Signed by Governor Jared Polis

Vote Smart's Synopsis:

Vote to concur with Senate amendments and pass a bill that amends regulations regarding funding, billing, and reporting for certain healthcare and managed care entities in Colorado.

Highlights:

• Exempts assisted living facilities from complying with the Facility Guidelines Institute (FGI) Guidelines, except in the case of new construction or major renovations (Sec. 2).

• Requires the Department of Health Care Policy and Financing (Department) to establish a process for annually reviewing and updating the general billing manual, and ensure that it includes all necessary CPT codes or links (Sec. 3).

• Authorizes the Colorado Healthcare Affordability and Sustainability Enterprise to receive public funds (Sec. 4).

• Requires a managed care organization to issue payment to a contracted provider within one year after the provider rate is updated, beginning January 1, 2026 (Sec. 5).

• Requires a managed care entity to annually submit the amount it is paid and its medical loss ratio to the Department for publication on its website (Sec. 6).

• Prohibits the Department from imposing signature requirements on a physician or practitioner certifying a medicaid member’s plan of care that involves physical, occupational, or speech therapy (Sec. 7).

• Requires the Department to notify a medicare or medicaid member of the timeline of any discontinued service that impacts that member (Sec. 8).

• Specifies that this Act takes effect on the 91st day after the end of the legislative session (Sec. 10).

Full Bill Text