SENATE BILL 24-168
BY SENATOR(S) Roberts and Simpson, Michaelson Jenet, Bridges,
Buckner, Cutter, Exum, Fields, Gardner, Jaquez Lewis, Kirkmeyer, Liston,
Lundeen, Marchman, Mullica, Priola, Van Winkle, Will, Zenzinger;
also REPRESENTATIVE(S) 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.
C
ONCERNING REMOTE MONITORING SERVICES FOR MEDICAID MEMBERS ,
AND, IN CONNECTION THEREWITH, MAKING AN APPROPRIATION.
Be it enacted by the General Assembly of the State of Colorado:
SECTION 1. Legislative declaration. (1) The general assembly
finds that:
(a) Concerning the use of telehealth remote monitoring to provide
outpatient clinical services:
(I) Telehealth helps connect Medicaid members with health-care
providers, enabling members to receive the care and consultation they need
NOTE: This bill has been prepared for the signatures of the appropriate legislative
officers and the Governor. To determine whether the Governor has signed the bill
or taken other action on it, please consult the legislative status sheet, the legislative
history, or the Session Laws.
________
Capital letters or bold & italic numbers indicate new material added to existing law; dashes
through words or numbers indicate deletions from existing law and such material is not part of
the act. without traveling to visit a provider in another city or area of the state;
(II) Telehealth visits may provide cost savings for the Medicaid
system by improving access to primary care and helping avoid unnecessary
trips to the emergency department;
(III) More than 700,000 Coloradans live in a rural or frontier county.
Rural Coloradans face several unique challenges in health-care access,
affordability, and outcomes. Rural residents tend to be older and in poorer
health than their urban counterparts, and rural communities often face
challenges with access to care and financial viability. According to the
Centers for Disease Control and Prevention, rural residents are more likely
to die prematurely from heart disease, cancer, unintentional injury, chronic
lower respiratory disease, and stroke.
(IV) Despite these challenges, rural Coloradans play an important
role in food and energy production in the state and serve as an integral part
of Colorado's economy;
(V) Telehealth, including telehealth remote monitoring, is one of the
tools the Centers for Disease Control and Prevention has identified that can
be used to improve the health of rural residents. Telehealth remote
monitoring uses digital technologies to collect health data from patients in
one location and electronically transmit that information securely to
providers in a different location.
(VI) Telehealth remote monitoring technologies provide a particular
benefit for patients with chronic conditions to receive the care they need
without the need for constant in-person visits to the patient's physician's
office. Patients with chronic conditions such as diabetes, heart disease, and
chronic obstructive pulmonary disease often require ongoing monitoring
and management. Telehealth remote monitoring can help these patients
better manage their conditions by providing regular monitoring, alerts, and
support.
(VII) Multiple studies indicate that telehealth remote monitoring
offers patients a clear return on investment over time, which extends beyond
initial health-care savings, including money associated with transportation,
time, and energy to visit their doctors; prescription, laboratory, and imaging
costs; and hard and soft expenses if a hospital stay or emergency department
PAGE 2-SENATE BILL 24-168 visit is required;
(VIII) The return on telehealth remote monitoring isn't limited to
financial measurements. It also improves health outcomes, eliminates
communication barriers, facilitates faster access to providers, reduces
hospital readmissions, shortens hospital stays, and enhances patient
education.
(IX) Expanding access to telehealth remote monitoring for patients
is crucial to achieving health equity in Colorado.
(b) Concerning the use of continuous glucose monitoring devices:
(I) More than 300,000 Coloradans live with type 1 or type 2
diabetes;
(II) Managing diabetes requires strict blood glucose control
consisting of multiple blood glucose level checks daily, medication
administration, and balancing diet and physical activity;
(III) Continuous glucose monitoring devices provide patients and
health-care providers with more health data and detail concerning blood
glucose levels than traditional blood glucose meters;
(IV) For people with diabetes, continuous glucose monitoring
devices provide significant, life-changing, and lifesaving benefits for
managing their diabetes and can prevent or delay serious medical
complications, including those that may require hospitalization or could
lead to death;
(V) Individuals with diabetes who use continuous glucose
monitoring devices experience fewer episodes of hypoglycemia and a
reduction in their average blood glucose levels (A1C); and
(VI) Access to continuous glucose monitoring technology is
extremely important to individuals with diabetes, especially those who live
in communities with a disproportionate rate of diabetes. However, many
Coloradans with diabetes still lack access to this critical technology, even
though the use of continuous glucose monitoring devices is a recognized
standard of care for all insulin-dependent individuals.
PAGE 3-SENATE BILL 24-168 (2) Therefore, the general assembly declares that it is in the best
interest of the state of Colorado to reduce health disparities and increase
health equity by prioritizing expanded access to remote patient monitoring
services in outpatient health-care settings across the state and to provide
access to continuous glucose monitoring services to diabetic Coloradans to
decrease health-care costs and improve health outcomes for all Coloradans.
SECTION 2. In Colorado Revised Statutes, add 25.5-5-337 as
follows:
25.5-5-337. Telehealth remote monitoring services for outpatient
clinical services - grant program - federal authorization - rules -
definitions. (1) A
S USED IN THIS SECTION, UNLESS THE CONTEXT
OTHERWISE REQUIRES
:
(a) "G
RANT PROGRAM " MEANS THE TELEHEALTH REMOTE
MONITORING GRANT PROGRAM CREATED IN SUBSECTION
(6) OF THIS SECTION.
(b) "M
EMBER" MEANS ANY PERSON WHO HAS BEEN DETERMINED
ELIGIBLE TO RECEIVE BENEFITS OR SERVICES UNDER THIS TITLE
25.5.
(c) "T
ELEHEALTH REMOTE MONITORING " MEANS THE ONGOING
REMOTE ASSESSMENT AND MONITORING OF CLINICAL DATA THROUGH
TECHNOLOGICAL EQUIPMENT IN ORDER TO DETECT CHANGES IN A MEMBER
'S
CLINICAL STATUS
, WHICH ALLOWS HEALTH-CARE PROVIDERS TO INTERVENE
BEFORE A HEALTH CONDITION EXACERBATES AND REQUIRES EMERGENCY
INTERVENTION OR INPATIENT HOSPITALIZATION
.
(2) (a) O
N OR BEFORE SEPTEMBER 1, 2024, THE STATE DEPARTMENT
SHALL INITIATE A STAKEHOLDER PROCESS TO DETERMINE THE BILLING
STRUCTURE FOR TELEHEALTH REMOTE MONITORING FOR OUTPATIENT
CLINICAL SERVICES
:
(b) T
HE STATE DEPARTMENT STAKEHOLDER PROCESS , REQUIRED BY
SUBSECTION
(2)(a) OF THIS SECTION, MUST ENGAGE WITH HEALTH -CARE
PROVIDERS WHO SERVE RURAL AND UNDERSERVED POPULATIONS
, INCLUDING
RURAL HEALTH CLINICS AND FEDERALLY QUALIFIED HEALTH CENTERS TO
ENSURE THE BILLING STRUCTURE IS SUSTAINABLE IN THESE HEALTH
-CARE
SETTINGS
.
PAGE 4-SENATE BILL 24-168 (c) ON OR BEFORE JUNE 30, 2025, THE STATE BOARD SHALL
PROMULGATE RULES REGARDING THE BILLING STRUCTURE BASED ON
FEEDBACK FROM THE STAKEHOLDER PROCESS REQUIRED IN SUBSECTIONS
(2)(a) AND (2)(b) OF THIS SECTION.
(3) (a) B
EGINNING JULY 1, 2025, THE STATE DEPARTMENT SHALL
PROVIDE REIMBURSEMENT FOR THE USE OF TELEHEALTH REMOTE
MONITORING FOR OUTPATIENT CLINICAL SERVICES IF
:
(I) T
HE MEMBER'S HEALTH-CARE PROVIDER DETERMINES THAT
TELEHEALTH REMOTE MONITORING IS MEDICALLY NECESSARY BASED ON THE
MEMBER
'S MEDICAL CONDITION OR STATUS;
(II) T
HE MEMBER'S HEALTH-CARE PROVIDER DETERMINES THAT
TELEHEALTH REMOTE MONITORING WOULD LIKELY PREVENT THE MEMBER
'S
ADMISSION OR READMISSION TO A HOSPITAL
, EMERGENCY DEPARTMENT ,
NURSING FACILITY, OR OTHER CLINICAL SETTING;
(III) T
HE MEMBER IS COGNITIVELY AND PHYSICALLY CAPABLE OF
OPERATING THE TELEHEALTH REMOTE MONITORING DEVICE OR EQUIPMENT
OR THE MEMBER HAS A CAREGIVER WHO IS ABLE AND WILLING TO ASSIST
WITH THE TELEHEALTH REMOTE MONITORING DEVICE OR EQUIPMENT
; AND
(IV) THE MEMBER RESIDES IN A SETTING THAT IS SUITABLE FOR
TELEHEALTH REMOTE MONITORING AND DOES NOT HAVE HEALTH
-CARE
STAFF ON SITE
.
(b) T
HE STATE BOARD SHALL PROMULGATE RULES REGARDING
ADDITIONAL ELIGIBILITY REQUIREMENTS
. THE ELIGIBILITY REQUIREMENTS
MUST PRIORITIZE MEMBERS WITH CHRONIC CONDITIONS AND MEMBERS WHO
ARE PREGNANT AND CARRYING A HIGH
-RISK PREGNANCY.
(4) T
HE ASSESSMENT AND MONITORING OF THE HEALTH DATA
TRANSMITTED BY TELEHEALTH REMOTE MONITORING MUST BE PERFORMED
BY ONE OF THE FOLLOWING LICENSED HEALTH
-CARE PROFESSIONALS:
(a) P
HYSICIAN;
(b) P
ODIATRIST;
PAGE 5-SENATE BILL 24-168 (c) ADVANCED PRACTICE REGISTERED NURSE ;
(d) P
HYSICIAN ASSISTANT;
(e) R
ESPIRATORY THERAPIST;
(f) P
HARMACIST; OR
(g) LICENSED HEALTH-CARE PROFESSIONAL WORKING UNDER THE
SUPERVISION OF A MEDICAL DIRECTOR
.
(5) T
HE STATE DEPARTMENT MAY SEEK ANY FEDERAL
AUTHORIZATION NECESSARY TO IMPLEMENT SUBSECTIONS
(3) AND (4) OF
THIS SECTION
.
(6) (a) T
HERE IS CREATED IN THE STATE DEPARTMENT THE
TELEHEALTH REMOTE MONITORING GRANT PROGRAM TO PROVIDE GRANTS
TO OUTPATIENT HEALTH
-CARE FACILITIES LOCATED IN A DESIGNATED RURAL
COUNTY OR A DESIGNATED HEALTH
-CARE PROFESSIONAL SHORTAGE AREA
TO ASSIST THE HOSPITALS AND CLINICS WITH THE FINANCIAL COSTS
ASSOCIATED WITH PROVIDING TELEHEALTH REMOTE MONITORING FOR
OUTPATIENT CLINICAL SERVICES
.
(b) T
HE STATE DEPARTMENT SHALL ADMINISTER THE GRANT
PROGRAM AND
, SUBJECT TO AVAILABLE APPROPRIATIONS , SHALL AWARD
GRANTS AS PROVIDED IN THIS SUBSECTION
(6).
(c) T
O BE ELIGIBLE FOR A GRANT, AN OUTPATIENT HEALTH-CARE
FACILITY MUST
:
(I) A
PPLY FOR A GRANT IN THE MANNER PRESCRIBED BY THE STATE
DEPARTMENT
;
(II) B
E LOCATED IN A DESIGNATED RURAL COUNTY OR DESIGNATED
HEALTH
-CARE PROFESSIONAL SHORTAGE AREA ; AND
(III) HAVE A DEMONSTRATED NEED FOR FINANCIAL ASSISTANCE TO
PURCHASE EQUIPMENT TO PROVIDE TELEHEALTH REMOTE MONITORING FOR
OUTPATIENT CLINICAL SERVICES
.
PAGE 6-SENATE BILL 24-168 (d) THE STATE DEPARTMENT MAY AWARD UP TO FIVE GRANTS
THROUGH THE GRANT PROGRAM
. EACH GRANT AWARDED MUST BE IN THE
AMOUNT OF ONE HUNDRED THOUSAND DOLLARS
.
(e) I
N SELECTING GRANT RECIPIENTS, THE STATE DEPARTMENT SHALL
PRIORITIZE APPLICANTS THAT SERVE POPULATIONS EXPERIENCING
DISPARITIES IN HEALTH
-CARE ACCESS AND OUTCOMES , INCLUDING, BUT NOT
LIMITED TO
, HISTORICALLY MARGINALIZED AND UNDERSERVED
COMMUNITIES
, DETERMINED BY THE COMMUNITIES WITH THE HIGHEST
PROPORTION OF PATIENTS RECEIVING ASSISTANCE THROUGH THE
"COLORADO MEDICAL ASSISTANCE ACT", THIS ARTICLE 5 AND ARTICLES 4
AND 6 OF THIS TITLE 25.5.
(f) G
RANT RECIPIENTS MAY USE MONEY RECEIVED THROUGH THE
GRANT PROGRAM TO IMPLEMENT TELEHEALTH REMOTE MONITORING FOR
OUTPATIENT CLINICAL SERVICES AND INCLUDES THE FOLLOWING
:
(I) T
RAINING STAFF TO USE, ASSESS, AND MONITOR TELEHEALTH
REMOTE MONITORING EQUIPMENT AND DEVICES
; AND
(II) ACQUIRING TELEHEALTH REMOTE MONITORING EQUIPMENT AND
DEVICES
.
(g) M
ONEY ALLOCATED TO THE GRANT PROGRAM MUST NOT BE
CONSIDERED IN RATE
-SETTING FOR FEDERALLY QUALIFIED HEALTH CENTERS ,
AS DEFINED IN THE FEDERAL "SOCIAL SECURITY ACT", 42 U.S.C. SEC. 1395X
(aa)(4).
(7) T
HE STATE DEPARTMENT IS AUTHORIZED TO RECEIVE AND
EXPEND GIFTS
, GRANTS, AND DONATIONS FROM INDIVIDUALS , PRIVATE
ORGANIZATIONS
, FOUNDATIONS, OR ANY GOVERNMENTAL UNIT ; EXCEPT
THAT NO GIFT
, GRANT, OR DONATION MAY BE ACCEPTED BY THE STATE
DEPARTMENT IF IT IS SUBJECT TO A CONDITION THAT IS INCONSISTENT WITH
THIS SECTION OR ANY OTHER LAW OF THIS STATE
.
(8) T
HIS SECTION DOES NOT APPLY TO HOME HEALTH-CARE BENEFITS
PROVIDED PURSUANT TO SECTION
25.5-5-321.
SECTION 3. In Colorado Revised Statutes, add 25.5-5-338 as
follows:
PAGE 7-SENATE BILL 24-168 25.5-5-338. Continuous glucose monitors - coverage - federal
authorization - definition. (1) A
S USED IN THIS SECTION, UNLESS THE
CONTEXT OTHERWISE REQUIRES
, "CONTINUOUS GLUCOSE MONITOR " MEANS
AN INSTRUMENT OR A DEVICE DESIGNED FOR THE PURPOSE OF AIDING IN THE
TREATMENT OF DIABETES BY MEASURING GLUCOSE LEVELS ON DEMAND OR
AT SET INTERVALS THROUGH A SMALL
, ELECTRONIC SENSOR THAT SLIGHTLY
PENETRATES AN INDIVIDUAL
'S SKIN WHEN APPLIED AND THAT IS DESIGNED
TO REMAIN IN PLACE AND ACTIVE FOR AT LEAST SEVEN DAYS
.
(2) (a) B
EGINNING NOVEMBER 1, 2025, THE STATE DEPARTMENT
SHALL PROVIDE COVERAGE FOR A CONTINUOUS GLUCOSE MONITOR AND
RELATED SUPPLIES TO MEMBERS UNDER THE MEDICAID MEDICAL AND
PHARMACY BENEFIT
.
(b) C
OVERAGE CRITERIA MUST ALIGN WITH THE CURRENT GLUCOSE
MONITOR LOCAL COVERAGE DETERMINATION STANDARDS ISSUED BY THE
CENTERS FOR MEDICARE AND MEDICAID THAT ARE USED TO D ETERMINE
COVERAGE FOR MEDICARE
-ELIGIBLE INDIVIDUALS, INCLUDING INDIVIDUALS
WITH GESTATIONAL DIABETES NOT BEING TREATED WITH INSULIN
.
(3) C
OVERAGE PURSUANT TO THIS SECTION INCLUDES THE COST OF
ANY NECESSARY REPAIRS OR REPLACEMENT PARTS FOR THE CONTINUOUS
GLUCOSE MONITOR
.
(4) T
HE STATE DEPARTMENT MAY SEEK ANY FEDERAL
AUTHORIZATION NECESSARY TO IMPLEMENT THIS SECTION
.
(5) T
HE STATE DEPARTMENT IS AUTHORIZED TO RECEIVE AND
EXPEND GIFTS
, GRANTS, AND DONATIONS FROM INDIVIDUALS , PRIVATE
ORGANIZATIONS
, FOUNDATIONS, OR ANY GOVERNMENTAL UNIT ; EXCEPT
THAT NO GIFT
, GRANT, OR DONATION MAY BE ACCEPTED BY THE STATE
DEPARTMENT IF IT IS SUBJECT TO A CONDITION THAT IS INCONSISTENT WITH
THIS SECTION OR ANY OTHER LAW OF THIS STATE
.
SECTION 4. Appropriation. For the 2024-25 state fiscal year,
$34,128 is appropriated to the department of health care policy and
financing for use by the executive director's office. This appropriation is
from the general fund. To implement this act, the department may use this
appropriation for personal services, which amount is based on an
assumption that the department will require an additional 0.3 FTE.
PAGE 8-SENATE BILL 24-168 SECTION 5. Act subject to petition - effective date. This act
takes effect at 12:01 a.m. on the day following the expiration of the
ninety-day period after final adjournment of the general assembly; except
that, if a referendum petition is filed pursuant to section 1 (3) of article V
of the state constitution against this act or an item, section, or part of this act
within such period, then the act, item, section, or part will not take effect
unless approved by the people at the general election to be held in
November 2024 and, in such case, will take effect on the date of the official
declaration of the vote thereon by the governor.
____________________________ ____________________________
Steve Fenberg Julie McCluskie
PRESIDENT OF SPEAKER OF THE HOUSE
THE SENATE OF REPRESENTATIVES
____________________________ ____________________________
Cindi L. Markwell Robin Jones
SECRETARY OF CHIEF CLERK OF THE HOUSE
THE SENATE OF REPRESENTATIVES
APPROVED________________________________________
(Date and Time)
_________________________________________
Jared S. Polis
GOVERNOR OF THE STATE OF COLORADO
PAGE 9-SENATE BILL 24-168