Colorado 2025 Regular Session

Colorado House Bill HB1033 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
	1	+	First Regular Session
	2	+	Seventy-fifth General Assembly
	3	+	STATE OF COLORADO
	4	+	REREVISED
	5	+	This Version Includes All Amendments
	6	+	Adopted in the Second House
	7	+	LLS NO. 25-0417.01 Chelsea Princell x4335
1	8		HOUSE BILL 25-1033
2		-	BY REPRESENTATIVE(S) Lieder and Garcia Sander, Bacon, Bird,
3		-	Brown, Carter, Duran, Hamrick, Joseph, Lindsay, Marshall, Paschal,
4		-	Phillips, Stewart R., Titone, Woodrow;
5		-	also SENATOR(S) Weissman, Amabile, Bridges, Cutter, Daugherty, Exum,
6		-	Gonzales J., Hinrichsen, Jodeh, Kipp, Michaelson Jenet, Mullica, Coleman.
	9	+	House Committees Senate Committees
	10	+	Health & Human Services Health & Human Services
	11	+	A BILL FOR AN ACT
7	12		C
8		-	ONCERNING MEDICAL ASSISTANCE THIRD -PARTY LIABILITY PAYMENTS.
9		-
10		-	Be it enacted by the General Assembly of the State of Colorado:
11		-	SECTION 1. In Colorado Revised Statutes, 25.5-4-209, amend
12		-	(2)(b)(III), (2)(b)(IV) introductory portion, and (2)(b)(IV)(B); and add
13		-	(2)(b)(V) as follows:
14		-	25.5-4-209. Payments by third parties - copayments by members
15		-	- review - appeal - children's waiting list reduction fund - rules.
16		-	(2) (b) A third party, as a condition of doing business in the state, shall:
	13	+	ONCERNING MEDICAL ASSISTANCE THIRD -PARTY LIABILITY101
	14	+	PAYMENTS.102
	15	+	Bill Summary
	16	+	(Note: This summary applies to this bill as introduced and does
	17	+	not reflect any amendments that may be subsequently adopted. If this bill
	18	+	passes third reading in the house of introduction, a bill summary that
	19	+	applies to the reengrossed version of this bill will be available at
	20	+	http://leg.colorado.gov
	21	+	.)
	22	+	The bill requires third-party payers to reimburse the department of
	23	+	health care policy and financing (state department) for health-care items
	24	+	and services rendered to a medicaid member regardless of whether prior
	25	+	authorization was obtained.
	26	+	The bill requires third-party payers to respond to the state
	27	+	department's inquiry regarding a claim for payment no later than 60 days
	28	+	SENATE
	29	+	3rd Reading Unamended
	30	+	February 12, 2025
	31	+	SENATE
	32	+	2nd Reading Unamended
	33	+	February 11, 2025
	34	+	HOUSE
	35	+	3rd Reading Unamended
	36	+	January 23, 2025
	37	+	HOUSE
	38	+	2nd Reading Unamended
	39	+	January 22, 2025
	40	+	HOUSE SPONSORSHIP
	41	+	Lieder and Garcia Sander, Bacon, Bird, Brown, Carter, Duran, Hamrick, Joseph,
	42	+	Lindsay, Marshall, Paschal, Phillips, Stewart R., Titone, Woodrow
	43	+	SENATE SPONSORSHIP
	44	+	Weissman, Amabile, Bridges, Coleman, Cutter, Daugherty, Exum, Gonzales J., Hinrichsen,
	45	+	Jodeh, Kipp, Michaelson Jenet, Mullica
	46	+	Shading denotes HOUSE amendment. Double underlining denotes SENATE amendment.
	47	+	Capital letters or bold & italic numbers indicate new material to be added to existing law.
	48	+	Dashes through the words or numbers indicate deletions from existing law. after receiving the state department's inquiry. The third party must
	49	+	respond either by paying the claim or issuing a written denial of the claim
	50	+	to the state department.
	51	+	Be it enacted by the General Assembly of the State of Colorado:1
	52	+	SECTION 1. In Colorado Revised Statutes, 25.5-4-209, amend2
	53	+	(2)(b)(III), (2)(b)(IV) introductory portion, and (2)(b)(IV)(B); and add3
	54	+	(2)(b)(V) as follows:4
	55	+	25.5-4-209. Payments by third parties - copayments by5
	56	+	members - review - appeal - children's waiting list reduction fund -6
	57	+	rules. (2) (b) A third party, as a condition of doing business in the state,7
	58	+	shall:8
17	59		(III) Respond to any inquiry by the state
18		-	NO LATER THAN SIXTY
19		-	DAYS FOLLOWING THE RECEIPT OF AN INQUIRY BY THE STATE DEPARTMENT
20		-	regarding a claim for payment for any health-care item or service that is
21		-	submitted not
22		-	NO later than three years after the date of the provision of the
23		-	NOTE: This bill has been prepared for the signatures of the appropriate legislative
24		-	officers and the Governor. To determine whether the Governor has signed the bill
25		-	or taken other action on it, please consult the legislative status sheet, the legislative
26		-	history, or the Session Laws.
27		-	________
28		-	Capital letters or bold & italic numbers indicate new material added to existing law; dashes
29		-	through words or numbers indicate deletions from existing law and such material is not part of
30		-	the act. health-care item or service; and SERVICE, RESPOND BY EITHER PAYING THE
31		-	CLAIM OR ISSUING A WRITTEN DENIAL TO THE STATE DEPARTMENT
32		-	;
33		-	(IV) Agree not to deny a claim submitted by the state
34		-	DEPARTMENT
35		-	solely on the basis of the date of submission of the claim, the type or format
36		-	of the claim form, or a failure to present proper documentation at the point
37		-	of sale that is the basis of the claim, if:
	60	+	NO LATER THAN SIXTY9
	61	+	DAYS FOLLOWING THE RECEIPT OF AN INQUIRY BY THE STATE DEPARTMENT10
	62	+	regarding a claim for payment for any health-care item or service that is11
	63	+	submitted not NO later than three years after the date of the provision of12
	64	+	the health-care item or service; and SERVICE, RESPOND BY EITHER PAYING13
	65	+	THE CLAIM OR ISSUING A WRITTEN DENIAL TO THE STATE DEPARTMENT ;14
	66	+	(IV) Agree not to deny a claim submitted by the state15
	67	+	DEPARTMENT solely on the basis of the date of submission of the claim,16
	68	+	the type or format of the claim form, or a failure to present proper17
	69	+	documentation at the point of sale that is the basis of the claim, if:18
38	70		(B) Any action by the state
39		-	DEPARTMENT to enforce its rights ~~with~~
	71	+	DEPARTMENT to enforce its rights with19
40	72		respect to the claim is commenced within six years after the state's
41		-	STATE
42		-	DEPARTMENT
43		-	'S submission of the claim; AND
44		-	(V) ACCEPT THE STATE DEPARTMENT 'S PAYMENT OF A CLAIM FOR A
45		-	HEALTH
46		-	-CARE ITEM OR SERVICE TO BE THE EQUIVALENT OF THE
47		-	HEALTH
48		-	-CARE PROVIDER OR THE MEMBER HAVING OBTAINED PRIOR
49		-	AUTHORIZATION FOR THE ITEM OR SERVICE FROM THE THIRD PARTY
50		-	.
51		-	SECTION 2. Safety clause. The general assembly finds,
52		-	determines, and declares that this act is necessary for the immediate
53		-	preservation of the public peace, health, or safety or for appropriations for
54		-	PAGE 2-HOUSE BILL 25-1033 the support and maintenance of the departments of the state and state
55		-	institutions.
56		-	____________________________ ____________________________
57		-	Julie McCluskie James Rashad Coleman, Sr.
58		-	SPEAKER OF THE HOUSE PRESIDENT OF
59		-	OF REPRESENTATIVES THE SENATE
60		-	____________________________ ____________________________
61		-	Vanessa Reilly Esther van Mourik
62		-	CHIEF CLERK OF THE HOUSE SECRETARY OF
63		-	OF REPRESENTATIVES THE SENATE
64		-	APPROVED________________________________________
65		-	(Date and Time)
66		-	_________________________________________
67		-	Jared S. Polis
68		-	GOVERNOR OF THE STATE OF COLORADO
69		-	PAGE 3-HOUSE BILL 25-1033
	73	+	STATE20
	74	+	DEPARTMENT'S submission of the claim; AND21
	75	+	(V) A
	76	+	CCEPT THE STATE DEPARTMENT 'S PAYMENT OF A CLAIM FOR22
	77	+	A HEALTH-CARE ITEM OR SERVICE TO BE THE EQUIVALENT OF THE23
	78	+	HEALTH-CARE PROVIDER OR THE MEMBER HAVING OBTAINED PRIOR24
	79	+	1033-2- AUTHORIZATION FOR THE ITEM OR SERVICE FROM THE THIRD PARTY .1
	80	+	SECTION 2. Safety clause. The general assembly finds,2
	81	+	determines, and declares that this act is necessary for the immediate3
	82	+	preservation of the public peace, health, or safety or for appropriations for4
	83	+	the support and maintenance of the departments of the state and state5
	84	+	institutions.6
	85	+	1033
	86	+	-3-