Colo. Rev. Stat. § 25.5-5-331
Federally qualified health center - reimbursement - rules.
Effective May 27, 2025L. 2021: Entire section added, (HB 21-1275), ch. 470, p. 3379, § 2, effective September 7. L. 2025: Entire section amended, (HB 25-1288), ch. 260, p. 1332, § 3, effective May 27.
- (1) Costs associated with services provided by clinical pharmacists through a federally qualified health center, as defined in the federal Social Security Act, 42 U.S.C. sec. 1395x (aa)(4), are considered allowable costs for the purpose of a federally qualified health center's cost report and must be included in the calculation of the reimbursement rate for a patient visit at a federally qualified health center.
(2)
(a) A federally qualified health center, as defined in the federal Social Security Act, 42 U.S.C. sec. 1395x (aa)(4), may establish a separate subsidiary company for the purpose of providing fee-for-service services outside of the federally qualified health center's standard cost report if:
- (I) The subsidiary is providing fee-for-service services that have historically been provided and reimbursed on a fee-for-service basis; and
- (II) The state department determines that the subsidiary's reimbursements would be budget neutral.
- (b) Upon receiving any necessary federal authorization, the state department shall reimburse a subsidiary company, as described in subsection (2)(a) of this section, on a fee-for-service basis for services that are eligible for fee-for-service reimbursement.
- (c) A subsidiary that receives reimbursement pursuant to this section may pass through money received from the reimbursement directly to the federally qualified health center operating as the subsidiary's parent corporation.
(d)
- (I) The state department shall exclude all costs associated with a subsidiary company established pursuant to this subsection (2) from the calculation of a federally qualified health center's reimbursement rates.
- (II) The state department shall require a federally qualified health center that establishes a separate subsidiary company pursuant to this subsection (2) to include the costs associated with the subsidiary in its cost report that is necessary to calculate reimbursement rates.
- (3) The state department shall promulgate rules to implement the provisions of this section.
Source: L. 2021: Entire section added, (HB 21-1275), ch. 470, p. 3379, § 2, effective September 7. L. 2025: Entire section amended, (HB 25-1288), ch. 260, p. 1332, § 3, effective May 27.
Cross references: For the legislative declaration in HB 25-1288, see section 1 of chapter 260, Session Laws of Colorado 2025.