Rep. Tony Hartsook

The act requires a health insurance carrier (carrier) that issues, sells, renews, or offers a dental coverage plan to file, beginning in 2024, dental loss ratio forms with the division of insurance (division) for the preceding calendar year in which dental coverage was provided. The division is required to post dental loss ratio information on its website or submit the information to the administrator of the all-payer health claims database (APCD). If the information is submitted to the APCD administrator, the administrator is directed to make the information available to the public. Once the division has collected dental loss ratio information for 2 years, the commissioner of insurance (commissioner) shall promulgate rules that create a process to identify any carriers that significantly deviate from average dental loss ratios and to investigate the causes of the deviation. The act requires the commissioner to adopt rules that require each carrier that provides a dental coverage plan to issue to covered persons to whom a dental coverage plan identification card is issued a standardized written or virtual card containing plan information. The act also requires prepaid dental plans to file rates with the division. The act appropriates $64,252 from the division of insurance cash fund to the department of regulatory agencies for use by the division of insurance for personal services and operating expenses. APPROVED by Governor June 2, 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 requires hospitals to make public and post each hospital's medicare reimbursement rates. The act: Requires the department of health care policy and financing (state department) to conduct a performance assessment for each hospital to determine the hospital's adherence to federal transparency rules and publish the results on its website; Repeals sections of statute regarding hospital price transparency and debt collection that are currently under the administration and authority of the department of public health and environment and relocates these sections so that hospital price transparency and debt collection provisions are under the administration and authority of the state department; and Makes a violation of the hospital transparency requirements outlined in the act a deceptive trade practice under the "Colorado Consumer Protection Act". APPROVED by Governor June 2, 2023 EFFECTIVE June 2, 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.)

For the purposes of health insurance coverage for a prosthetic device (device), the act requires a health insurance carrier to provide coverage for an additional device or devices if the covered person's treating physician determines that the additional device or devices are necessary for the covered person to engage in physical and recreational activities. The required coverage applies to large employer plans issued or renewed on or after January 1, 2025. For individual and small group plans, the act requires the division of insurance (division) to make a determination as to whether the required coverage for a prosthetic device or devices is in addition to essential health benefits that requires the state to defray the costs of the required coverage and to submit the determination to the federal department of health and human services (federal department) for confirmation of the division's determination. If the federal department confirms that the required coverage is not in addition to essential health benefits or fails to respond within 365 days after the division submitted the request, the required coverage applies to individual and small group plans issued or renewed on or after January 1, 2025. APPROVED by Governor May 25, 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 bill requires all individual and group health benefit plans to provide coverage for biomarker testing if the testing is supported by medical and scientific evidence. Biomarker testing is defined as an analysis of a patient's tissue, blood, or other biospecimen for the presence of an indicator of normal biological processes, pathogenic processes, or pharmacologic responses to a specific therapeutic intervention. The bill requires the commissioner of insurance to implement biomarker testing coverage for all individual and group health benefit plans issued or renewed on or after January 1, 2025. Biomarker testing is subject to the health benefit plan's annual deductibles, copayment, or coinsurance but is not subject to any annual or lifetime maximum benefit limit. If a carrier requires prior authorization for biomarker testing, the bill requires the carrier to use an expedited prior authorization process. Subject to federal authorization and federal financial participation, beginning July 1, 2024, the bill includes coverage for biomarker testing as part of the state medical assistance program if the testing is supported by medical and scientific evidence. Under the state medical assistance program, the bill requires an expedited utilization review and prior authorization process, as well as an appeal process if biomarker testing is denied. (Note: This summary applies to this bill as introduced.)

With regard to a contract between a health insurance carrier (carrier) and a licensed health-care provider (provider) for the provision of health-care services to covered persons under a health coverage plan issued by the carrier (contract), the act: Requires the carrier to offer at least one method of payment to the provider for which there is not an associated fee; and Prohibits the carrier from restricting the form or method of payment the carrier uses to make payments to the provider so that the only acceptable payment method is a credit card payment. If a carrier initiates a payment to a provider using, or changes the payment method to, electronic funds transfer payments, including virtual credit card payments, the act requires the carrier to: Notify the provider of any fees associated with the particular payment method; Advise the provider of the available payment methods and include instructions on how to select an alternative available method; and With each payment, remit an explanation of benefits. The act prohibits a carrier from charging a fee for a change in the payment method to a specified electronic transaction and allows a provider's billing service to charge a fee under certain circumstances. The act grants enforcement authority to the commissioner of insurance. APPROVED by Governor April 10, 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.)

Currently, the division of veterans affairs (division) is authorized to accept gifts, grants, contributions, and donations to the western slope military veterans' cemetery fund but is not authorized to expend such gifts, grants, contributions, or donations. The act gives the division such authority to expend. Current law also allows certain programs housed within the department of public safety (department) to accept and expend gifts, grants, and donations for each program's specific purpose. However, the department does not have authority to accept or expend gifts, grants, or donations generally. The act authorizes the department to accept and expend gifts, grants, and donations for the purposes of the department and creates the department of public safety gifts, grants, and donations fund. The act does not affect existing programs within the department that are authorized to accept and expend gifts, grants, and donations for their specific purposes. APPROVED by Governor March 10, 2023 EFFECTIVE March 10, 2023 (Note: This summary applies to this bill as enacted.)

The bill prohibits the governor from renewing a state of disaster emergency declared beyond 30 days. Instead, the bill authorizes the general assembly, upon the written request of the governor and by adopting a joint resolution, to extend the state of disaster emergency for up to 30 additional days. The general assembly may continue, at the written request of the governor and by adopting a joint resolution for each extension, to extend a state of disaster emergency for periods of up to 30 days for as long as it deems it necessary to do so. If the general assembly is not scheduled to convene in a regular session when a state of disaster emergency will end as required by the bill, the governor or a two-thirds majority of the members of each house of the general assembly, in accordance with applicable state constitutional provisions, may call the general assembly into an extraordinary session to consider extending the state of disaster emergency.(Note: This summary applies to this bill as introduced.)