CCB to CMA: What Case Management Redesign Changes for Colorado Providers

Short answer: Since July 1, 2024, Medicaid case management for Colorado's home- and community-based services has been done by contracted Case Management Agencies (CMAs): one per defined service area, serving every waiver and every age group. HCPF's directory lists 15 of them. Community Centered Boards still exist, but as a separate designation for local, non-Medicaid resources for people with intellectual and developmental disabilities. Being a CCB no longer makes an agency anyone's case manager. For a provider agency, the practical changes are these: find the CMA by the member's county, expect the CMA's case manager to write the Person-Centered Support Plan and submit the prior authorization request, sign the Statement of Agreement before services start, and confirm an approved PAR before you deliver or bill. Behind all of it is one rule: the organization that manages a member's case should not also deliver that member's services.

What Case Management Redesign is

Case Management Redesign (CMRD) comes from HB21-1187, signed on May 1, 2021 and codified at C.R.S. 25.5-6-1701 to 1709. Its core provisions took effect on July 1, 2024. The statute defines a case management agency as "a public or private not-for-profit or for-profit organization contracted with the State of Colorado to provide case management services and activities," and it replaced the terms "community-centered board" and "single entry point agency" with "case management agency" for case management purposes.

The reason was federal. Under 42 CFR 441.301(c)(1)(vi), providers of HCBS for an individual, or anyone with an interest in or employed by such a provider, "must not provide case management or develop the person-centered service plan" for that individual. HCPF lists "achieving federal compliance" among the redesign's aims, next to simpler access, stability, quality and accountability.

Before the redesign, the waiver a person applied for decided which agency they went to. Single Entry Point agencies handled the waivers for people without an intellectual or developmental disability (BI, CLLI, CMHS, CIH and EBD). Community Centered Boards handled the I/DD waivers (CES, CHRP, DD and SLS). Private case management agencies handled children with significant medical needs (CHCBS). In its November 2022 budget request, HCPF counted 24 SEP agencies and 20 CCBs.

The handover ran in three phases, according to HCPF's July 2024 report to the Joint Budget Committee: November 2023 covered nine defined service areas, March 2024 seven, and July 1, 2024 the last four.

Before and after, side by side

Section numbers refer to 10 CCR 2505-10, the 8.7000 series, in the version effective August 14, 2026.

What a Community Centered Board is now

The CCB did not disappear. It changed jobs. Under § 8.7300, a CCB is the agency, "in addition to the Case Management Agency, responsible for leveraging local and regional resources to meet unmet needs for individuals with Intellectual and Developmental Disabilities (IDD) and their families." In practice that means locally generated funding, such as a county mill levy, which sits outside Medicaid.

Three details in the rule matter. Designation is based on one factor only: prior CCB designation. It is valid for up to ten years. And if no agency requests it for a defined service area, CCB designation for that area is discontinued. HCPF's directory tells residents of counties without a CCB to ask their CMA about local resources.

The two roles now often sit with different organizations. In the directory, six of the 15 CMAs also carry the CCB label in at least one county. The other nine are county agencies, a council of local governments and a health plan.

Conflict-free: the rule behind every change

Colorado's rule puts it in one sentence (§ 8.7100.A.9): members in long-term services and supports programs or HCBS waivers "must receive direct Home and Community-Based Services and Case Management from separate entities." A CMA must be separate from the delivery of direct services "paid for by any payer for the same individual" it case-manages (§ 8.7201.A.3.c).

There is one exception. HCPF can grant a CMA a Conflict-Free Case Management Waiver, formerly called the rural exception, when no other willing and qualified provider has capacity (§ 8.7201.A.4). It comes with conditions: the CMA reports annually, keeps its direct-service and case-management functions administratively separate, including staff, and documents that members were offered a choice of provider.

The rule also reaches individuals. HCPF's case management Q&A says case managers who also work for provider agencies may not provide case management and direct services to the same member.

What changes for your agency day to day

Who you deal with. Service and support coordination is the CMA's responsibility (§ 8.7202.J). Intake, screening and referral run through the CMA in the member's defined service area. The directory by county is the place to start.

The plan and the authorization. The CMA's case manager builds the Person-Centered Support Plan and submits the PAR within one calendar month of the eligibility determination. Every unit of service requested has to appear on the plan (§ 8.7202.CC). If the plan changes, a revised PAR follows.

Your signature comes first. HCPF's Q&A says the provider agency signs the Statement of Agreement as its attestation that it will provide the service, and "services may not start until the Provider Agency's signature is obtained." The case manager must send the plan documents to every provider serving under the plan within 15 working days after the plan is completed.

Before you deliver or bill. Your own rule is § 8.7407.A: verify member eligibility before delivering services, and verify that a PAR "has been approved for the services in question, prior to service provision and claim submission."

Member choice. The case manager documents that the member was told of the right to choose among all available qualified providers (§ 8.7202.X). Members can ask for a new case manager, and can ask to be served by a CMA outside their area if that CMA agrees and the Department oversees it (§ 8.7202.N).

Incidents. Your reports still go to the member's case manager, now at the CMA. We covered those deadlines in PASA requirements in Colorado.

What we could not confirm

• Whether the redesign is finished. HCPF has not published a statement that CMRD is complete. Its pages still describe the Colorado Single Assessment and the new Person-Centered Support Plan as rolling out.
• Current directory details. The directory is dated July 1, 2025. It labels The Resource Exchange "CMA and CCB" in its county entries but leaves it off the CCB list. Check your county's entry and call before you rely on a contact.
• Who holds a waiver. We found no public list of the CMAs that hold a Conflict-Free Case Management Waiver.
• Where PARs are entered. The most recent HCPF statement on which system case managers use for PARs dates from 2023.

Where OutcomeGrid fits

The redesign moved the plan and the authorization to someone outside your agency. Your record still has to match them. OutcomeGrid keeps each member's authorized services next to the service notes, the verified visits and the claims built from them, so a unit delivered beyond what the PAR allows is flagged before it is billed. The documents a CMA sends you can sit on the member's record, alongside incident reports addressed to the right case manager.

See how this works for a Colorado CCB or CMA on our Community Centered Boards page, or for provider agencies on I/DD HCBS waiver software.

Sources: HB21-1187 (C.R.S. 25.5-6-1701 to 1709); 10 CCR 2505-10, Section 8.7000 (Colorado Secretary of State, version effective August 14, 2026); 42 CFR 441.301(c)(1)(vi); HCPF's Case Management Agency directory (updated July 1, 2025), Case Management Q&A (updated July 22, 2026), Care and Case Management System page, FY 2023-24 budget request R-13 and July 2024 report to the Joint Budget Committee. This article is general information, not legal advice.