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SB 25-229

Reimbursement for Community Health Workers

2025 Regular Session Introduced by Judy Amabile and 29 co-sponsors

Delays Medicaid reimbursement for community health workers to Jan 1, 2026, pending state funding and any federal authorization; reports pushed to Jan 31, 2027.

Governor Signed
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Bill Summary · SB 25-229

SB 25-229 — Reimbursement for Community Health Workers

Status: Governor signed (May 20, 2025) | Introduced: March 31, 2025

Main purpose

SB 25-229 modifies the timetable and funding conditions for Medicaid reimbursement of services provided by community health workers (CHWs). Rather than immediate implementation under prior law, the enacted bill defers Medicaid reimbursement until January 1, 2026 and makes that reimbursement subject to available appropriations and any required federal authorization. The bill also delays related reporting requirements.

Key provisions

  • Delays the start of Medicaid reimbursement for CHW services to January 1, 2026, and conditions reimbursement on (a) available state appropriations and (b) receipt of any necessary federal authorization. (Adds subsection (11) to statute 25.5-5-334.)
  • Moves the program reporting deadline to January 31, 2027 (for HCPF’s SMART Act hearing) — delaying the reporting requirement by one year.
  • Includes adjustments to FY 2025-26 appropriations for the Department of Health Care Policy and Financing (HCPF) to reflect the delayed/conditional start of CHW reimbursement.
  • Effective date: the Act took effect on signature (May 20, 2025).

Fiscal impact (FY 2025‑26)

  • Enacted/final Legislative Council Staff estimate: net decrease in state expenditures of $5,713,346 in FY 2025‑26 (one-time, available only in FY 2025‑26).
    • General Fund: -$1,364,558
    • Health Care Affordability & Sustainability Cash Fund: -$342,750
    • Federal funds: -$4,006,038
  • Appropriation change to HCPF in FY 2025‑26 mirrors these savings. Earlier bill drafts reflected larger savings (up to ~$11.7M) but the final fiscal note reflects the $5.7M reduction.

Who is affected

  • Community health workers and organizations that employ them: reimbursement under Medicaid will not begin as originally scheduled (mid‑2025) and will depend on future appropriations and federal approval.
  • Department of Health Care Policy and Financing: implementation timeline, reporting schedule, and FY 2025‑26 appropriations are adjusted.
  • Medicaid (Colorado Medical Assistance Program) members and community-based organizations relying on CHW services may experience a delayed expansion of covered CHW services.

Timeline / procedural notes

  • Introduced in Senate (Mar 31, 2025); passed both chambers with amendments; sent to Governor May 2, 2025; signed by Governor May 20, 2025.
  • Implementation (reimbursement) begins Jan 1, 2026, subject to funding and federal authorization.
  • HCPF SMART Act report due Jan 31, 2027.

Additional context

  • SB 25-229 modifies earlier legislative actions implementing Senate Bill 23-002, which had required HCPF to cover CHW services. The enacted bill does not permanently prohibit CHW reimbursement but delays and conditions implementation.

Compiled from official sources — confirm details with the bill’s official record.

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