Colorado § 25.5-1-210 - Centralized member integrity service - transition plan - member integrity service fund.

§ 25.5-1-210. Centralized member integrity service - transition plan - member integrity service fund.

(1) The state department, in coordination with the department of human services and the department of early childhood, shall contract with a single county department to administer the centralized member integrity service. Pursuant to the terms of the contract, the county administering the centralized member integrity service may subcontract with other counties to fulfill its obligations. The centralized member integrity service must be operational and utilized on July 1, 2027.

(2) The centralized member integrity service is responsible for conducting fraud investigations for fraud claims, fraud recovery, fraud dispute resolution conferences, and state-level fraud hearings, intentional program violation waivers, and criminal court proceedings, concerning program eligibility or fraud affecting electronic benefits transfer cards or similar credit-card-type devices through which food stamp or cash assistance benefits may be delivered.

(3) The centralized member integrity service must be utilized for the following public assistance programs:

(a) The medical assistance program established pursuant to articles 4 to 6 of this title 25.5;

(b) The children's basic health plan established pursuant to article 8 of title 25.5;

(c) The supplemental nutrition assistance program established pursuant to part 3 of article 2 of title 26;

(d) The Colorado child care assistance program established pursuant to part 1 of article 4 of title 26.5;

(e) The temporary assistance for needy families program, as defined in section 26-2-703; and

(f) Adult financial programs established pursuant to part 1 of article 2 of title 26, which include the old age pension, aid to the needy disabled, and home care allowance.

(4) (a) By January 1, 2027, the state departments shall collaborate with the county departments to create a transition plan that must be used to transition counties to the centralized member integrity service.

(b) The transition plan must outline the parameters for county department fraud and program integrity functions, including fraud claims, fraud recovery, fraud dispute resolution conferences, and state-level fraud hearings, related to the programs detailed in subsection (3) of this section.

(c) The transition plan must include a phased transition process, which begins July 1, 2027, and concludes with all fraud and program integrity functions being conducted through the centralized member integrity service by July 1, 2028.

(d) A county department shall continue to conduct and complete fraud program integrity functions in accordance with all applicable state and federal laws and regulations until the county department has transitioned to the centralized member integrity service in accordance with the transition plan. All fraud and program integrity functions, including open investigations, unworked referrals, recoveries, fraud dispute resolution conferences, state-level fraud hearings, intentional program violation waivers, and criminal court proceedings, must be transferred to the centralized member integrity service by July 1, 2028.

(5) (a) The centralized member integrity service cash fund is created in the state treasury. The fund consists of recouped money by the state department that results from member fraud investigations and any other money that the general assembly may appropriate or transfer to the fund. Subject to annual appropriation by the general assembly, money in the fund may be used for the administration of centralized member integrity service functions as required by this section, including contractor expenses.

(b) The state treasurer shall credit all interest and income derived from the deposit and investment of money in the centralized member integrity service cash fund to the fund.

Source: L. 2026: Entire section added, (HB 26-1429), ch. 374, p. 2283, § 2, effective June 4.

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

PART 3

MEDICAL SERVICES BOARD