Colorado budget panel questions higher Medicaid ride fee amid rural access concerns

Colorado’s Joint Budget Committee on Monday pressed state officials over a proposed increase in the Medicaid non-emergency medical transportation pickup fee, warning that low rates could make rural rides harder to get.

The request would raise the pickup fee from $12.15 to $19.28. Officials said the increase would cost about $6.6 million in general fund dollars and $14.5 million in federal funds, or roughly $22 million total.

According to the public record of the July 6 hearing, department and budget officials said they did not believe the higher rate was necessary based on their analysis. They said they brought the request forward because the committee had asked for it and because changing rates could disrupt service before the state knows the real-world effects.

Lawmakers said providers in western Colorado, mountain communities, the eastern plains and other rural areas could stop offering trips if the payment structure stays too low. One version of the request would raise the fee to $20 instead of the $12.40 assumed in the Long Bill.

Committee members said that if a non-emergency ride is unavailable, patients could miss care or turn to more expensive emergency transportation, shifting rather than reducing costs.

The department said it was monitoring provider impacts and could return with another 1331 request if service begins to break down. Officials also said a rate change could be implemented quickly, including retroactively.

Monday’s discussion did not resolve the issue. But it highlighted a split between state staff, who said the current structure already pays mileage after pickup, and lawmakers who said the state’s analysis did not adequately reflect rural Colorado.