House Committee of Reference Report
Committee on Health & Human Services
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February 10, 2026
After consideration on the merits, the Committee recommends the following:
HB26-1002 be amended as follows, and as so amended, be referred to the Committee on Appropriations with favorable recommendation:
Page 1, Line 1Amend printed bill, strike everything below the enacting clause and
Page 1, Line 2substitute:
Page 1, Line 3"SECTION 1. In Colorado Revised Statutes, 10-16-704, add
Page 1, Line 4(15.5) as follows:
Page 1, Line 510-16-704. Network adequacy - required disclosures - balance
Page 1, Line 6billing - rules - legislative declaration - definitions.
Page 1, Line 7(15.5) (a) Beginning January 1, 2027, at least once every
Page 1, Line 8twelve months, a carrier shall confirm the network
Page 1, Line 9participation of a mental health provider, substance use
Page 1, Line 10provider, or psychiatric nurse, as the terms are defined in
Page 1, Line 11section 10-16-705.7, who has not submitted a claim in the
Page 1, Line 12preceding twelve months or has otherwise communicated with
Page 1, Line 13the carrier in a manner evidencing the provider's intent to
Page 1, Line 14continue participating in the carrier's network and for whom no
Page 1, Line 15change in provider status is reported by a centralized national
Page 1, Line 16provider database that collects, standardizes, and maintains
Page 1, Line 17provider credentialing and practice information.
Page 1, Line 18(b) The carrier shall contact the provider, or the
Page 1, Line 19provider's designated notice contact identified in the provider's
Page 1, Line 20contract agreement with the carrier, by mail or the electronic
Page 1, Line 21means that the carrier traditionally uses to communicate with
Page 1, Line 22providers in the carrier's provider network to confirm the
Page 1, Line 23provider's intent to continue participating in the carrier's
Page 1, Line 24provider network and to inquire whether the provider is
Page 1, Line 25accepting new patients. If, based on the provider's feedback, the
Page 1, Line 26provider's information needs to be updated in the carrier's
Page 1, Line 27provider network directories, the carrier must update its
Page 2, Line 1carrier's provider network directories, as necessary, within five
Page 2, Line 2business days after contacting the provider.
Page 2, Line 3(c) If the provider fails to respond to a carrier's inquiry
Page 2, Line 4within thirty days after the carrier contacts or attempts to
Page 2, Line 5contact the provider or the provider's designated notice
Page 2, Line 6contact identified in the provider's contract agreement with the
Page 2, Line 7carrier, the carrier shall mail a follow-up request to the
Page 2, Line 8provider by certified mail, return receipt requested, or the
Page 2, Line 9electronic means that the carrier traditionally uses to
Page 2, Line 10communicate with providers in the carrier's provider network.
Page 2, Line 11If the provider fails to respond to the carrier's follow-up
Page 2, Line 12request within thirty days after receipt of the request, the
Page 2, Line 13carrier must remove the provider from its carrier provider
Page 2, Line 14network and update its carrier's provider network directories,
Page 2, Line 15as necessary, within five business days after the expiration of
Page 2, Line 16the thirty-day period.
Page 2, Line 17SECTION 2. In Colorado Revised Statutes, 10-16-705.7, amend
Page 2, Line 18(1)(a), (1)(b), (1)(d), (1)(j), (2)(c), (5), (6) introductory portion, (6)(b),
Page 2, Line 19(8)(a) introductory portion, (8)(a)(II), (8)(b), (8)(c), (9), (9.5), and (10);
Page 2, Line 20and add (1)(g.5), (1)(g.9), (1)(h.2), (1)(i.5), (1)(i.7), (1)(k), and (9.7) as
Page 2, Line 21follows:
Page 2, Line 2210-16-705.7. Timely credentialing of providers by carriers -
Page 2, Line 23notice of receipt required - notice of incomplete applications required
Page 2, Line 24- delegated credentialing agreements - discrepancies - denials of
Page 2, Line 25claims prohibited - disclosures - recredentialing - enforcement - rules
Page 2, Line 26- definitions.
Page 2, Line 27(1) As used in this section, unless the context otherwise requires:
Page 2, Line 28(a) "Applicant" means a physician, mental health provider,
Page 2, Line 29substance use provider, or psychiatric nurse who submits an
Page 2, Line 30application to a carrier to become a participating physician provider in
Page 2, Line 31the carrier's provider network.
Page 2, Line 32(b) "Application" means an applicant's application to become
Page 2, Line 33credentialed by a carrier as a participating physician provider in at least
Page 2, Line 34one of the carrier's provider networks.
Page 2, Line 35(d) "Credentialing" or "credential" means the process by which a
Page 2, Line 36carrier or its designee collects information concerning an applicant;
Page 2, Line 37assesses whether the applicant satisfies the relevant licensing, education,
Page 2, Line 38and training requirements to become a participating physician provider;
Page 2, Line 39verifies the assessment; and approves or disapproves the applicant's
Page 2, Line 40application.
Page 2, Line 41(g.5) "Mental health provider" means a mental health
Page 2, Line 42entity licensed pursuant to article 1.5 of title 25 or mental
Page 2, Line 43health professional licensed or certified pursuant to article 245
Page 3, Line 1of title 12, except for unlicensed psychotherapists regulated
Page 3, Line 2pursuant to article 245 of title 12.
Page 3, Line 3 (g.9) "Participating mental health provider, substance
Page 3, Line 4use provider, or psychiatric nurse" means a mental health
Page 3, Line 5provider, substance use provider, or psychiatric nurse who is
Page 3, Line 6credentialed by a carrier or its designee to provide health-care
Page 3, Line 7items or services to covered persons in at least one of the
Page 3, Line 8carrier's provider networks.
Page 3, Line 9(h.2) "Participating provider" means a participating
Page 3, Line 10physician or a participating mental health provider, substance
Page 3, Line 11use provider, or psychiatric nurse.
Page 3, Line 12(i.5) "Pre-licensed provider" means a "registrant" as
Page 3, Line 13defined in section 12-245-202.
Page 3, Line 14(i.7) "Psychiatric nurse" means a registered professional
Page 3, Line 15nurse, as defined in section 12-255-104, who, by virtue of
Page 3, Line 16postgraduate education and additional nursing preparation, has
Page 3, Line 17gained knowledge, judgment, and skill in psychiatric or mental
Page 3, Line 18health nursing.
Page 3, Line 19(j) "Recredentialing" or "recredential" means the process by which
Page 3, Line 20a carrier or its designee confirms that a participating physician provider
Page 3, Line 21is in good standing and continues to satisfy the carrier's requirements for
Page 3, Line 22participating physicians providers.
Page 3, Line 23(k) "Substance use disorder provider" means a mental
Page 3, Line 24health entity licensed pursuant to article 1.5 of title 25 that
Page 3, Line 25specializes in treating substance use disorders or a mental
Page 3, Line 26health professional licensed or certified pursuant to article 245
Page 3, Line 27of title 12 who specializes in treating substance use disorders,
Page 3, Line 28except for unlicensed psychotherapists regulated pursuant to
Page 3, Line 29article 245 of title 12.
Page 3, Line 30(2) (c) If a carrier receives a completed application but fails to
Page 3, Line 31provide the applicant a receipt in written or electronic form within seven
Page 3, Line 32calendar days after receiving the completed application, as required by
Page 3, Line 33subsection (2)(a) of this section, the carrier shall consider the applicant
Page 3, Line 34a participating physician provider, effective no later than fifty-three
Page 3, Line 35calendar days following the carrier's receipt of the application.
Page 3, Line 36(5) A carrier shall correct discrepancies in its provider or network
Page 3, Line 37directory within thirty calendar days after receiving a report of the
Page 3, Line 38discrepancy from a the participating physician provider. A participating
Page 3, Line 39physician provider shall notify a carrier by mail or the electronic
Page 3, Line 40means that the carrier traditionally uses to communicate with
Page 3, Line 41the providers in the carrier's provider network of any change in
Page 3, Line 42the physician's provider's name, address, telephone number, business
Page 3, Line 43structure, or tax identification number within fifteen business days after
Page 4, Line 1making the change.
Page 4, Line 2(6) A carrier may shall not deny a claim for a medically
Page 4, Line 3necessary covered service provided to a covered person if the service:
Page 4, Line 4(b) Is provided by a participating physician provider who is in
Page 4, Line 5the carrier's provider network for the carrier's health coverage plan and
Page 4, Line 6has concluded the carrier's credentialing process.
Page 4, Line 7(8) (a) A carrier or its designee may recredential a participating
Page 4, Line 8physician provider if such recredentialing is:
Page 4, Line 9(II) Permitted by the carrier's contract with the participating
Page 4, Line 10physician provider.
Page 4, Line 11(b) A carrier shall not require a participating physician provider
Page 4, Line 12to submit an application or participate in a contracting process in order to
Page 4, Line 13be recredentialed.
Page 4, Line 14(c) Nothing in This subsection (8) affects does not affect the
Page 4, Line 15contract termination rights of a carrier or a participating physician
Page 4, Line 16provider.
Page 4, Line 17(9) Except as described in subsection (8) of this section and as
Page 4, Line 18may be provided in a contract between a carrier and a participating
Page 4, Line 19physician provider, a carrier shall allow a participating physician
Page 4, Line 20provider to remain credentialed and include the participating physician
Page 4, Line 21provider in the carrier's health coverage plan provider network unless
Page 4, Line 22the carrier discovers information indicating that the participating
Page 4, Line 23physician provider no longer satisfies the carrier's guidelines for
Page 4, Line 24participation, in which case the carrier shall satisfy the requirements
Page 4, Line 25described in section 10-16-705 (5) before terminating the participating
Page 4, Line 26physician's provider's participation in the carrier's provider network.
Page 4, Line 27(9.5) A carrier shall not refuse to credential an applicant or
Page 4, Line 28terminate a participating physician's provider's participation in a
Page 4, Line 29carrier's provider network based solely on the applicant's or
Page 4, Line 30participating physician's provider's provision of, or assistance in the
Page 4, Line 31provision of, a legally protected health-care activity, as defined in section
Page 4, Line 3212-30-121 (1)(d), in this state, so long as the care provided did not violate
Page 4, Line 33Colorado law.
Page 4, Line 34(9.7) (a) A carrier shall reimburse a participating mental
Page 4, Line 35health provider, substance use provider, or psychiatric nurse
Page 4, Line 36for covered medically necessary treatment, as defined in
Page 4, Line 37section 10-16-104 (5.5)(d)(IV), furnished by a pre-licensed
Page 4, Line 38provider who is under the supervision of the participating
Page 4, Line 39mental health provider, substance use provider, or psychiatric
Page 4, Line 40nurse who has satisfied all required supervision rules and
Page 4, Line 41criteria.
Page 4, Line 42(b) If a health benefit plan offers out-of-network
Page 4, Line 43benefits, the carrier must reimburse the covered person for
Page 5, Line 1covered medically necessary treatment, as defined in section
Page 5, Line 210-16-104 (5.5)(d)(IV), that is provided by an out-of-network
Page 5, Line 3pre-licensed provider under the supervision of a
Page 5, Line 4nonparticipating mental health provider, substance use
Page 5, Line 5provider, or psychiatric nurse in accordance with the terms of
Page 5, Line 6coverage applicable to nonparticipating providers under the
Page 5, Line 7health benefit plan as long as the supervising provider submits
Page 5, Line 8documentation evidencing the supervision.
Page 5, Line 9(10) The commissioner shall enforce this section and may
Page 5, Line 10promulgate such adopt rules as are necessary for the implementation of
Page 5, Line 11to implement this section. Upon receiving more than one complaint
Page 5, Line 12from an applicant or a participating physician provider alleging a
Page 5, Line 13violation of this section by a carrier, the commissioner shall investigate
Page 5, Line 14the complaints. A carrier that fails to comply with this section or with any
Page 5, Line 15rules adopted pursuant to this section is subject to such civil penalties as
Page 5, Line 16that the commissioner may order pursuant to section 10-1-310.
Page 5, Line 17SECTION 3. In Colorado Revised Statutes, 12-245-404, amend
Page 5, Line 18(2)(c) as follows:
Page 5, Line 1912-245-404. Qualifications - examination - licensure and
Page 5, Line 20registration - rules.
Page 5, Line 21(2) The board shall license as a licensed clinical social worker a
Page 5, Line 22person who files an application, in a form and manner required by the
Page 5, Line 23board, submits the fee required by the board pursuant to section
Page 5, Line 2412-245-205, and submits evidence satisfactory to the board that the
Page 5, Line 25applicant:
Page 5, Line 26(c) Has practiced social work for at least two years under the
Page 5, Line 27virtual or in-person supervision of a licensed clinical social worker or
Page 5, Line 28other person with equivalent experience as determined by the board,
Page 5, Line 29which practice includes training and work experience in the area of
Page 5, Line 30clinical social work practice and includes at least three thousand
Page 5, Line 31hours of practice; and
Page 5, Line 32SECTION 4. Act subject to petition - effective date. This act
Page 5, Line 33takes effect at 12:01 a.m. on the day following the expiration of the
Page 5, Line 34ninety-day period after final adjournment of the general assembly (August
Page 5, Line 3512, 2026, if adjournment sine die is on May 13, 2026); except that, if a
Page 5, Line 36referendum petition is filed pursuant to section 1 (3) of article V of the
Page 5, Line 37state constitution against this act or an item, section, or part of this act
Page 5, Line 38within such period, then the act, item, section, or part will not take effect
Page 5, Line 39unless approved by the people at the general election to be held in
Page 5, Line 40November 2026 and, in such case, will take effect on the date of the
Page 5, Line 41official declaration of the vote thereon by the governor.".