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July 7, 2023 SB 23-176
Legislative Council Staff
Nonpartisan Services for Colorado’s Legislature
Final Fiscal Note
Drafting Number:
Prime Sponsors:
LLS 23-0473
Sen. Moreno; Cutter
Rep. deGruy Kennedy
Date:
Bill Status:
Fiscal Analyst:
July 7, 2023
Signed into Law
Shukria Maktabi | 303-866-4720
shukria.maktabi@coleg.gov
Bill Topic: PROTECTIONS FOR PEOPLE WITH AN EATING DISORDER
Summary of
Fiscal Impact:
☒ State Revenue
☒ State Expenditure
☐ State Transfer
☐ TABOR Refund
☒ Local Government
☐ Statutory Public Entity
The bill creates prohibitions and requirements related to health care services for
individuals with disordered eating. The bill minimally increases state expenditures in
FY 2023-24 and may increase state revenue and local expenditures beginning in
FY 2024-25.
Appropriation
Summary:
No appropriation is required.
Fiscal Note
Status:
The fiscal note reflects the enacted bill.
Summary of Legislation
The bill prohibits Medicaid, starting July 1, 2023, and health insurance plans, starting January 1, 2024,
from using body mass index, ideal body weight, or any achieved weight standard to determine
medical need or the level of care for individuals with certain types of disordered eating. The bill also
prohibits retail establishments from selling over-the-counter diet pills to individuals under
18-years-old without prescriptions beginning July 1, 2024, with rules to be created by the Department
of Regulatory Agencies (DORA) and failure to comply constituting a deceptive trade practice under
the Colorado Consumer Protection Act.
State Revenue
The bill may increase state revenue from civil penalties and filing fees beginning in FY 2024-25.
Civil penalties. Under the Colorado Consumer Protection Act, a person committing a deceptive trade
practice may be subject to a civil penalty of up to $20,000 for each violation. Additional penalties may
be imposed for subsequent violations of a court order or injunction. This revenue is classified as a
damage award and not subject to TABOR. Given the uncertainty about the number of cases that may
be pursued by the Attorney General and district attorneys, as well as the wide range in potential
penalty amounts, the fiscal note cannot estimate the potential impact of these civil penalties. Page 2
July 7, 2023 SB 23-176
Filing fees. The bill may increase revenue to the Judicial Department from an increase in civil case
filings. Revenue from filing fees is subject to TABOR.
State Expenditures
The bill increases state workload for DORA and the Department of Health Care Policy and Financing
in FY 2023-24 and may increase state workload for the Department of Law and the Judicial
Department beginning in FY 2024-25, as discussed below.
Department of Regulatory Agencies. Workload in the Division of Insurance and the State Board of
Pharmacy, both located within DORA, will increase by a minimal amount starting in FY 2023-24.
Specifically, these divisions will need to update rules, conduct outreach with health insurance carriers
and retail establishments, and respond to consumer inquiries and complaints. It is assumed that this
work can be accomplished within existing appropriations.
Department of Health Care Policy and Financing. Any impact from the prohibition on using certain
metrics to determine medical necessity is anticipated to have a minimal effect on the number of
Medicaid members with disordered eating from being admitted and discharged from residential
facilities, or the length of time members stay in such facilities. Any changes in utilization will be
addressed through the annual budget process.
Department of Law. Workload in the Department of Law will minimally increase to the extent that
deceptive trade practice complaints are filed. The department will review complaints under the bill
and prioritize investigations as necessary within the overall number of deceptive trade practice
complaints and available resources.
Judicial Department. The trial courts in the Judicial Department may have an increase in cases filed
under the Colorado Consumer Protection Act from the addition of a new deceptive trade practice. It
is assumed that online marketplaces will abide by the law and that any violation of the legislation will
result in minimal number of new cases. The fiscal note assumes that this can be accomplished within
existing resources and that no change in appropriations is required.
Local Government
Similar to the state, to the extent district attorneys receive deceptive trade practice complaints related
to the new deceptive trade practice under the bill, workload will increase to investigate complaints
and seek relief when appropriate. It is assumed most such cases will be handled at the state level by
the Attorney General.
Effective Date
This bill was signed into law by the Governor and took effect on May 30, 2023.
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July 7, 2023 SB 23-176
State and Local Government Contacts
Behavioral Health Administration Corrections
Health Care Policy and Financing Higher Education
Human Services Information Technology
Law Public Health and Environment
Regulatory Agencies Revenue
The revenue and expenditure impacts in this fiscal note represent changes from current law under the bill for each
fiscal year. For additional information about fiscal notes, please visit: leg.colorado.gov/fiscalnotes.