The act requires the department of health care policy and financing (department) to: At least quarterly, publish on its website an audit activity report detailing current and recently completed recovery audits and summaries of the findings of recovery audits; When the department enters into a new contract for recovery audits, post on its website a copy of the contract, scope of work, and information regarding supervision of contractor deliverables for such audits; At least quarterly, conduct trainings for providers and hold stakeholder meetings; and Create a provider advisory group to advise the department on issues that providers have concerning the recovery audits. The act requires the office of the state auditor to: During the 2023-24 state fiscal year, contract for an independent review of the department's recovery audit contractor program for compliance with requirements of the federal recovery audit contractor's program, coding practice standards, and state law; and Contract with an entity to assess federal flexibilities to improve the recovery audit contractors program and assist the department in pursuing those flexibilities. The act appropriates from the general fund $39,287 to the department and $850,000 to the legislative department for use by the office of the state auditor. APPROVED by Governor June 1, 2023 EFFECTIVE June 1, 2023 (Note: This summary applies to this bill as enacted.)
The act creates the urgent incident response fund (fund). Money in the fund is annually appropriated to the division of homeland security and emergency management (division) in the department of public safety (department) to reimburse state agencies and local governments for the costs of responding to urgent incidents that do not rise to the level of disasters or emergencies. The act requires the division to: Publish certain information on its website regarding reimbursements made to state agencies or local governments for the costs of responding to urgent incidents; and Promulgate rules to establish a process for local governments and state agencies to receive reimbursements. For the 2023-24 state fiscal year, $1,000,000 is appropriated from the general fund to the fund and reappropriated from the fund to the department for use by the division for urgent incident response. The department is responsible for the accounting related to this appropriation. APPROVED by Governor June 1, 2023 EFFECTIVE June 1, 2023 (Note: This summary applies to this bill as enacted.)
The act lists the minimum factors to be considered when determining medical necessity or appropriate level of care for an individual with an eating disorder. The act prohibits certain health benefit plans or the state medical assistance program from utilizing the body mass index, ideal body weight, or any other standard requiring an achieved weight when determining medical necessity criteria or appropriate level of care for an individual with a diagnosed eating disorder. The prohibition does not apply when determining medical necessity or the appropriate level of care for an individual diagnosed with anorexia nervosa, restricting subtype or binge-eating/purging subtype; however, body mass index, ideal body weight, or any other standard requiring an achieved body weight must not be the determining factor when assessing medical necessity or the appropriate level of care for an individual diagnosed with anorexia nervosa, restricting subtype or binge-eating/purging subtype. The act states a retail establishment engages in a deceptive trade practice if the retail establishment sells, transfers, or otherwise furnishes over-the-counter diet pills to any individual under 18 years of age. APPROVED by Governor May 30, 2023 PORTIONS EFFECTIVE May 30, 2023 PORTIONS EFFECTIVE January 1, 2024 PORTIONS EFFECTIVE July 1, 2024 (Note: This summary applies to this bill as enacted.)
Under existing law, the office of public guardianship (office) is authorized to operate in 3 judicial districts and is scheduled to repeal on June 30, 2024. The act extends the office indefinitely and requires the office to begin operating in additional judicial districts in 2025 and to operate in every judicial district in the state by December 31, 2030. The act establishes a board of directors (board) to oversee the office. The board consists of 7 members: 3 members who are attorneys appointed by the chief justice of the Colorado supreme court and 4 non-attorney members appointed by the governor. The existing public guardianship commission that oversees the office is repealed, effective August 31, 2023. The act permits the office to initiate petitions for guardianship and take any action on behalf of a client that a private guardian may take. The act requires the office to prioritize individuals with the greatest needs when the number of cases in which services have been requested exceeds the number of cases in which public guardianship can provide services. The office of administrative services for independent agencies created in the judicial department in Senate Bill 23-228 in 2023 provides administrative and fiscal support to the office of public guardianship. The office is required to employ guardians to provide guardianship services to the office's clients. A guardian must be certified as a guardian or become certified within 2 years after being hired by the office. The office shall provide training to guardians in specified subjects. The act requires a court to waive filing fees for petitions for guardianship filed by the office in cases that involve an indigent and incapacitated person who is eligible for guardianship services from the office. A court is prohibited from requiring the office or a guardian employed by the office to post a bond as a condition for appointment as a guardian. The act authorizes the office to spend any gifts, grants, or donations it receives without prior appropriation by the general assembly. The act requires the state auditor to conduct, or cause to be conducted, a performance audit of the office during the period between July 1, 2027, and June 30, 2030. APPROVED by Governor May 30, 2023 EFFECTIVE May 30, 2023 NOTE: Certain sections of the act are contingent on whether or not Senate Bill 23-228 becomes law. Senate Bill 23-228 was signed by the governor April 20, 2023. (Note: This summary applies to this bill as enacted.)
The act requires the state department of human services (state department) to contract with an independent third party to conduct a feasibility study to determine the feasibility of creating a system to support individuals with serious mental illness through a collaboration between Colorado's behavioral health and judicial systems. The act requires the state department to work with the behavioral health administration, department of local affairs, department of public safety, department of health care policy and financing, judicial department, and other state agencies to determine the eligibility requirements and application process for selecting the independent third party. The act requires the state department to submit a report detailing the findings and recommendations from the feasibility study to the general assembly, the governor's office, and impacted state agencies by March 1, 2024. The act appropriates $300,000 to the state department in state fiscal year 2023-24 for purposes of conducting the feasibility study. The appropriation consists of $160,000 from the general fund and $140,000 from the behavioral and mental health cash fund. APPROVED by Governor May 30, 2023 EFFECTIVE May 30, 2023 (Note: This summary applies to this bill as enacted.)
Not later than September 1, 2023, the act requires the department of health care policy and financing (state department) to initiate a stakeholder process to promote the expansion and utilization of doula services for pregnant and postpartum medicaid recipients (recipients). The act requires the state department to work with a maternity advisory committee to create a report detailing the findings and recommendations from the stakeholder process and submit the report to the general assembly during the state department's "SMART Act" hearing. Not later than July 1, 2024, the act requires the state department to seek federal authorization for medicaid providers to provide doula services for pregnant and postpartum people. The act creates a doula scholarship program to provide financial support to eligible individuals to pursue doula training and certification. To be eligible for a scholarship, individuals must agree to enroll as a doula provider and provide doula services to recipients. The act requires the division of insurance (division) to contract with an independent entity to study the potential health-care costs and benefits of providing coverage for doula services in health benefit plans. The act requires the division to submit a report to the general assembly during the state department's "SMART Act" hearing detailing the results and recommendations from the study during state fiscal year 2024-25. The act appropriates $100,000 from the general fund to the state department for use by the other medical services division for the doula scholarship program. The act appropriates $100,000 from the division of insurance cash fund to the department of regulatory agencies for use by the division of insurance to use for personal services. APPROVED by Governor May 30, 2023 EFFECTIVE May 30, 2023 (Note: This summary applies to this bill as enacted.)
No later than September 1, 2023, the act requires the department of health care policy and financing (state department) to engage in a stakeholder process to address concerns and identify viable solutions related to individuals who receive long-term services and supports. No later than January 2025, the act requires the state department to report on the stakeholder process, including identifying any administrative resources needed to address any concerns identified during the stakeholder process. The act appropriates $75,000 from the general fund to the state department for use by the office of community living. It is anticipated that the state department will receive $75,000 in federal funds to implement the act. APPROVED by Governor May 30, 2023 EFFECTIVE May 30, 2023 (Note: This summary applies to this bill as enacted.)
The act extends for an additional 5 years the income tax credit for expenses incurred by an individual with a family income at or below $150,00, adjusted for inflation, (qualified individual) in retrofitting the individual's residence to increase its accessibility for persons with disabilities. The act also extends the credit carry-forward period from 5 to 8 years. APPROVED by Governor May 30, 2023 EFFECTIVE August 7, 2023 NOTE: This act was passed without a safety clause and takes effect 90 days after sine die. (Note: This summary applies to this bill as enacted.)
The act establishes the disordered eating prevention program (program) in the department of public health and environment (department) within the prevention services division (division). The division is required to: Create and maintain an external-facing resource that is updated annually and includes key information about disordered eating, including risk factors and prevention factors; Collaborate with the office of suicide prevention and other programs within the division to align work focused on disordered eating, facilitate public outreach, and increase awareness regarding disordered eating prevention and care with a focus on impacted communities, such as youth, older Coloradans, people of color, and lesbian, gay, bisexual, and transgender individuals; Partner with the department of education to inform teachers, administrators, school staff, students, and parents on disordered eating preventions; and Coordinate the disordered eating prevention research grant program. The division may: Contract with a third-party to conduct focus groups, interview key individuals, conduct surveys, and establish a collaborative group to discuss key issues regarding disordered eating prevention; Partner with the behavioral health administration; and Identify disordered eating prevention strategies, including dismantling discrimination and bias with regard to weight. The act creates the disordered eating prevention research grant program (grant program) in the division. The purpose of the grant program is to provide financial assistance to eligible applicants to research root causes of disordered eating and examine risk factors for and protective factors against disordered eating in youth, adults, and older Coloradans. The act appropriates $26,679 to the department from the general fund for use by the division for the program. APPROVED by Governor May 30, 2023 EFFECTIVE August 7, 2023 NOTE: This act was passed without a safety clause and takes effect 90 days after sine die. (Note: This summary applies to this bill as enacted.)
The act adjusts the supplemental medicaid payment rates a qualifying nursing facility receives from the department of health care policy and financing (state department). Beginning July 1, 2024, the payment must not be less than 12% of total provider fee payments and must be adjusted for fiscal years 2024-25 and 2025-26. No later than July 1, 2026, the payment must not be less than 15% of total provider fee payments and must be annually adjusted thereafter. Current law limits the annual increase of the general fund share of the aggregate statewide average of the per diem rate to not more than 3%. The act removes this limitation and requires that the general fund share be calculated based on specific percentage increases. The act requires the state department to initiate a process no later than July 1, 2023, to remove the medicare costs from the provider rate setting by July 1, 2026. The act repeals the requirement that only such costs as are reasonable, necessary, and patient-related be reported for reimbursement purposes. The act authorizes the state department to require a nursing facility, as a condition of receiving medicaid funds, to submit any documentation necessary to ensure the state's interest in transparency, stability, and sound fiscal stewardship. As part of developing and implementing a transition plan to regulate nursing facility reimbursement, the act requires the state department to: No later than July 1, 2026, define "nursing home reimbursement" and provide payments to nursing facilities; Engage with stakeholders regularly to seek input on any proposed methodology changes; and From November 1, 2023, to November 1, 2026, submit an annual report to the joint budget committee of the general assembly regarding the implementation process. Each nursing facility that receives medicaid funds is required to submit a plan to the state department that demonstrates how the nursing facility will: Improve the health and safety of the nursing facility's residents, including infection control and staffing; Increase access to care; Improve financial sustainability, including opportunities for diversification of business lines and stabilization of revenue streams; and Promote innovation to meet the emerging needs of individuals with disabilities and aging and older adults. The act requires the state department to issue additional supplemental payments to nursing facility providers with disproportionately high medicaid utilization, to facilities that are geographically critical to ensuring access to care, and to facilities that admit compassionate release individuals from the department of corrections. The act requires each nursing facility that receives medicaid funds to develop and submit a plan to the state department that meets the state department's standards and demonstrates how the nursing facility will improve the health and safety of the nursing facility's residents, increase access to care, improve financial sustainability, and promote innovation to meet the emerging needs of individuals with disabilities and aging and older adults. Effective July 1, 2028, the act repeals the requirement that the state department exempt certain nursing facility providers from the provider fee. Effective July 1, 2026, the act repeals: The process for providing a wage enhancement supplemental payment to eligible nursing home providers that pay their employees a wage of at least $15 per hour; and Requirements for issuing additional supplemental payments to nursing facility providers that meet certain requirements. For the 2023-24 state fiscal year, the act appropriates $30,509,457 from the general fund to the state department for medical and long-term care services for medicaid eligible individuals. For the 2023-24 state fiscal year, the general assembly anticipates that the state department will receive $31,754,740 in federal funds for medical and long-term care services for medicaid eligible individuals to implement the act. APPROVED by Governor May 30, 2023 EFFECTIVE May 30, 2023 (Note: This summary applies to this bill as enacted.)
The act requires a carrier that offers a health benefit plan (carrier) or a pharmacy benefit management firm that administers or manages contraception coverage under a health benefit plan (PBM) to provide coverage for, and reimburse a prescribing provider or in-network dispensing entity for, the single dispensing or furnishing of contraception intended to last the covered person for a duration of 12 months, as permitted by the covered person's prescription, dispensed or furnished at one time, unless requested otherwise by the covered person. A carrier or PBM is subject to certain requirements, as applicable, including: Allowing coverage of continuous use of contraception, as determined by the prescribing provider; A prohibition against implementing utilization management practices that prevent the dispensing of a 12-months' duration of contraception; Allowing for alternate prescribed contraception, if medically necessary; and Providing coverage for over-the-counter contraception without a prescription and without prior authorization, step therapy, utilization management, or cost sharing. The act requires carriers to report annually to the division of insurance in the department of regulatory agencies concerning contraception coverage and requires PBM's to provide information to carriers for purposes of this reporting. The act authorizes the commissioner of insurance to promulgate rules regarding the coverage. APPROVED by Governor May 30, 2023 EFFECTIVE August 7, 2023 NOTE: This act was passed without a safety clause and takes effect 90 days after sine die. (Note: This summary applies to this bill as enacted.)
On and after July 1, 2024, the act prohibits a health-care provider (provider), which is an individual provider or a health facility, or a health system, which is a corporation or organization that owns, contains, or operates 3 or more hospitals, from charging, billing, or collecting a facility fee directly from a patient that is not covered by the patient's insurance for mandatory coverage for preventive health-care services that are provided in an outpatient setting. The act defines "facility fee" as any fee that a hospital or health system charges or bills for outpatient services that is intended to compensate the hospital or health system for its operational expenses and that is separate and distinct from a professional fee charged or billed by a provider for professional medical services. The limitation on charging, billing, or collecting a facility fee does not apply to a critical access hospital, a sole community hospital in a rural or frontier area, a community clinic affiliated with a sole community hospital in a rural or frontier area, or a hospital established by the Denver health and hospital authority. The act: Requires a provider that charges a facility fee to provide notice to a patient that the provider charges the fee and to use a standardized bill that includes itemized charges identifying the facility fee, as well as other information; Requires a health facility that is newly affiliated with or owned by a hospital or health system on or after July 1, 2024, to provide written notice to patients of the health facility during the previous 12 months concerning the change in ownership and that the health facility may now charge a facility fee, and prohibits the collection of a facility fee until at least 30 days after the notice is sent; and Makes it a deceptive trade practice to charge, bill, or collect a facility fee when doing so is prohibited. The act creates a steering committee (steering committee) in the department of health care policy and financing (department) to facilitate the development of a preliminary report by August 1, 2024, and a final report by October 1, 2024, detailing the impact of outpatient facility fees on the Colorado health-care system, including the impact on consumers, employers, and providers. The steering committee consists of 7 members appointed by the governor with relevant expertise in health-care billing and payment policy, including, among others, members representing consumers, payers, and providers. The act lists specific data and information to be collected, identified, evaluated, and analyzed, including: Data from: The all-payer health-claims database; Hospital and health systems; The department, the division of insurance, and commercial payers; and Independent health-care providers that are not affiliated with or owned by a hospital or health system evaluated in the report; The impact of facility fees and payer coverage policies on the Colorado healthcare affordability and sustainability enterprise, the medicaid expansion, uncompensated care, and undercompensated care; The impact of facility fees on access to care, integrated care systems, health equity, and the health-care workforce; and A description of the way in which providers may be paid or reimbursed by payers for outpatient health-care services. To the extent feasible, data must be sourced from 2014 through 2022, as determined by the steering committee and any third-party contractors, and disaggregated, as described in the act. The steering committee shall seek to exhaust existing data sources before making additional requests and shall minimize the number of data requests. To implement the act, for the 2023-24 state fiscal year, the act: Increases general fund appropriations to the department in the 2023 long bill by $18,326 for personal services and $337 for operating expenses; Decreases anticipated federal funds received by the department by $18,663; and Appropriates $516,950 from the general fund to the department for general professional services and special projects. APPROVED by Governor May 30, 2023 EFFECTIVE May 30, 2023 (Note: This summary applies to this bill as enacted.)
