Healthcare

On and after January 1, 2027, when determining coverage for health-care services, the act requires entities that use an artificial intelligence system (AI system) for the purpose of conducting utilization review of health-care services, including health insurance companies (carriers), pharmacy benefit managers, private utilization review organizations, behavioral health administrative services organizations, and managed care entities (entities), ensure that the AI system complies with certain requirements specified in the act. Specifically, an entity shall ensure that the AI system:Makes determinations based on medical or clinical history, the patient's individual clinical circumstances, and other relevant clinical factors specified in the act, with denial of coverage reviewed by a licensed clinician or physician or other competent regulated professional who is competent to evaluate the specific clinical issues and review the health benefit plan's terms of coverage (competent regulated professional);Does not base its determination solely on group data without reference to the individual's data;Is not used in any way that discriminates against individuals in violation of other state or federal laws and is fairly and equitably applied, including in accordance with regulations and guidance issued by the federal department of health and human services; andIs periodically reviewed to ensure the AI systems outcomes are accurate and reliable and that an individual's health data is not used beyond its intended or stated purpose.     Entities that use AI systems shall disclose to the division of insurance, the department of human services, or the department of health care policy and financing, as applicable, the utilization review functions for which the AI system will be used and the points in the utilization review process when it will be used, the process for human oversight of adverse coverage determinations, and the process for maintaining audit information to ensure that the use of the AI system complies with the requirements in the act.     The AI system may be used to assist in utilization review, including expedited approvals. A carrier's denial of coverage for a service based in whole or in part on medical necessity shall not be issued solely on the output of an AI system without human review by a licensed clinician or physician or other competent regulated professional.     Further, the act prohibits a carrier and a payer of services under the 'Colorado Medical Assistance Act' and the 'Children's Basic Health Plan Act' from paying for psychotherapy services that are provided directly to a client and that are conducted by an AI system.(Note: This summary applies to this bill as enacted.)

The act requires a licensee, nurse, or certified midwife who performs a medical forensic examination to inform the victim-survivor about how to determine when the testing related to the examination is complete and how to obtain the results and records.     The act subjects a cause of action against a person arising from any protected statement by a victim-survivor to a special motion to dismiss unless the court determines that the plaintiff has established that there is a reasonable likelihood that the plaintiff will prevail on the claim.     The act makes a predispute arbitration agreement and predispute joint-action waiver void and unenforceable upon request of an individual who alleges conduct that results in a sexual harassment dispute or a sexual misconduct dispute or upon request of a named representative of a joint action, class action, or collective action that results in a sexual harassment dispute or a sexual misconduct dispute.     The act requires a judge to allow a forensic scientist to testify remotely in a criminal proceeding if a party requests and both parties consent to the remote testimony.     The act authorizes the court to order that the testimony of a victim-survivor of domestic violence, unlawful sexual behavior, stalking, human trafficking for involuntary servitude, or human trafficking for sexual servitude be taken in a room other than the courtroom and be televised by closed-circuit television in the courtroom under certain circumstances.     The act requires peace officer annual in-service training programs to include a 2-hour training to improve a peace officer's understanding of the impact of trauma on victim-survivors of crimes and the optimal way for a peace officer to respond to victim-survivors who are experiencing trauma and includes trauma-informed investigation and response training as a permissible use of peace officer training and support fund money.     The act renames the Colorado sexual assault forensic medical evidence review board as the Colorado sexual assault response review board and adds 4 members to the board.(Note: This summary applies to this bill as enacted.)

The act acknowledges the human-animal bond as a life-enhancing resource that impacts the length and quality of human life. The act authorizes the health disparities and community grant program (grant program) to award grants to entities that support the human-animal bond if the grant program is appropriated additional funds for that purpose by the general assembly.(Note: This summary applies to this bill as enacted.)

The bill creates three enterprises (enterprises) in the behavioral health administration; the:Beer, cider, and apple wine impact and recovery enterprise;Spirits impact and recovery enterprise; andWine impact and recovery enterprise.The enterprises collect a fee from licensees that are manufacturers and wholesalers that distribute alcohol in Colorado, and use the fee for services described in the bill.The bill creates an alcohol impact and recovery enterprise board that governs the enterprises.The bill requires the state auditor to conduct an audit of the enterprise in the 2032-33 state fiscal year and each fourth state fiscal year thereafter.(Note: This summary applies to this bill as introduced.)

Current law requires the department of public health and environment (CDPHE) to consider certain criteria as a basis for distributing grants from the nursing home penalty cash fund (fund). The act strikes these criteria and instead requires CDPHE to distribute such grants in accordance with priorities and allowable uses identified by the centers for medicare and medicaid services within the federal department of health and human services (centers).     Current law requires the nursing home innovations grant board (board) to make recommendations for the approval of grants from the fund. The act requires such recommendations to be consistent with the processes for grant cycles of, and priorities and allowable uses identified by, the centers.     Current law requires CDPHE and the department of health care policy and financing, with the board's assistance, to jointly submit an annual report to the governor and certain legislative committees of reference regarding the expenditure of money in the fund. The act changes the due date of the report from October 1 to January 1.     In current law, the term 'benefit residents of nursing facilities' is defined to mean that a grant has a direct impact on the residents of nursing facilities or has an indirect impact on the residents through education of nursing facility staff. The act amends this definition to include training, as well as education, of nursing facility staff.     Current law states that a governmental entity may not apply for or receive a grant from the fund unless the entity is a facility that is owned or operated by a governmental agency and licensed as a nursing care facility. The act removes this restriction.(Note: This summary applies to this bill as enacted.)

The bill requires the department of human services to include in the admission criteria for admitting a person to a mental health residential facility a prohibition on admitting a person who is required to register the person's residence in accordance with the "Colorado Sex Offender Registration Act" to a mental health residential facility that is located within 1,000 feet of a school.(Note: This summary applies to this bill as introduced.)

The act implements the recommendation of the department of regulatory agencies in its 2025 sunset review and report to sunset the kidney disease prevention and education task force.(Note: This summary applies to this bill as enacted.)

The 'Colorado Licensing of Controlled Substances Act' (Act) is set to repeal September 1, 2026.     The act implements the department of regulatory agencies' recommendations to:Continue the Act until September 1, 2041;Modernize the definition of 'substance use disorder' in the Act to more accurately reflect the type of conditions being treated by behavioral-health-administration-licensed facilities and the practitioners who may diagnose these conditions; and Remove defined terms that are no longer referenced in the Act.(Note: This summary applies to this bill as enacted.)

The bill adds to the list of impermissible collection actions that a medical creditor is prohibited from using when collecting on a medical debt. Current law requires a medical creditor to comply with certain conditions and notify a patient with medical debt 30 days before taking any permissible extraordinary collection actions. In addition to providing notice before taking any permissible extraordinary collection actions, the bill requires a medical creditor to notify a patient 30 days before collecting, transferring, selling, or assigning a medical debt, and to verify the patient has been screened for public health insurance programs and discounted care. The bill requires a medical creditor to offer a reasonable payment plan to each patient with medical debt. If the medical creditor violates the requirements for selling, transferring, or assigning medical debt, or undertaking collection activities, the patient is entitled to damages in the amount of $3,000 or actual damages, whichever is greater.(Note: This summary applies to this bill as introduced.)

Beginning July 1, 2027, the act requires municipal jails to comply with existing jail data collection requirements, standards, and oversight.     The act requires a keeper of a municipal jail to release a pregnant person charged with a violation of a municipal ordinance from custody if jail staff have a reasonable belief the person is in labor unless remaining in custody is necessary for the health or welfare of the person. If the pregnant person in labor is not released, the use of restraints is prohibited during the labor, delivery, and postpartum recovery, and the jail staff shall make a written record that the labor, delivery, and postpartum recovery occurred at the jail and record the reason the pregnant person was not released from custody.     The act requires council members of a city that has a city jail to examine the jail's management and sufficiency at least once a year and allows the attorney general to conduct assessments of municipal jails to identify gaps and deficiencies based on the jail standards.     The act adds a nonvoting member who represents a municipality to the jail standards advisory committee.(Note: This summary applies to this bill as enacted.)