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Feb. 26, 2026 Get Citation Alerts Download PDF Add Note

Jefferson v. Colo Dept of Healthcare

Colorado Court of Appeals

• Citations: None known
• Docket Number: 25CA1046

• Precedential Status: Non-Precedential

• Opinion

• Authorities (9)

• Cited By (0)

• Summaries (0)

• Similar Cases (0)

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Combined Opinion

25CA1046 Jefferson v Colo Dept of Healthcare 02-26-2026

COLORADO COURT OF APPEALS

Court of Appeals No. 25CA1046
City and County of Denver District Court No. 24CV778
Honorable Jon J. Olafson, Judge

Demetrius Lamont Jefferson,

Plaintiff-Appellant,

v.

Colorado Department of Healthcare Policy and Financing,

Defendant-Appellee.

JUDGMENT AFFIRMED

Division VI
Opinion by JUDGE SCHOCK
Grove and Yun, JJ., concur

NOT PUBLISHED PURSUANT TO C.A.R. 35(e)
Announced February 26, 2026

Demetrius Lamont Jefferson, Pro Se

Philip J. Weiser, Attorney General, Joan E. Smith, Senior Assistant Attorney
General, Joshua Woolf, Assistant Attorney General, Denver, Colorado, for
Defendant-Appellee
¶1 Plaintiff, Demetrius Lamont Jefferson, appeals the dismissal of

his complaint against defendant, the Colorado Department of

Health Care Policy and Financing (HCPF), for failure to exhaust

administrative remedies. We affirm the judgment.

I. Background

¶2 Jefferson owns Deetransportationco, LLC, which previously

provided nonemergent medical transportation to Colorado Medicaid

recipients under a provider agreement with HCPF.

¶3 From February to April 2024, Jefferson submitted several

claims for payment to HCPF, which HCPF did not pay. The

remittance statements denying the claims were dated between

March 8 and April 26, 2024. Each included the following notice

regarding Jefferson’s right to appeal:

If all means of achieving satisfactory claim
resolution through the fiscal agent, including
reconsideration, have been exhausted,
providers may file a written appeal with the
Office of Administrative Courts . . . . Appeals
submitted to the Office of Administrative
Courts must be received within 30 days from
the mailing date of the last notice of adverse
action.

¶4 On May 8, 2024, HCPF notified Jefferson that it was

terminating his provider agreement, effective immediately. Two

1
days later, Jefferson filed an administrative appeal of the

termination. His appeal did not mention the unpaid claims.

¶5 In July 2024, Jefferson attempted to raise the unpaid claims

in that appeal. An attorney in the Attorney General’s Office told

Jefferson that the appeal was limited to the termination of his

provider agreement and that the deadline to appeal the denial of his

claims had expired. On July 24, Jefferson filed an appeal of the

denied claims anyway.1 The record does not reveal a resolution of

that appeal, but in October 2024, the state attorney reiterated that

Jefferson’s “appeal rights as to all denied claims have expired.”

¶6 Jefferson then sued HCPF for the unpaid claims, asserting

that he had not been reimbursed for services he provided and

requesting immediate payment of all amounts owed.

¶7 HCPF moved to dismiss the complaint, arguing, among other

things, that Jefferson had failed to exhaust his administrative

remedies before seeking judicial review.

1 Neither the parties nor the district court addressed this attempted

appeal, which was stamped as received and attached to Jefferson’s
response to HCPF’s motion to dismiss.

2
¶8 The district court agreed with HCPF and dismissed the

complaint. The court noted that Jefferson had “initiated some type

of administrative process in May [2024],” but it concluded that

there was no record of any final agency action. The court also

found that no exception to the exhaustion requirement applied.

II. Failure to Exhaust Administrative Remedies

¶9 In his opening brief, Jefferson does not address the only basis

for the district court’s dismissal — the failure to exhaust

administrative remedies.2 We could affirm the order on that ground

alone. See People v. Archer, 2022 COA 71, ¶ 42 (explaining that we

must conclude a district court’s ruling was correct when the

appellant does not challenge the court’s ground for its ruling).

¶ 10 In his reply brief, Jefferson asserts that his administrative

remedies were “inadequate or futile” because the appeal process did

not provide him with a meaningful remedy. We do not ordinarily

consider arguments raised for the first time in a reply brief. See

2 In his statement of facts, Jefferson says he “attempted to resolve

the dispute administratively, but those efforts failed.” But he does
not develop that assertion, factually or legally. See Woodbridge
Condo. Ass’n v. Lo Viento Blanco, LLC, 2020 COA 34, ¶ 41 n.12
(declining to consider undeveloped arguments), aff’d, 2021 CO 56.

3
Sandra K. Morrison Tr. v. Bd. of Cnty. Comm’rs, 2020 COA 74, ¶ 30.

It also is not clear that Jefferson preserved this argument in the

district court. See Melat, Pressman & Higbie, L.L.P. v. Hannon L.

Firm, L.L.C., 2012 CO 61, ¶ 18 (“[I]ssues not raised in or decided by

a lower court will not be addressed for the first time on appeal.”).

¶ 11 Nevertheless, because the district court addressed the futility

exception to exhaustion of administrative remedies, and because we

broadly construe Jefferson’s arguments in the district court and on

appeal, we will consider this issue. See Jones v. Williams, 2019 CO

61, ¶ 5 (“Pleadings by pro se litigants must be broadly construed to

ensure that they are not denied review of important issues because

of their inability to articulate their argument like a lawyer.”).

A. Applicable Law and Standard of Review

¶ 12 The doctrine of administrative exhaustion requires a party to

pursue available administrative remedies before seeking judicial

review. Thomas v. Fed. Deposit Ins. Corp., 255 P.3d 1073, 1077

(Colo. 2011). If a party does not exhaust their administrative

remedies, the district court does not have jurisdiction over the case.

State v. Golden’s Concrete Co., 962 P.2d 919, 923 (Colo. 1998).

4
¶ 13 The doctrine is subject to limited exceptions, including futility.

Thomas, 255 P.3d at 1077. Under the futility exception, a party

need not exhaust administrative remedies when “it is ‘clear beyond

a reasonable doubt’ that further administrative review by the

agency would be futile because the agency will not provide the relief

requested.” Golden’s Concrete, 962 P.2d at 923 (citation omitted).

¶ 14 We apply a mixed standard of review to the dismissal of a

complaint for failure to exhaust administrative remedies. Egle v.

City & County of Denver, 93 P.3d 609, 611 (Colo. App. 2004). We

review the district court’s factual findings for clear error and its

legal conclusions de novo. Id. The plaintiff bears the burden of

proving either exhaustion or the applicability of an exception. Id.

B. Analysis

¶ 15 Jefferson does not challenge the district court’s conclusion

that he failed to exhaust his available administrative remedies with

respect to his unpaid claims. And the record contains no indication

that he did. See Dep’t of Health Care Pol’y & Fin. Reg. 8.049.01, 10

Code Colo. Regs. 2505-10 (requiring provider to first submit

adjustment requests through “routine fiscal agent operations” and

5
then file “written reconsideration”); id. at Regs. 8.049.02, 8.050.3.A

(requiring appeal of adverse decision to be filed within thirty days).

¶ 16 Jefferson argues only that exhaustion would have been futile

because “[HCPF’s] process provided no meaningful remedy.” But he

does not say why that is so. HCPF has authority to reconsider

compensation for denied claims. See § 25.5-4-401, C.R.S. 2025;

Dep’t of Health Care Pol’y & Fin. Reg. 8.049, 10 Code Colo. Regs.

2505-10. And when it improperly denies a claim, the provider may

appeal that decision to the Office of Administrative Courts. See

Dep’t of Health Care Pol’y & Fin. Regs. 8.049.02, 8.050, 10 Code

Colo. Regs. 2505-10; § 24-4-105, C.R.S. 2025. Jefferson does not

explain why such an appeal would not have allowed him to recover

any payments to which he was entitled. See City & County of

Denver v. United Air Lines, Inc., 8 P.3d 1206, 1215 (Colo. 2000). He

does not, for example, assert (much less prove) that HCPF

categorically “refuses to reconsider its decisions.” Id. at 1213.

¶ 17 Instead, he simply notes that he did not receive his requested

relief. But that is at least in part because he did not timely avail

himself of these procedures — a conclusion that, again, he does not

6
contest. A party’s failure to receive a remedy they do not properly

pursue does not show the procedures are futile. See id. at 1215.

¶ 18 Thus, because Jefferson did not show beyond a reasonable

doubt that the available administrative remedies were futile, the

district court correctly dismissed his complaint for failure to

exhaust those remedies.3 See Golden’s Concrete, 962 P.2d at 923.

III. Other Contentions

¶ 19 Jefferson raises other issues regarding the merits of his

claims, the inapplicability of sovereign immunity, and his damages.

Because we conclude that the district court correctly dismissed

Jefferson’s complaint for failure to exhaust administrative remedies,

we do not address his other contentions. See Liberty Bankers Life

Ins. Co. v. First Citizens Bank & Tr. Co., 2014 COA 151, ¶ 28.

IV. Disposition

¶ 20 The judgment is affirmed.

3 Jefferson also contends that the district court denied him due

process by dismissing his claim without a hearing. But because
Jefferson did not exhaust his administrative remedies, the district
court lacked jurisdiction over the action. State v. Golden’s Concrete
Co., 962 P.2d 919, 923 (Colo. 1998). In other words, the court
could not consider the merits of Jefferson’s claim. See Grant Bros.
Ranch, LLC v. Antero Res. Piceance Corp., 2016 COA 178, ¶ 35.

7
JUDGE GROVE and JUDGE YUN concur.

8