republic-os/legislation/us/states/co/2021a/hb-21-1227.md

---
type: "Bill"
title: "Medicaid Nursing Facilities Demonstration Of Need"
description: "The act requires the department of health care policy and financing (department) to develop, analyze, and enforce a demonstration of need for each new nursing facility provider seeking medicaid certification. The requirement does not apply to a nursing facility provider certified prior to June 30, 2021. The act allows the department to exempt nursing facilities with 5 or fewer medicaid beds from the current reimbursement methodology and instead require the facilities to be reimbursed at the statewide average rate.The act requires the medical services board to promulgate rules, no later than June 30, 2022, addressing the establishment of criteria to be used in determining a nursing facility provider's medicaid certification.(Note: This summary applies to this bill as enacted.)"
jurisdiction: "us/states/co"
legislature: "Colorado General Assembly"
session: "2021A"
identifier: "HB 21-1227"
citation: "Colorado HB 21-1227 (2021A)"
classification: ["bill"]
subjects: []
status: "enacted"
primary_sponsors: ["Barbara Kirkmeyer", "Matt Soper", "Rhonda Fields", "Susan Lontine"]
version_count: 9
action_count: 14
vote_count: 4
first_action: "2021-03-18T06:00:00+00:00"
last_action: "2021-05-27T06:00:00+00:00"
source: "openstates"
source_identifier: "ocd-bill/0e128c41-9b1a-4d68-9071-6a4ed4a1fb09"
source_url: "http://leg.colorado.gov/bills/hb21-1227"
source_hash: "1ed6e6ee7de23794054477fa286ed0f890ab8fb1273b86ed7817a39763bc01d2"
vintage: "2026-07-01"
source_snapshot: "https://data.openstates.org/daily/2026-07-01/public.pgdump"
retrieved_at: "2026-07-06"
confidence: "reported"
tags: ["legislation", "bill", "us-co"]
---

# Colorado HB 21-1227 (2021A) — Medicaid Nursing Facilities Demonstration Of Need

The act requires the department of health care policy and financing (department) to develop, analyze, and enforce a demonstration of need for each new nursing facility provider seeking medicaid certification. The requirement does not apply to a nursing facility provider certified prior to June 30, 2021. The act allows the department to exempt nursing facilities with 5 or fewer medicaid beds from the current reimbursement methodology and instead require the facilities to be reimbursed at the statewide average rate.The act requires the medical services board to promulgate rules, no later than June 30, 2022, addressing the establishment of criteria to be used in determining a nursing facility provider's medicaid certification.(Note: This summary applies to this bill as enacted.)

## Version chain

The bill's text revisions, in order — the diff chain from filing to enrollment.

1. **Committee Amendment** (committee substitute) — [source](http://leg.colorado.gov/sites/default/files/2021a_hb1227_s_fin_001.pdf)
2. **Engrossed (04/09/2021)** (committee substitute) — [source](http://leg.colorado.gov/sites/default/files/documents/2021A/bills/2021a_1227_eng.pdf)
3. **Final Act (05/19/2021)** (committee substitute) — [source](http://leg.colorado.gov/sites/default/files/documents/2021A/bills/2021a_1227_enr.pdf)
4. **Introduced (03/18/2021)** (committee substitute) — [source](http://leg.colorado.gov/sites/default/files/documents/2021A/bills/2021a_1227_01.pdf)
5. **PA1 (04/29/2021)** (committee substitute) — [source](http://leg.colorado.gov/sites/default/files/documents/2021A/bills/2021a_1227sfin_01.pdf)
6. **Reengrossed (04/12/2021)** (committee substitute) — [source](http://leg.colorado.gov/sites/default/files/documents/2021A/bills/2021a_1227_ren.pdf)
7. **Rerevised (05/04/2021)** (committee substitute) — [source](http://leg.colorado.gov/sites/default/files/documents/2021A/bills/2021a_1227_rer.pdf)
8. **Revised (05/03/2021)** (committee substitute) — [source](http://leg.colorado.gov/sites/default/files/documents/2021A/bills/2021a_1227_rev.pdf)
9. **Signed Act (05/27/2021)** (committee substitute) — [source](http://leg.colorado.gov/sites/default/files/2021a_1227_signed.pdf)

## Votes

- REPASS — **40–22** (pass) · lower
- BILL — **43–22** (pass) · lower
- BILL — **29–6** (pass) · upper
- CONCUR — **41–21** (pass) · lower

## Sponsors

- Barbara Kirkmeyer — primary (person)
- Matt Soper — primary (person)
- Rhonda Fields — primary (person)
- Susan Lontine — primary (person)

## Timeline

The legislative action history — every referral, reading, and vote.

- **2021-05-27T06:00:00+00:00** Governor Signed `executive-signature`
- **2021-05-21T06:00:00+00:00** Sent to the Governor `executive-receipt`
- **2021-05-19T06:00:00+00:00** Signed by the President of the Senate
- **2021-05-19T06:00:00+00:00** Signed by the Speaker of the House
- **2021-05-07T06:00:00+00:00** House Considered Senate Amendments - Result was to Concur - Repass
- **2021-05-05T06:00:00+00:00** House Considered Senate Amendments - Result was to Laid Over Daily
- **2021-05-04T06:00:00+00:00** Senate Third Reading Passed - No Amendments `passage, reading-3`
- **2021-05-03T06:00:00+00:00** Senate Second Reading Passed with Amendments - Committee `reading-2`
- **2021-04-28T06:00:00+00:00** Senate Committee on Finance Refer Amended - Consent Calendar to Senate Committee of the Whole `committee-passage`
- **2021-04-14T06:00:00+00:00** Introduced In Senate - Assigned to Finance `introduction`
- **2021-04-12T06:00:00+00:00** House Third Reading Passed - No Amendments `passage, reading-3`
- **2021-04-09T06:00:00+00:00** House Second Reading Passed - No Amendments `reading-2`
- **2021-04-06T06:00:00+00:00** House Committee on Health & Insurance Refer Unamended to House Committee of the Whole `committee-passage, referral-committee`
- **2021-03-18T06:00:00+00:00** Introduced In House - Assigned to Health & Insurance `introduction`

## Source

OpenStates / OpenCivicData bulk snapshot [2026-07-01](https://data.openstates.org/daily/2026-07-01/public.pgdump); origin `ocd-bill/0e128c41-9b1a-4d68-9071-6a4ed4a1fb09`. Confidence: reported (aggregated from official Colorado legislature records).