Colorado moves ahead with phased Medicaid ride overhaul as NEMT bill awaits final signature record

Colorado is moving ahead with a phased overhaul of Medicaid nonemergency medical transportation even though the public legislative record reviewed for this story did not yet show final action by Gov. Jared Polis on the enrolled bill tied to the change.

The Colorado General Assembly's bill page shows House Bill 26-1328 was sent to Polis on June 3. The enrolled bill says it would take effect July 1 if signed, and would make nonemergency medical transportation, or NEMT, a mandated Medicaid service under Colorado law rather than an optional administrative service.

The bill also assumes the state could draw about $21 million in additional federal funds in fiscal year 2026-27 by classifying eligible NEMT spending as medical services.

Meanwhile, the Department of Health Care Policy and Financing says it is transitioning to a single statewide NEMT broker model with MediDrive in two phases. Under the department's posted timeline, Phase 1 begins July 1 in the nine-county Denver metro area — Adams, Arapahoe, Boulder, Broomfield, Denver, Douglas, Jefferson, Larimer and Weld counties — while Phase 2 would expand to the rest of the state in fall 2026.

That staggered rollout is central to the bill. HB26-1328 would require any brokered NEMT program to be implemented one region at a time, with the next region delayed until the prior one is fully operating. The bill defines full implementation to include working technology for scheduling, eligibility checks, trip assignment, provider payment and customer support; enough time for providers to finish onboarding; a sufficient provider network; and state verification that payments and customer support are functioning.

In a May 7 operational memo, HCPF said members in the metro rollout area must contact MediDrive for rides for appointments on or after July 1. The department said MediDrive would make "all efforts" to transfer existing scheduled rides from the prior Transdev system, while advising members to confirm those rides themselves. The memo also says the full statewide go-live date for Phase 2 is not yet confirmed.

For providers outside metro Denver, HCPF said in the same memo they should not enroll with or seek credentialing from MediDrive yet, because transition resources are focused first on the nine-county area. Existing providers in the other 55 counties are expected to begin contracting in September or when the department announces the next phase, and can keep receiving trip requests and billing HCPF directly until statewide implementation takes effect.

HB26-1328 would add statewide guardrails meant to reduce service gaps during that transition. The bill says brokers must publish a contingency plan for system outages or other failures, provide provider training and technical support at least 90 days before rollout in a region, give providers software at no cost, and allow direct state billing in limited circumstances during implementation or if a broker is terminated. It also says broker rollout cannot limit member access or create service gaps during implementation.

Beyond the broker transition, the bill would require the state, working with an advisory board, to adopt rules on driver, vehicle and provider credentialing; claims and payment procedures; complaint processes; member accommodations; and digital trip-dispatch data collection. It would also prohibit trip caps and market-share restrictions except as corrective action for documented performance problems.

Some of the most operationally sensitive provisions involve verification, oversight and privacy. The bill would require the broker, or providers where there is no broker, to verify member eligibility in real time when a ride is requested. It would require annual audits of each transportation broker, while provider audits would happen as resources allow. And for larger fleets, it would require two-way video dash cameras and trip recording systems, while directing HCPF to set policies on storage, access, retention and deletion of recordings and barring routine eligibility checks that require showing a member ID card on camera.

HCPF's transition materials indicate some implementation details are still to come. The department says MediDrive will handle provider credentialing, network management, trip scheduling, member support, reimbursement, auditing and advisory-board oversight, and a provider bulletin says routine roster maintenance and credentialing with MediDrive will begin after July 1, 2026.

HCPF has framed the shift as a way to create a consistent statewide process, improve safety and complaint resolution, and strengthen program integrity. For Medicaid members who rely on rides to dialysis, behavioral health visits, primary care, hospital discharges and other appointments, the practical question is whether the new system can add those controls without missed rides or payment disruptions.

What remains unclear from the current public record is whether Polis has signed HB26-1328, when HCPF expects to publish the rules required by the bill, and whether the department will need to adjust any part of the rollout to match provider readiness, customer-support capacity or privacy-compliant video and eligibility systems.