House Committee of Reference Report
Committee on Health & Human Services
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All text that will be removed from the bill will be indicated by strikethrough as follows:
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This is text that is removed from law. -
Text that is added to a bill will be indicated by either all capitals or bold & italic as follows:
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March 31, 2026
After consideration on the merits, the Committee recommends the following:
HB26-1328 be amended as follows, and as so amended, be referred to the Committee on Appropriations with favorable recommendation:
Page 1, Line 1Amend printed bill, page 4, line 17, strike "The state department" and
Page 1, Line 2substitute "The transportation broker".
Page 1, Line 3Page 4, line 18, strike "advisory board." and substitute "advisory
Page 1, Line 4board, which is composed of representatives of a cross-section
Page 1, Line 5of NEMT stakeholders, including members, transportation
Page 1, Line 6providers, health-care treatment providers, and disability
Page 1, Line 7advocates.".
Page 1, Line 8Page 5, strike lines 4 and 5 and substitute:
Page 1, Line 9"(f) Hospital and health system representatives, including
Page 1, Line 10entities involved in discharge planning and care transitions for
Page 1, Line 11members; and
Page 1, Line 12(g) A representative from the state department with
Page 1, Line 13knowledge and specialization in NEMT.".
Page 1, Line 14Page 5, line 26, before "department" insert "state".
Page 1, Line 15Page 6, line 9, strike "market;" and insert "market, except as
Page 1, Line 16allowed pursuant to subsection (11) of this section;".
Page 1, Line 17Page 7, line 7, strike "and".
Page 1, Line 18Page 7, line 9, strike "services." and substitute "services;
Page 1, Line 19(k) Require a transportation provider to maintain
Page 1, Line 20auditable electronic trip records that include, at a minimum,
Page 1, Line 21member pickup and drop-off locations; GPS location data with
Page 2, Line 1time stamps, when available; mileage traveled; driver and
Page 2, Line 2vehicle identification; and any other data required by the state
Page 2, Line 3department; and
Page 2, Line 4(l) Establish that members have a right to receive NEMT
Page 2, Line 5services that are accessible and appropriate to their individual
Page 2, Line 6medical and functional needs, including mobility and
Page 2, Line 7communication accommodations.".
Page 2, Line 8Page 7, after line 9 insert:
Page 2, Line 9"(11) The state department may impose trip caps or
Page 2, Line 10market-share restrictions on a transportation provider as
Page 2, Line 11corrective action as part of a corrective action plan based on
Page 2, Line 12a transportation provider's documented material performance
Page 2, Line 13deficiencies that are supported by objective measurable criteria
Page 2, Line 14applied on an individualized, proportional, and time-limited basis
Page 2, Line 15following prior written notice of the deficiencies and a
Page 2, Line 16meaningful opportunity to cure.".
Page 2, Line 17Renumber succeeding subsections accordingly.
Page 2, Line 18Page 7, line 10, before "The" insert "For the primary purpose of
Page 2, Line 19safety and driver accountability, each transportation provider
Page 2, Line 20shall implement and utilize a video recording system within each
Page 2, Line 21vehicle used to transport members.".
Page 2, Line 22Page 7, strike lines 15 through 17 and substitute "for billing
Page 2, Line 23purposes.".
Page 2, Line 24Page 7, line 25, after "section." insert "The procedures must be
Page 2, Line 25consistent with state and federal medicaid requirements and
Page 2, Line 26must not require payment for claims that do not meet applicable
Page 2, Line 27program integrity, documentation, or eligibility standards.".
Page 2, Line 28Page 8, strike line 7, and substitute "procedures adopted pursuant to
Page 2, Line 29subsection (14) of this section, except as necessary to address
Page 2, Line 30program integrity risks, including fraud, waste, or abuse, or to
Page 2, Line 31ensure compliance with state or federal law. In instances of
Page 2, Line 32fraud, waste, or abuse of NEMT services, the state department
Page 2, Line 33may provide immediate interim operational guidance if the state
Page 2, Line 34department includes the justification for the interim
Page 2, Line 35operational guidance in the guidance and provides reasonable
Page 2, Line 36advanced notice to affected transportation providers, unless
Page 3, Line 1immediate action is required to prevent ongoing fraud. If the
Page 3, Line 2state department takes immediate action, the actions must be:
Page 3, Line 3(a) Limited in scope and duration;
Page 3, Line 4(b) Include prompt written notice explaining the change;
Page 3, Line 5(c) Applied prospectively to the extent permitted by state
Page 3, Line 6and federal law and must not alter claims submitted prior to
Page 3, Line 7the effective date of the interim operational guidance, except as
Page 3, Line 8required to address fraud, waste, or abuse.".
Page 3, Line 9Page 8, after line 15 add:
Page 3, Line 10"(17) Nothing in this section entitles a provider to
Page 3, Line 11payment or limits the state department's authority to deny,
Page 3, Line 12recoup, or adjust claims in accordance with state or federal
Page 3, Line 13law.
Page 3, Line 14(18) Matters outside the scope of the board or that
Page 3, Line 15cannot be resolved among board members must be directed to
Page 3, Line 16the state department.".
Page 3, Line 17Page 9, line 18, strike "member demand" and substitute "members'
Page 3, Line 18medical needs".
Page 3, Line 19Page 11, line 18, strike "require" and substitute "encourage".
Page 3, Line 20Page 11, line 19, strike "more than" and substitute "at least".
Page 3, Line 21Page 11, line 22, strike "transportation requests." and substitute
Page 3, Line 22"and next-day transportation requests, including requests for
Page 3, Line 23urgent medical and behavioral health outpatient, specialty,
Page 3, Line 24and hospital visits; time-sensitive in-state and out-of-state
Page 3, Line 25transfers; and discharges from health-care facilities, when
Page 3, Line 26feasible, and shall not require advanced notice that would
Page 3, Line 27unreasonably limit access to medically necessary services.".
Page 3, Line 28Page 12, line 3, after "purposes." insert "The transportation broker
Page 3, Line 29may only provide members the option to request a specific
Page 3, Line 30provider after all service regions have been implemented.".
Page 3, Line 31Page 13, after line 20 add:
Page 3, Line 32"(19) (a) Transportation network companies, as defined in
Page 3, Line 33section 40-10.1-602, may provide NEMT services if:
Page 3, Line 34(I) The transportation provider originally assigned to
Page 4, Line 1complete a trip is unable to fulfill the assignment and no other
Page 4, Line 2enrolled transportation provider is available to complete the
Page 4, Line 3trip within the time frame necessary to ensure the member
Page 4, Line 4arrives at their appointment; or
Page 4, Line 5(II) No transportation provider is available to serve the
Page 4, Line 6member in the member's county or service area at the time the
Page 4, Line 7trip is requested.
Page 4, Line 8(b) Each use of a transportation network company in
Page 4, Line 9accordance with this subsection must be documented by the
Page 4, Line 10transportation broker in writing or an electronic records,
Page 4, Line 11including the reason for using the transportation network
Page 4, Line 12company, the reason a transportation provider was unable to
Page 4, Line 13complete the trip, and the date and time of the request. The
Page 4, Line 14transportation broker shall make the documentation available
Page 4, Line 15to the state department or its designee upon request for audit
Page 4, Line 16purposes.
Page 4, Line 17(c) The transportation network company providing NEMT
Page 4, Line 18services must comply with all applicable driver and vehicle
Page 4, Line 19safety requirements including video recording requirements
Page 4, Line 20established in section 25.5-1-802.
Page 4, Line 21(20) A licensed ambulance service provider is not subject
Page 4, Line 22to the requirements of this section and may provide NEMT
Page 4, Line 23services to members.".
Page 4, Line 24Page 14, lines 5 and 6, strike "billing or payment purposes." and
Page 4, Line 25substitute "routine billing purposes.".
Page 4, Line 26Page 14, line 8, after "purposes." insert "The state department may
Page 4, Line 27request video recordings for program integrity review without
Page 4, Line 28advanced notice to the transportation provider, provided that
Page 4, Line 29requests are narrowly tailored to specific issues under review.
Page 4, Line 30The use of video recordings must comply with applicable privacy
Page 4, Line 31and confidentiality requirements. Transportation providers are
Page 4, Line 32not required to retain or produce video recordings beyond the
Page 4, Line 33standard retention period established in their operating
Page 4, Line 34procedures. Absence of video recordings outside a retention
Page 4, Line 35period does not constitute noncompliance, and adverse action
Page 4, Line 36shall not be taken against a transportation provider on this
Page 4, Line 37basis.".
Page 4, Line 38Page 15, strike lines 6 through 27.
Page 4, Line 39Page 16, strike lines 1 through 27 and substitute:
Page 5, Line 1"(1) The state department shall, subject to available
Page 5, Line 2appropriations, audit transportation providers to ensure
Page 5, Line 3reimbursement is made only for trips performed by credentialed
Page 5, Line 4drivers operating credentialed vehicles pursuant to the rules
Page 5, Line 5adopted pursuant to section 25.5-1-802.
Page 5, Line 6(2) The state department may use data analytics,
Page 5, Line 7complaints by members, and other program integrity indicators
Page 5, Line 8to prioritize which transportation providers to audit. The state
Page 5, Line 9department is not required to annually perform audits but must
Page 5, Line 10perform audits as resources allow. An audit of a transportation
Page 5, Line 11provider may include a review of the following, as they relate
Page 5, Line 12to the provider:
Page 5, Line 13(a) Claims submitted;
Page 5, Line 14(b) The provider's policies and procedures;
Page 5, Line 15(c) Driver and vehicle credentials;
Page 5, Line 16(d) Compliance with state department and broker
Page 5, Line 17requirements;
Page 5, Line 18(e) Trip records;
Page 5, Line 19(f) Member grievances, complaints, and incidents,
Page 5, Line 20including their resolution; or
Page 5, Line 21(g) Other data necessary to evaluate safety, timeliness,
Page 5, Line 22and quality of the services provided by the provider.
Page 5, Line 23(3) The state department shall, subject to available
Page 5, Line 24appropriations, conduct audits of each transportation broker
Page 5, Line 25at least annually. The department may use third-party
Page 5, Line 26contractors to conduct audits of transportation brokers. An
Page 5, Line 27audit of a transportation broker may include a review of the
Page 5, Line 28broker's:
Page 5, Line 29(a) Policies and procedures;
Page 5, Line 30(b) Trip distribution among transportation providers,
Page 5, Line 31including analysis by geography and trip type;
Page 5, Line 32(c) Compliance with prohibitions on trip caps established
Page 5, Line 33in state department rule;
Page 5, Line 34(d) Compliance with driver, vehicle, and provider
Page 5, Line 35credentialing requirements established in state department
Page 5, Line 36rule; and
Page 5, Line 37(f) Response to member requests for specific
Page 5, Line 38transportation providers, including whether they were honored
Page 5, Line 39and, if not, the reason for denial.
Page 5, Line 40Strike page 17.
Page 5, Line 41Page 18, strike lines 1 and 2 and substitute:
Page 6, Line 1"SECTION 6. In Colorado Revised Statutes, 25.5-5-102, amend
Page 6, Line 2(1)(m); and add (1)(n), (3), (4), (5), and (6) as follows:
Page 6, Line 325.5-5-102. Basic services for the categorically needy -
Page 6, Line 4mandated services.
Page 6, Line 5(1) Subject to the provisions of subsection (2) of this section and
Page 6, Line 6section 25.5-4-104, the program for the categorically needy must include
Page 6, Line 7the following services as mandated and defined by federal law:
Page 6, Line 8(m) Federally qualified health centers; and
Page 6, Line 9(n) Nonemergency medical transportation services, as
Page 6, Line 10required by 42 U.S.C. 1396a(a)(4)(A).
Page 6, Line 11(3) The state department shall classify nonemergency
Page 6, Line 12medical transportation expenditures as medical services for all
Page 6, Line 13eligible populations.
Page 6, Line 14(4) The state department shall, to the extent permitted by
Page 6, Line 15federal law, ensure that all eligible nonemergency medical
Page 6, Line 16transportation expenditures classified as medical services
Page 6, Line 17receive available federal financial participation.
Page 6, Line 18(5) On November 1, 2026, and November 1, 2027, the state
Page 6, Line 19department shall submit a report to the joint budget committee
Page 6, Line 20and the Colorado healthcare affordability and sustainability
Page 6, Line 21enterprise board about state savings expected or received as a
Page 6, Line 22result of classifying nonemergency medical transportation as
Page 6, Line 23a medical service. The report must include, at a minimum:
Page 6, Line 24(a) The total amount of nonemergency medical
Page 6, Line 25transportation expenditures classified as medical services;
Page 6, Line 26(b) The federal financial participation as a result of the
Page 6, Line 27classification;
Page 6, Line 28(c) A description of actions taken to implement subsection
Page 6, Line 29(3) of this section, including state plan amendments, waivers, or
Page 6, Line 30program changes;
Page 6, Line 31(d) Identification of remaining nonemergency medical
Page 6, Line 32transportation expenditures not yet classified as medical
Page 6, Line 33services and the barriers to the classification; and
Page 6, Line 34(e) Recommendations for additional statutory or
Page 6, Line 35administrative changes necessary to maximize federal financial
Page 6, Line 36participation.
Page 6, Line 37(6) Subsection (5) of this section repeals, effective
Page 6, Line 38January 1, 2028.".
Page 6, Line 39Renumber succeeding sections accordingly.