Second Regular Session
Seventy-fourth General Assembly
STATE OF COLORADO
REREVISED
This Version Includes All Amendments
Adopted in the Second House
LLS NO. 24-0080.01 Chelsea Princell x4335
SENATE BILL 24-168
Senate Committees House Committees
Health & Human Services Health & Human Services
Appropriations Appropriations
A BILL FOR AN ACT
C
ONCERNING REMOTE MONITORING SERVICES FOR MEDICAID101
MEMBERS, AND, IN CONNECTION THEREWITH , MAKING AN
102
APPROPRIATION.103
Bill Summary
(Note: This summary applies to this bill as introduced and does
not reflect any amendments that may be subsequently adopted. If this bill
passes third reading in the house of introduction, a bill summary that
applies to the reengrossed version of this bill will be available at
http://leg.colorado.gov
.)
Beginning July 1, 2025, the bill requires the department of health
care policy and financing (state department) to provide reimbursement for
the use of telehealth remote monitoring for outpatient services for certain
medicaid members (member).
The bill creates the telehealth remote monitoring grant program to
HOUSE
3rd Reading Unamended
May 7, 2024
HOUSE
2nd Reading Unamended
May 6, 2024
SENATE
3rd Reading Unamended
April 24, 2024
SENATE
Amended 2nd Reading
April 23, 2024
SENATE SPONSORSHIP
Roberts and Simpson, Michaelson Jenet, Bridges, Buckner, Cutter, Exum, Fields,
Gardner, Jaquez Lewis, Kirkmeyer, Liston, Lundeen, Marchman, Mullica, Priola, Van
Winkle, Will, Zenzinger
HOUSE SPONSORSHIP
McCluskie and Martinez, Young, Amabile, Bird, Boesenecker, Bradley, Brown, Clifford,
Daugherty, Duran, Frizell, Hamrick, Jodeh, Kipp, Lieder, Lindsay, Lukens, Mabrey, Marvin,
Mauro, McCormick, McLachlan, Ortiz, Ricks, Rutinel, Sirota, Snyder, Taggart, Titone,
Velasco, Woodrow
Shading denotes HOUSE amendment. Double underlining denotes SENATE amendment.
Capital letters or bold & italic numbers indicate new material to be added to existing law.
Dashes through the words or numbers indicate deletions from existing law. provide grants to an outpatient health-care facility located in a designated
rural county or designated provider shortage area to assist the outpatient
health-care facility clinic with the financial cost of providing telehealth
remote monitoring for outpatient clinical services.
Beginning November 1, 2025, the bill requires the state
department to provide coverage for continuous glucose monitors for
members.
Be it enacted by the General Assembly of the State of Colorado:1
SECTION 1. Legislative declaration. (1) The general assembly2
finds that:3
(a) Concerning the use of telehealth remote monitoring to provide4
outpatient clinical services:5
(I) Telehealth helps connect Medicaid members with health-care6
providers, enabling members to receive the care and consultation they7
need without traveling to visit a provider in another city or area of the8
state;9
(II) Telehealth visits may provide cost savings for the Medicaid10
system by improving access to primary care and helping avoid11
unnecessary trips to the emergency department;12
(III) More than 700,000 Coloradans live in a rural or frontier13
county. Rural Coloradans face several unique challenges in health-care14
access, affordability, and outcomes. Rural residents tend to be older and15
in poorer health than their urban counterparts, and rural communities16
often face challenges with access to care and financial viability.17
According to the Centers for Disease Control and Prevention, rural18
residents are more likely to die prematurely from heart disease, cancer,19
unintentional injury, chronic lower respiratory disease, and stroke.20
(IV) Despite these challenges, rural Coloradans play an important21
role in food and energy production in the state and serve as an integral22
168-2- part of Colorado's economy;1
(V) Telehealth, including telehealth remote monitoring, is one of2
the tools the Centers for Disease Control and Prevention has identified3
that can be used to improve the health of rural residents. Telehealth4
remote monitoring uses digital technologies to collect health data from5
patients in one location and electronically transmit that information6
securely to providers in a different location.7
(VI) Telehealth remote monitoring technologies provide a8
particular benefit for patients with chronic conditions to receive the care9
they need without the need for constant in-person visits to the patient's10
physician's office. Patients with chronic conditions such as diabetes, heart11
disease, and chronic obstructive pulmonary disease often require ongoing12
monitoring and management. Telehealth remote monitoring can help13
these patients better manage their conditions by providing regular14
monitoring, alerts, and support.15
(VII) Multiple studies indicate that telehealth remote monitoring16
offers patients a clear return on investment over time, which extends17
beyond initial health-care savings, including money associated with18
transportation, time, and energy to visit their doctors; prescription,19
laboratory, and imaging costs; and hard and soft expenses if a hospital20
stay or emergency department visit is required;21
(VIII) The return on telehealth remote monitoring isn't limited to22
financial measurements. It also improves health outcomes, eliminates23
communication barriers, facilitates faster access to providers, reduces24
hospital readmissions, shortens hospital stays, and enhances patient25
education.26
(IX) Expanding access to telehealth remote monitoring for27
168
-3- patients is crucial to achieving health equity in Colorado.1
(b) Concerning the use of continuous glucose monitoring devices:2
(I) More than 300,000 Coloradans live with type 1 or type 23
diabetes;4
(II) Managing diabetes requires strict blood glucose control5
consisting of multiple blood glucose level checks daily, medication6
administration, and balancing diet and physical activity;7
(III) Continuous glucose monitoring devices provide patients and8
health-care providers with more health data and detail concerning blood9
glucose levels than traditional blood glucose meters;10
(IV) For people with diabetes, continuous glucose monitoring11
devices provide significant, life-changing, and lifesaving benefits for12
managing their diabetes and can prevent or delay serious medical13
complications, including those that may require hospitalization or could14
lead to death;15
(V) Individuals with diabetes who use continuous glucose16
monitoring devices experience fewer episodes of hypoglycemia and a17
reduction in their average blood glucose levels (A1C); and18
(VI) Access to continuous glucose monitoring technology is19
extremely important to individuals with diabetes, especially those who20
live in communities with a disproportionate rate of diabetes. However,21
many Coloradans with diabetes still lack access to this critical technology,22
even though the use of continuous glucose monitoring devices is a23
recognized standard of care for all insulin-dependent individuals.24
(2) Therefore, the general assembly declares that it is in the best25
interest of the state of Colorado to reduce health disparities and increase26
health equity by prioritizing expanded access to remote patient27
168
-4- monitoring services in outpatient health-care settings across the state and1
to provide access to continuous glucose monitoring services to diabetic2
Coloradans to decrease health-care costs and improve health outcomes for3
all Coloradans.4
SECTION 2. In Colorado Revised Statutes, add 25.5-5-337 as5
follows:6
25.5-5-337. Telehealth remote monitoring services for7
outpatient clinical services - grant program - federal authorization -8
rules - definitions. (1) A
S USED IN THIS SECTION, UNLESS THE CONTEXT9
OTHERWISE REQUIRES:10
(a) "G
RANT PROGRAM" MEANS THE TELEHEALTH REMOTE11
MONITORING GRANT PROGRAM CREATED IN SUBSECTION (6) OF THIS12
SECTION.13
(b) "M
EMBER" MEANS ANY PERSON WHO HAS BEEN DETERMINED14
ELIGIBLE TO RECEIVE BENEFITS OR SERVICES UNDER THIS TITLE 25.5.15
(c) "T
ELEHEALTH REMOTE MONITORING " MEANS THE ONGOING16
REMOTE ASSESSMENT AND MONITORING OF CLINICAL DATA THROUGH17
TECHNOLOGICAL EQUIPMENT IN ORDER TO DETECT CHANGES IN A18
MEMBER'S CLINICAL STATUS, WHICH ALLOWS HEALTH-CARE PROVIDERS TO19
INTERVENE BEFORE A HEALTH CONDITION EXACERBATES AND REQUIRES20
EMERGENCY INTERVENTION OR INPATIENT HOSPITALIZATION .21
(2) (a) O
N OR BEFORE SEPTEMBER 1, 2024, THE STATE22
DEPARTMENT SHALL INITIATE A STAKEHOLDER PROCESS TO DETERMINE23
THE BILLING STRUCTURE FOR TELEHEALTH REMOTE MONITORING FOR24
OUTPATIENT CLINICAL SERVICES:25
(b) T
HE STATE DEPARTMENT STAKEHOLDER PROCESS , REQUIRED26
BY SUBSECTION (2)(a) OF THIS SECTION, MUST ENGAGE WITH27
168
-5- HEALTH-CARE PROVIDERS WHO SERVE RURAL AND UNDERSERVED1
POPULATIONS, INCLUDING RURAL HEALTH CLINICS AND FEDERALLY2
QUALIFIED HEALTH CENTERS TO ENSURE THE BILLING STRUCTURE IS3
SUSTAINABLE IN THESE HEALTH-CARE SETTINGS.4
(c) O
N OR BEFORE JUNE 30, 2025, THE STATE BOARD SHALL5
PROMULGATE RULES REGARDING THE BILLING STRUCTURE BASED ON6
FEEDBACK FROM THE STAKEHOLDER PROCESS REQUIRED IN SUBSECTIONS7
(2)(a)
AND (2)(b) OF THIS SECTION.8
(3) (a) B
EGINNING JULY 1, 2025, THE STATE DEPARTMENT SHALL9
PROVIDE REIMBURSEMENT FOR THE USE OF TELEHEALTH REMOTE10
MONITORING FOR OUTPATIENT CLINICAL SERVICES IF :11
(I) T
HE MEMBER'S HEALTH-CARE PROVIDER DETERMINES THAT12
TELEHEALTH REMOTE MONITORING IS MEDICALLY NECESSARY BASED ON13
THE MEMBER'S MEDICAL CONDITION OR STATUS;14
(II) T
HE MEMBER'S HEALTH-CARE PROVIDER DETERMINES THAT15
TELEHEALTH REMOTE MONITORING WOULD LIKELY PREVENT THE16
MEMBER'S ADMISSION OR READMISSION TO A HOSPITAL , EMERGENCY17
DEPARTMENT, NURSING FACILITY, OR OTHER CLINICAL SETTING;18
(III) T
HE MEMBER IS COGNITIVELY AND PHYSICALLY CAPABLE OF19
OPERATING THE TELEHEALTH REMOTE MONITORING DEVICE OR EQUIPMENT20
OR THE MEMBER HAS A CAREGIVER WHO IS ABLE AND WILLING TO ASSIST21
WITH THE TELEHEALTH REMOTE MONITORING DEVICE OR EQUIPMENT ; AND22
(IV) T
HE MEMBER RESIDES IN A SETTING THAT IS SUITABLE FOR23
TELEHEALTH REMOTE MONITORING AND DOES NOT HAVE HEALTH -CARE24
STAFF ON SITE.25
(b) T
HE STATE BOARD SHALL PROMULGATE RULES REGARDING26
ADDITIONAL ELIGIBILITY REQUIREMENTS. THE ELIGIBILITY REQUIREMENTS27
168
-6- MUST PRIORITIZE MEMBERS WITH CHRONIC CONDITIONS AND MEMBERS1
WHO ARE PREGNANT AND CARRYING A HIGH -RISK PREGNANCY.2
(4) T
HE ASSESSMENT AND MONITORING OF THE HEALTH DATA3
TRANSMITTED BY TELEHEALTH REMOTE MONITORING MUST BE PERFORMED4
BY ONE OF THE FOLLOWING LICENSED HEALTH -CARE PROFESSIONALS:5
(a) P
HYSICIAN;6
(b) P
ODIATRIST;7
(c) A
DVANCED PRACTICE REGISTERED NURSE ;8
(d) P
HYSICIAN ASSISTANT;9
(e) R
ESPIRATORY THERAPIST;
10
(f) P
HARMACIST; OR
11
(g) LICENSED HEALTH-CARE PROFESSIONAL WORKING UNDER THE12
SUPERVISION OF A MEDICAL DIRECTOR.13
(5) T
HE STATE DEPARTMENT MAY SEEK ANY FEDERAL14
AUTHORIZATION NECESSARY TO IMPLEMENT SUBSECTIONS (3) AND (4) OF15
THIS SECTION.16
(6) (a) T
HERE IS CREATED IN THE STATE DEPARTMENT THE17
TELEHEALTH REMOTE MONITORING GRANT PROGRAM TO PROVIDE GRANTS18
TO OUTPATIENT HEALTH-CARE FACILITIES LOCATED IN A DESIGNATED19
RURAL COUNTY OR A DESIGNATED HEALTH -CARE PROFESSIONAL
20
SHORTAGE AREA TO ASSIST THE HOSPITALS AND CLINICS WITH THE21
FINANCIAL COSTS ASSOCIATED WITH PROVIDING TELEHEALTH REMOTE22
MONITORING FOR OUTPATIENT CLINICAL SERVICES .23
(b) T
HE STATE DEPARTMENT SHALL ADMINISTER THE GRANT24
PROGRAM AND, SUBJECT TO AVAILABLE APPROPRIATIONS , SHALL AWARD25
GRANTS AS PROVIDED IN THIS SUBSECTION (6).26
(c) T
O BE ELIGIBLE FOR A GRANT, AN OUTPATIENT HEALTH-CARE27
168
-7- FACILITY MUST:1
(I) A
PPLY FOR A GRANT IN THE MANNER PRESCRIBED BY THE STATE2
DEPARTMENT;3
(II) B
E LOCATED IN A DESIGNATED RURAL COUNTY OR DESI GNATED4
HEALTH-CARE PROFESSIONAL
SHORTAGE AREA; AND5
(III) H
AVE A DEMONSTRATED NEED FOR FINANCIAL ASSISTANCE TO6
PURCHASE EQUIPMENT TO PROVIDE TELEHEALTH REMOTE MONITORING7
FOR OUTPATIENT CLINICAL SERVICES.8
(d) T
HE STATE DEPARTMENT MAY AWARD UP TO FIVE GRANTS
9
THROUGH THE GRANT PROGRAM . EACH GRANT AWARDED MUST BE IN THE10
AMOUNT OF ONE HUNDRED THOUSAND DOLLARS .11
(e) IN SELECTING GRANT RECIPIENTS, THE STATE DEPARTMENT12
SHALL PRIORITIZE APPLICANTS THAT SERVE POPULATIONS EXPERIENCING13
DISPARITIES IN HEALTH-CARE ACCESS AND OUTCOMES , INCLUDING, BUT14
NOT LIMITED TO, HISTORICALLY MARGINALIZED AND UNDERSERVED15
COMMUNITIES, DETERMINED BY THE COMMUNITIES WITH THE HIGHEST16
PROPORTION OF PATIENTS RECEIVING ASSISTANCE THROUGH THE17
"C
OLORADO MEDICAL ASSISTANCE ACT", THIS ARTICLE 5 AND ARTICLES18
4
AND 6 OF THIS TITLE 25.5.19
(f)
GRANT RECIPIENTS MAY USE MONEY RECEIVED THROUGH THE20
GRANT PROGRAM TO IMPLEMENT TELEHEALTH REMOTE MONITORING FOR21
OUTPATIENT CLINICAL SERVICES AND INCLUDES THE FOLLOWING :22
(I) T
RAINING STAFF TO USE, ASSESS, AND MONITOR TELEHEALTH23
REMOTE MONITORING EQUIPMENT AND DEVICES ; AND24
(II) A
CQUIRING TELEHEALTH REMOTE MONITORING EQUIPMENT25
AND DEVICES.26
(g)
MONEY ALLOCATED TO THE GRANT PROGRAM MUST NOT BE27
168
-8- CONSIDERED IN RATE-SETTING FOR FEDERALLY QUALIFIED HEALTH1
CENTERS, AS DEFINED IN THE FEDERAL "SOCIAL SECURITY ACT", 42 U.S.C.2
SEC. 1395X (aa)(4).3
(7) T
HE STATE DEPARTMENT IS AUTHORIZED TO RECEIVE AND
4
EXPEND GIFTS, GRANTS, AND DONATIONS FROM INDIVIDUALS , PRIVATE5
ORGANIZATIONS, FOUNDATIONS, OR ANY GOVERNMENTAL UNIT ; EXCEPT6
THAT NO GIFT, GRANT, OR DONATION MAY BE ACCEPTED BY THE STATE7
DEPARTMENT IF IT IS SUBJECT TO A CONDITION THAT IS INCONSISTENT8
WITH THIS SECTION OR ANY OTHER LAW OF THIS STATE .9
(8) THIS SECTION DOES NOT APPLY TO HOME HEALTH -CARE10
BENEFITS PROVIDED PURSUANT TO SECTION 25.5-5-321.11
SECTION 3. In Colorado Revised Statutes, add 25.5-5-338 as12
follows:13
25.5-5-338. Continuous glucose monitors - coverage - federal14
authorization - definition. (1) A
S USED IN THIS SECTION, UNLESS THE15
CONTEXT OTHERWISE REQUIRES , "CONTINUOUS GLUCOSE MONITOR "16
MEANS AN INSTRUMENT OR A DEVICE DESIGNED FOR THE PURPOSE OF17
AIDING IN THE TREATMENT OF DIABETES BY MEASURING GLUCOSE LEVELS18
ON DEMAND OR AT SET INTERVALS THROUGH A SMALL , ELECTRONIC19
SENSOR THAT SLIGHTLY PENETRATES AN INDIVIDUAL 'S SKIN WHEN APPLIED20
AND THAT IS DESIGNED TO REMAIN IN PLACE AND ACTIVE FOR AT LEAST21
SEVEN DAYS.22
(2) (a) B
EGINNING NOVEMBER 1, 2025, THE STATE DEPARTMENT23
SHALL PROVIDE COVERAGE FOR A CONTINUOUS GLUCOSE MONITOR AND24
RELATED SUPPLIES TO MEMBERS UNDER THE MEDICAID MEDICAL AND
25
PHARMACY BENEFIT.26
(b) C
OVERAGE CRITERIA MUST ALIGN WITH THE CURRENT GLUCOSE27
168
-9- MONITOR LOCAL COVERAGE DETERMINATION STANDARDS ISSUED BY THE1
CENTERS FOR MEDICARE AND MEDICAID THAT ARE USED TO DETERMINE2
COVERAGE FOR MEDICARE -ELIGIBLE INDIVIDUALS , INCLUDING3
INDIVIDUALS WITH GESTATIONAL DIABETES NOT BEING TREATED WITH4
INSULIN.5
(3) C
OVERAGE PURSUANT TO THIS SECTION INCLUDES THE COST OF6
ANY NECESSARY REPAIRS OR REPLACEMENT PARTS FOR THE CONTINUOUS7
GLUCOSE MONITOR.8
(4) T
HE STATE DEPARTMENT MAY SEEK ANY FEDERAL9
AUTHORIZATION NECESSARY TO IMPLEMENT THIS SECTION .10
(5) T
HE STATE DEPARTMENT IS AUTHORIZED TO RECEIVE AND
11
EXPEND GIFTS, GRANTS, AND DONATIONS FROM INDIVIDUALS , PRIVATE12
ORGANIZATIONS, FOUNDATIONS, OR ANY GOVERNMENTAL UNIT ; EXCEPT13
THAT NO GIFT, GRANT, OR DONATION MAY BE ACCEPTED BY THE STATE14
DEPARTMENT IF IT IS SUBJECT TO A CONDITION THAT IS INCONSISTENT15
WITH THIS SECTION OR ANY OTHER LAW OF THIS STATE .16
SECTION 4. Appropriation. For the 2024-25 state fiscal year,17
$34,128 is appropriated to the department of health care policy and18
financing for use by the executive director's office. This appropriation is19
from the general fund. To implement this act, the department may use this20
appropriation for personal services, which amount is based on an21
assumption that the department will require an additional 0.3 FTE.22
SECTION 5. Act subject to petition - effective date. This act23
takes effect at 12:01 a.m. on the day following the expiration of the24
ninety-day period after final adjournment of the general assembly; except25
that, if a referendum petition is filed pursuant to section 1 (3) of article V26
of the state constitution against this act or an item, section, or part of this27
168
-10- act within such period, then the act, item, section, or part will not take1
effect unless approved by the people at the general election to be held in2
November 2024 and, in such case, will take effect on the date of the3
official declaration of the vote thereon by the governor.4
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-11-