Colorado § 25.5-5-329 - Family planning services - federal authorization - rules - definitions.

§ 25.5-5-329. Family planning services - federal authorization - rules - definitions.

(1) As used in this section, unless the context otherwise requires:

(a) "Eligible individual" means an individual who is not pregnant and whose income does not exceed the state's current effective income level for pregnant women under the children's basic health plan established pursuant to article 8 of title 25.5, and whose income is adjusted for family size based on the methodology allowed under federal law to count the applicant as a household of two in addition to any other household members, and who meets other requirements under federal law.

(b) "Family-planning-related services" means services provided in a family planning setting as part of or as a follow-up to a family planning visit, including:

(I) Medically necessary evaluations or preventive services, such as tobacco utilization screening, counseling, testing, and cessation services;

(II) Cervical cancer screening and prevention;

(III) Diagnosis or treatment of a sexually transmitted infection or sexually transmitted disease and medication and supplies to prevent a sexually transmitted infection or sexually transmitted disease; and

(IV) Any other medical diagnosis, treatment, or preventive service that is routinely provided pursuant to a family planning visit, including abortion care.

(c) "Family planning services" means all services covered by the federal Title X family planning program, regardless of an individual's age, sex, or gender identity, or the age, sex, or gender identity of the individual's partner, including but not limited to:

(I) All contraception, as defined in section 2-4-401 (1.5);

(II) Health-care and counseling services focused on preventing, delaying, or planning for a pregnancy;

(III) Follow-up visits to evaluate or manage problems associated with contraceptive methods;

(IV) Sterilization services, regardless of an individual's sex; and

(V) Basic fertility services.

(d) "Presumptive eligibility" has the same meaning as defined in section 25.5-5-204 (1).

(2) (a) No later than January 31, 2022, the state department shall seek federal authorization through an amendment to the state medical assistance plan to provide family planning services to eligible individuals.

(b) The state plan amendment must:

(I) Not impose age, sex, or gender identity limitations on eligible individuals; and

(II) Include a process by which an eligible individual may be presumptively eligible to receive family planning services.

(3) Upon approval of the state plan amendment, the state department shall:

(a) Unless requested otherwise by the eligible individual, ensure that an eligible individual receives a one-year supply of self-administered hormonal contraceptives at one time as permitted by the eligible individual's prescription; and

(b) Collaborate with the state insurance marketplace, health-care consumer advocates, and other interested stakeholders to educate eligible individuals about all available health-care coverage options and encourage eligible individuals to enroll in full health insurance coverage through available sources, including the medical assistance program, the children's basic health plan, a public benefit corporation, or the state insurance marketplace.

(4) The state department shall promulgate any rules necessary to implement this section, including rules establishing the specific family-planning-related services and family planning services identified in subsections (1)(b) and (1)(c) of this section. Prior to promulgating the rules, the state department shall engage in a stakeholder process that attempts to include individuals who have received family planning services through the state's medical assistance program or the children's basic health plan, representatives of consumer advocacy organizations, and family planning providers. The stakeholders must be diverse with regard to race, ethnicity, immigration status, age, ability, sexual orientation, gender identity, or geographic region of the state.

Source: L. 2021: Entire section added, (SB 21-025), ch. 432, p. 2855, § 2, effective September 7. L. 2025: (1)(b)(IV) amended, (SB 25-183), ch. 97, p. 444, § 4, effective January 1, 2026.

Cross references: For the legislative declaration in SB 21-025, see section 1 of chapter 432, Session Laws of Colorado 2021.