2025 HB23-1295 Quarterly Provider Advisory Board Meeting 12/11/25
Health First Colorado Provider Advisory Board (RAC program) · January 14, 2026
Provider advisory board discussed a planned small pilot of DRG audits that will combine clinical guideline validation with review of resources used; HMS outlined five automated audit scenarios (duplicate behavioral-health claims, pediatric behavioral therapy place-of-service/provider-type/ordering-provider errors, and NEMT trips) and providers asked about evidence burdens and rebilling. CMS/state rule changes and website updates were also reviewed.
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