Medicaid Transition to Community Request Form

Community options counseling referrals submitted using this form will be sent to agencies contracted with the Colorado Department of Health Care Policy and Financing (HCPF) to conduct In-Reach counseling related to transitioning back into the community. Agencies are required to meet with Medicaid Members within 10 business days of receiving a referral. If the Member has not been contacted within 10 business days of this form's submission or if you have any questions or concerns about this referral, please email hcpf_clo_inreach@state.co.us.

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