A Bill for an Act
Page 1, Line 101Concerning mandatory health-care coverage for preventive
Page 1, Line 102kidney function screening services.
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.)
The bill adds kidney function screening services as preventive health-care services for which insurance policies or contracts in the state must provide total-cost coverage. Coverage for kidney function screening services will be implemented for all large employer health benefit policies or contracts issued or renewed in this state after January 1, 2027, and all individual and small group health benefit plans issued or renewed in this state on or after January 1, 2028, as long as the state is not required to defray the cost of the coverage of the kidney function screening services.
Page 2, Line 1Be it enacted by the General Assembly of the State of Colorado:
Page 2, Line 2SECTION 1. In Colorado Revised Statutes, 10-16-104, amend
Page 2, Line 3(18)(a)(I) introductory portion; and add (18)(b.8) as follows:
Page 2, Line 410-16-104. Mandatory coverage provisions - applicability -
Page 2, Line 5rules - legislative declaration - definitions.
Page 2, Line 6(18) Prevention health-care services - legislative declaration
Page 2, Line 7- rules - definitions.
Page 2, Line 8(a) (I) The following policies and contracts that are issued or
Page 2, Line 9renewed in this state must provide coverage for the total cost of the
Page 2, Line 10preventive health-care services specified in subsections (18)(b), (18)(b.3),
Page 2, Line 11
andPage 2, Line 12(b.8) (I) The general assembly finds and declares that:
Page 2, Line 13(A) Chronic kidney disease and end-stage renal disease
Page 2, Line 14impose a severe health and financial burden on Colorado
Page 2, Line 15residents. In 2021, over eight thousand Colorado residents were
Page 2, Line 16being treated for end-stage renal disease, with four thousand
Page 2, Line 17nine hundred ninety-four of those residents depending on
Page 2, Line 18dialysis to stay alive. The annual insurance costs for chronic
Page 2, Line 19kidney disease in Colorado have reached four hundred
Page 2, Line 20fifty-seven million dollars with patients paying nearly
Page 2, Line 21fifty-eight million dollars out-of-pocket. According to the
Page 2, Line 22centers for disease control and prevention in the federal
Page 2, Line 23department of health and human services, one out of every
Page 2, Line 24seven Americans has chronic kidney disease, and up to ninety
Page 2, Line 25percent of those individuals do not know that they have it. The
Page 3, Line 1number of individuals who have chronic kidney disease is
Page 3, Line 2disproportionately higher in minority communities.
Page 3, Line 3(B) Early screening for chronic kidney disease is essential
Page 3, Line 4but currently underutilized in Colorado. Among the eight
Page 3, Line 5hundred thousand two hundred six Coloradans who have
Page 3, Line 6hypertension, diabetes, or both hypertension and diabetes, an
Page 3, Line 7estimated one hundred forty-four thousand two hundred
Page 3, Line 8seventeen individuals likely have advanced, stages four or five,
Page 3, Line 9chronic kidney disease but many remain undiagnosed due to
Page 3, Line 10inadequate screening. Screening is critical because it allows for
Page 3, Line 11earlier diagnosis and cheaper interventions, which prevent the
Page 3, Line 12significant rise in cost and strain on the health-care system
Page 3, Line 13that occurs when chronic kidney disease is diagnosed late and,
Page 3, Line 14as a result, is often more advanced.
Page 3, Line 15(C) Early detection through screening is cost-effective
Page 3, Line 16and prevents disease progression. Each comprehensive kidney
Page 3, Line 17function screening test includes serum creatinine, estimated
Page 3, Line 18glomerular filtration rate, and urine albumin-creatinine
Page 3, Line 19testing. This modest investment in preventive care can identify
Page 3, Line 20disease at earlier and more treatable stages.
Page 3, Line 21(D) Without early detection, the financial burden of
Page 3, Line 22chronic kidney disease escalates dramatically as the condition
Page 3, Line 23progresses. Patient out-of-pocket expenses rise from an average
Page 3, Line 24of two hundred eight dollars annually for stage one chronic
Page 3, Line 25kidney disease to ten thousand one hundred eighty-three
Page 3, Line 26dollars for end-stage renal disease.
Page 3, Line 27(E) The kidney disease prevention and education task
Page 4, Line 1force, established pursuant to House Bill 21-1171, enacted in
Page 4, Line 22021, conducted a comprehensive study and identified early
Page 4, Line 3detection through accessible screening as critical to reducing
Page 4, Line 4both health complications and the financial strain of kidney
Page 4, Line 5disease on Colorado residents and the Colorado health-care
Page 4, Line 6system.
Page 4, Line 7(II) The general assembly further declares that the
Page 4, Line 8purpose of this subsection (18)(b.8) is to:
Page 4, Line 9(A) Implement the recommendations of the kidney disease
Page 4, Line 10prevention and education task force by requiring health
Page 4, Line 11insurance coverage for annual preventive kidney function
Page 4, Line 12screening services without cost-sharing requirements;
Page 4, Line 13(B) Remove financial barriers that currently prevent
Page 4, Line 14early diagnosis of chronic kidney disease, particularly among
Page 4, Line 15high-risk populations with hypertension or diabetes;
Page 4, Line 16(C) Enable timely medical intervention before kidney
Page 4, Line 17disease progresses to costly advanced stages that require
Page 4, Line 18dialysis or kidney transplantation;
Page 4, Line 19(D) Reduce the overall financial burden of kidney disease
Page 4, Line 20on Colorado patients, insurance plans, and state health-care
Page 4, Line 21programs through cost-effective preventive care; and
Page 4, Line 22(E) Improve health outcomes for Colorado residents by
Page 4, Line 23facilitating earlier detection and treatment of chronic kidney
Page 4, Line 24disease.
Page 4, Line 25(III) The coverage required by this subsection (18) must
Page 4, Line 26include annual kidney function screening services designed to
Page 4, Line 27identify patients at risk for chronic kidney disease, including
Page 5, Line 1glomerular filtration rate, or "GFR", testing, basic metabolic
Page 5, Line 2panel, or "BMP", testing, and urine testing for screening albumin
Page 5, Line 3and creatinine levels.
Page 5, Line 4(IV) Except as provided in subsection (18)(b.8)(VI) of this
Page 5, Line 5section, and to the extent that such coverage is not in addition
Page 5, Line 6to benefits provided pursuant to the state benchmark plan
Page 5, Line 7required pursuant to 45 CFR 156.111, all large employer health
Page 5, Line 8benefit plans issued or renewed in this state on or after January
Page 5, Line 91, 2027, shall provide coverage for kidney function screening
Page 5, Line 10services.
Page 5, Line 11(V) Except as provided in subsection (18)(b.8)(VI) of this
Page 5, Line 12section, and to the extent that such coverage is not in addition
Page 5, Line 13to benefits provided pursuant to the state benchmark plan
Page 5, Line 14required pursuant to 45 CFR 156.111, all individual and small
Page 5, Line 15group health benefit plans issued or renewed in this state on or
Page 5, Line 16after January 1, 2028, shall provide coverage for kidney
Page 5, Line 17function screening services.
Page 5, Line 18(VI) This subsection (18)(b.8) is inoperative and the state
Page 5, Line 19shall not assume an obligation for the coverage required
Page 5, Line 20pursuant to this subsection (18)(b.8) if the division determines
Page 5, Line 21that the benefit specified in this subsection (18)(b.8) requires
Page 5, Line 22state defrayal of the cost of coverage pursuant to a provision
Page 5, Line 23of the federal act, including 42 U.S.C. sec. 18031 (d)(3)(B) or a
Page 5, Line 24successor provision, and the implementing regulations or the
Page 5, Line 25state is otherwise required to defray the cost of coverage
Page 5, Line 26required pursuant to this subsection (18)(b.8).
Page 5, Line 27SECTION 2. Act subject to petition - effective date. This act
Page 6, Line 1takes effect at 12:01 a.m. on the day following the expiration of the
Page 6, Line 2ninety-day period after final adjournment of the general assembly (August
Page 6, Line 312, 2026, if adjournment sine die is on May 13, 2026); except that, if a
Page 6, Line 4referendum petition is filed pursuant to section 1 (3) of article V of the
Page 6, Line 5state constitution against this act or an item, section, or part of this act
Page 6, Line 6within such period, then the act, item, section, or part will not take effect
Page 6, Line 7unless approved by the people at the general election to be held in
Page 6, Line 8November 2026 and, in such case, will take effect on the date of the
Page 6, Line 9official declaration of the vote thereon by the governor.