eligibility, provider standards, benefit coverage, and administrative procedures.
Department Responsibilities
The Department of Health Care Policy and Financing administers Colorado’s public health programs, including:
Health First Colorado (Medicaid) – provides health coverage for low-income individuals and families.
Children’s Basic Health Plan (CHP+) – covers children in families with incomes too high for Medicaid but too low for private insurance.
Long-Term Services and Supports – including nursing facilities, home health care, and hospice care.
Program Management – sets provider standards, eligibility rules, claims procedures, and monitors program compliance.
Rule Content in 10 CCR 2505
The Department’s rules cover:
Eligibility – criteria for individuals and families to qualify for Medicaid or CHP+.
Provider Standards – requirements for physicians, hospitals, pharmacies, and other providers to participate.
Covered Services – benefits such as physician visits, hospital care, dental care, vision care, prescription drugs, home health, and long-term care.
Claims and Payments – procedures for providers to submit claims and receive reimbursement.
Program Integrity – measures to prevent fraud, waste, and abuse.
Case Management and Coordination – ensuring clients receive appropriate care and services.
Key Points
CCR 1305 no longer exists; all current rules are in 10 CCR 2505.
The Department manages Medicaid and CHP+ programs, ensuring proper access, quality care, and compliance with state and federal law.
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