The Tort and Casualty Unit is required by state and federal law to take all reasonable measures to identify legally responsible parties and to seek reimbursement when the Department has paid claims on behalf of a Health First Colorado (Colorado's Medicaid Program) member. These circumstances commonly include payments, awards, or settlements from auto, homeowners' and malpractice insurance carriers intended to compensate the members for their injuries. Health First Colorado has an automatic lien by statute in these circumstances.
Health First Colorado Members
To report an incident or accident, submit a Case Information Form that includes the following case information:
- Injured party's name
- Health First Colorado ID or Social Security Number
- Date of birth
- Date of incident or accident
- Type of incident or accident
- Nature of the injuries
- Contact information of the insurance company and claim number
- Contact information for your attorney
- If you have received a Medical Services Questionnaire (MSQ)
Attorneys
To notify the Department of a claim on behalf of a Health First Colorado member, the Department must receive:
- A Letter of Representation that includes the case information elements shown above; and,
- A HIPAA-compliant Authorization Form
Insurance Company Representatives
When providing notice of a Health First Colorado member's claim, include the case information elements described above or provide a Case Information Form.
Contact the Tort & Casualty Unit
Email: Tort.Casualty@state.co.us
Mail: Colorado Department of Health Care Policy and Financing
Attention: Tort & Casualty Unit
303 E. 17th Avenue, Suite 1100
Denver, CO 80203
Fax: 303-866-3552
Online portal access for law firms and insurance carriers.
Reporting cases and document submission are available through an online portal managed by our partner. Click here to obtain information regarding SOLARIS.
Required notice
Under Colorado State Law, failure to comply with providing notice of an action within fifteen (15) days or failure by a party to a judgment award or settlement to satisfy Health First Colorado's lien shall make the recipient, legal guardian, executor, administrator, attorney, or other representative liable for the entire amount of medical assistance furnished to or on behalf of the recipient for the injuries that gave rise to the action or claim. Section 25.5-4-301(6), C.R.S.
If the case and its associated documents were submitted through the online portal, by fax or email, this meets the statutory reporting requirement, and documents do not need to be mailed to the Department. We request that cases and documents are submitted through one reporting option to avoid duplication of documentation.