Health care coverage - prior authorization for health care services - publication of requirements and restrictions - deadline for making determination - required criteria - exceptions for compliant providers - duration of prior authorization - rules. With regard to the prior authorization process used by carriers or private utilization review organizations (organizations) acting on behalf of carriers to review and determine whether a particular health care service prescribed by a health care provider is approved as a covered benefit under the patient's health benefit plan, the act requires carriers and organizations to: Publish and update their prior authorization requirements and restrictions; Comply with specified deadlines for making a determination on a prior authorization request; Use current, clinically based prior authorization criteria that are aligned with other quality initiatives of the carrier or organization and with other carriers' and organizations' prior authorization criteria for the same health care service; and Consider limiting the use of prior authorization to providers whose prescribing or ordering patterns differ significantly from the patterns of their peers after adjusting for patient mix and other relevant factors. The act authorizes a carrier or organization to offer providers with a history of adherence to the carrier's or organization's prior authorization requirements an alternative to prior authorization, including an exemption from prior authorization for providers with an 80% approval rate of prior authorization requests over the previous 12 months. Carriers and organizations are to annually reevaluate a provider's eligibility for exemption from or other alternative to prior authorization requirements. If a carrier or organization fails to make a determination within the time required, the request is deemed approved. An approved prior authorization request is valid for at least 180 days, with some exceptions, and continues for the duration of the authorized course of treatment. The commissioner of insurance is authorized to adopt rules as necessary to implement the act. (Note: This summary applies to this bill as enacted.) Read More
Sponsored bills
Sales and use tax - sourcing method for development of electronic sales and use tax simplification system. The act requires the office of information technology (office) and the department of revenue (department), within existing resources, to conduct a sourcing method in accordance with the applicable provisions of the procurement code, and any applicable rules, for the development of an electronic sales and use tax simplification system (system). The act also requires the office and the department to involve stakeholders to develop the scope of work. The act requires the general assembly to make any necessary appropriations for the initial funding and ongoing maintenance of the system from any net sales tax revenues that are credited to the general fund. The act specifies that on and after the date the system is online the department is required to accept any returns and payments processed through the system for state sales and use tax and for any sales and use taxes that are collected by the department on behalf of any local taxing jurisdiction. The act specifies that it is the general assembly's intent that 3 local taxing jurisdictions with home rule charters voluntarily use the system when the system comes online. Additionally, the act states that it is the general assembly's intent that all local taxing jurisdictions with home rule charters voluntarily use the system within 3 years. (Note: This summary applies to this bill as enacted.) Read More
Emergency management - homeland security and all-hazards senior advisory committee - public safety communications subcommittee - continuation under sunset law. The act implements the recommendations of the department of regulatory agencies' sunset review and report on the public safety communications subcommittee by continuing the subcommittee.(Note: This summary applies to this bill as enacted.) Read More
The bill repeals the death penalty in Colorado for offenses charged on or after July 1, 2019, and makes conforming amendments. (Note: This summary applies to this bill as introduced.) Read More
Prohibition on local government requiring license or permit for a business operated on an occasional basis by a minor - minor business must be located sufficient distance from commercial entity - general police powers still apply. The act prohibits any county, municipality, or city and county (local government) or any agency of a local government from requiring a license or permit for a business that is: Operated on an occasional basis by a minor (a person under the age of 18 years); and Located a sufficient distance from a commercial entity, determined by the local government, that is required to obtain a permit or license from the local government or an agency of the local government to prevent the minor's business from becoming a direct economic competitor of the commercial entity. The act defines "occasional basis" to mean the business does not operate more than 84 days in any one calendar year. The act specifies that it does not prohibit a local government from enacting and enforcing local laws under the local government's general police power in regard to the manner in which a business may be conducted by a minor with the exception of a requirement that the minor obtain a permit or license prior to engaging in the business. (Note: This summary applies to this bill as enacted.) Read More
Athletic trainers - regulation - change from registration to licensing. The act changes the terms describing the regulation of athletic trainers from "registration" to "license" and "licensure" and from "registrant" and "registered athletic trainer" to "licensee".(Note: This summary applies to this bill as enacted.) Read More
The bill establishes continuing professional competency requirements for psychotherapists registered in Colorado by the state board of registered psychotherapists (board). The requirements mirror the continuing professional competency requirements established for social workers, marriage and family therapists, licensed professional counselors, and addiction counselors. On or before March 1, 2020, the board is required to adopt rules establishing a continuing professional competency program that includes the following elements: A self-assessment of the knowledge and skills of a registered psychotherapist; The development, execution, and documentation of a learning plan; and Periodic demonstration of knowledge and skills through documentation of activities.(Note: This summary applies to this bill as introduced.) Read More
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Alcohol beverages - removal of dual licensing requirement - fermented malt beverage and malt liquor manufacturers, wholesalers, and importers. The act removes the dual licensing requirement for manufacturers, wholesalers, and importers under the "Colorado Beer Code" (beer code) and the "Colorado Liquor Code" (liquor code) by: Converting each manufacturer's license issued under the beer code to a manufacturer's license issued under the liquor code; Converting each wholesaler's license issued under the beer code to a wholesaler's beer license issued under the liquor code; Converting each nonresident manufacturer's license issued under the beer code to a nonresident manufacturer's license issued under the liquor code; Converting each importer's license issued under the beer code to a malt liquor importer's license issued under the liquor code; and Repealing the authority of the state licensing authority to issue new licenses under the beer code, except for licenses authorizing the retail sale of fermented malt beverages. The act specifies that it applies to conduct occurring on or after January 31, 2019. (Note: This summary applies to this bill as enacted.) Read More