Colorado § 25.5-1-115 - Locating violators - recoveries - repeal.

§ 25.5-1-115. Locating violators - recoveries - repeal.

(1) The executive director of the state department, and a county contracted to administer the centralized member integrity service pursuant to section 25.5-1-210, or district attorneys may request and must receive from departments, boards, bureaus, or other agencies of the state or any of its political subdivisions, and the same are authorized to provide, the assistance and data as will enable the state department, county departments, and a county contracted to administer the centralized member integrity service pursuant to section 25.5-1-210 to properly carry out their powers and duties to locate and prosecute a person who has fraudulently obtained medical assistance under this title 25.5. Records established pursuant to the provisions of this section are available only to the state department, the department of human services, the county departments, a county contracted to administer the centralized member integrity service pursuant to section 25.5-1-210, the attorney general, and the district attorneys, county attorneys, and courts having jurisdiction in fraud or recovery proceedings or actions.

(2) (a) All departments and agencies of the state and local governments shall cooperate in the location and prosecution of a person who has fraudulently obtained medical assistance under this title 25.5, and, on request of the county board, the county director, the state department, or the district attorney of any judicial district in this state, shall supply all information on hand relative to the location, employment, income, and property of the persons, notwithstanding any other provision of law making such information confidential, except the laws pertaining to confidentiality of any tax returns filed pursuant to law with the department of revenue. The department of revenue shall furnish at no cost to inquiring departments and agencies information necessary to effectuate the purposes of this article 1. The procedures used to request and provide this information must be established by rule of the state department. The state department or county departments shall use the information only for the purposes of administering medical assistance under this title 1, and the district attorney shall use it only for the prosecution of persons who have fraudulently obtained medical assistance under this title, and shall not use the information, or disclose it, for any other purpose. The state department shall utilize the centralized member integrity service, established pursuant to section 25.5-1-210, to conduct fraud investigations, fraud claims, fraud recovery, fraud dispute resolution conferences, state-level hearings, intentional program violation waivers, and criminal court proceedings concerning member eligibility in the medical assistance program.

(b) (I) Whenever the state department, a county department contracted to administer the centralized member integrity service pursuant to section 25.5-1-210, or a district attorney for the state department, or the state department on behalf of a county department, recovers any amount of fraudulently obtained medical assistance funds, the federal government is entitled to a share proportionate to the amount of federal funds paid unless a different amount is otherwise provided by federal law, the state is entitled to a share proportionate to the amount of state funds paid and additional amounts of federal funds recovered as provided by federal law, and the county department is entitled to a share proportionate to the amount of county funds paid unless a different amount is provided pursuant to federal law or this section.

(II) (A) Whenever a county department, a county board, a district attorney, a county contracted to administer the centralized member integrity service pursuant to section 25.5-1-210, or a state department on behalf of a county department recovers any amount of fraudulently obtained public assistance funds in the form of assistance payments, the recovered funds must be deposited in the county social services fund until the county has fully transitioned to utilizing the centralized member integrity service pursuant to section 25.5-1-210. When the county has fully transitioned to utilizing the centralized member integrity service, the county shall notify the state department of the full transition and the county shall transfer the money in the county social services fund to the state treasurer, who shall credit the money to the centralized member integrity service cash fund created in section 25.5-1-210. After the county has fully transitioned to utilizing the centralized member integrity service, an entity that recovers, on behalf of a county, an amount of fraudulently obtained public assistance funds shall transfer the recovered funds to the state treasurer, who shall credit the money to the centralized member integrity service cash fund. The federal government is entitled to a share proportionate to the amount of federal funds paid, unless a different amount is provided for by federal law, the state is entitled to a share proportionate to one-half the amount of state funds paid, and the county is entitled to a share proportionate to the amount of county funds paid and, in addition, a share proportionate to one-half the amount of state funds paid.

(B) Whenever a county department, a county board, a district attorney, a county contracted to administer the centralized member integrity service pursuant to section 25.5-1-210, or a state department on behalf of a county department recovers any amount of fraudulently obtained medical assistance, the recovered funds must be deposited in the county social services fund until the county has fully transitioned to utilizing the centralized member integrity service pursuant to section 25.5-1-210. When the county has fully transitioned to utilizing the centralized member integrity service, the county shall notify the state department of the full transition and the county shall transfer the money in the county social services fund to the state treasurer, who shall credit the money to the centralized member integrity service cash fund created in section 25.5-1-210. After the county has fully transitioned to utilizing the centralized member integrity service, an entity that recovers, on behalf of a county, an amount of fraudulently obtained medical assistance funds shall transfer the recovered funds to the state treasurer, who shall credit the money to the centralized member integrity service cash fund. The federal government is entitled to a share proportionate to the amount of federal funds paid, unless a different amount is provided for by federal law, and the county is entitled to the remaining funds.

(C) This subsection (2)(b)(II) is repealed, effective July 1, 2028.

(III) (A) Beginning July 1, 2028, whenever a county department, a county board, a district attorney, a county contracted to administer the centralized member integrity service pursuant to section 25.5-1-210, or a state department on behalf of a county department recovers any amount of fraudulently obtained public assistance funds in the form of assistance payments, the fraudulent funds shall be transferred to the state treasurer, who shall credit the money to the centralized member integrity service cash fund created in section 25.5-1-210. The federal government is entitled to a share proportionate to the amount of federal funds paid, unless a different amount is provided for by federal law, the state is entitled to a share proportionate to one-half the amount of state funds paid, and the county is entitled to a share proportionate to the amount of county funds paid and, in addition, a share proportionate to one-half the amount of state funds paid.

(B) Beginning July 1, 2028, whenever a county department, a county board, a district attorney, a county contracted to administer the centralized member integrity service pursuant to section 25.5-1-210, or a state department on behalf of a county department recovers any amount of fraudulently obtained medical assistance, an amount from an individual for the value of the medical assistance benefits the individual fraudulently obtained shall be transferred to the state treasurer, who shall credit the money to the centralized member integrity service cash fund created in section 25.5-1-210. The federal government is entitled to a share proportionate to the amount of federal funds paid, unless a different amount is provided for by federal law, and the county is entitled to the remaining funds.

(3) and (4) (Deleted by amendment, L. 2026.)

(5) The state portion of the money recouped by the state department pursuant to this section must be deposited into the centralized member integrity service cash fund created in section 25.5-1-210.

Source: L. 2006: Entire part amended, p. 1788, § 1, effective July 1. L. 2012: (2)(b)(II) amended, (SB 12-060), ch. 166, p. 578, § 3, effective August 8. L. 2024: (3) amended, (SB 24-176), ch. 152, p. 616, § 3, effective August 7. L. 2026: Entire section amended, (HB 26-1429), ch. 374, p. 2308, § 8, effective June 4.

Editor's note: This section was contained in a 2006 act that amended this part, resulting in the addition of this section.

Cross references: For the legislative declaration in HB 26-1429, see section 1 of chapter 374, Session Laws of Colorado 2026.