A Bill for an Act
Page 1, Line 101Concerning limits on the amounts that certain health
Page 1, Line 102insurers may reimburse for the provision of certain
Page 1, Line 103health-care services, and, in connection therewith,
Page 1, Line 104creating the "Support Colorado's Health-Care Safety
Page 1, Line 105Net Act of 2025".
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 sets the reimbursement rates that a health insurance carrier (carrier) may reimburse a health-care provider (provider) for covered services for the state employee group benefit plans (state group benefit plans) and for small employer group benefit plans (small group plans).
The bill prohibits a provider that is subject to the reimbursement limitations from billing or collecting payment from a person covered under a state group benefit plan or small group plan for any outstanding balance for covered services that is not reimbursed by the carrier, except for the applicable in-network coinsurance, copayment, or deductible amounts.
The bill requires a carrier to provide cost and quality of care information to the commissioner of insurance (commissioner) in the case of small group plans and to the director of the department of personnel (director) in the case of state group benefit plans, at the request of the commissioner or director, as applicable, and prohibits a carrier from entering into an agreement with a provider or third party that would restrict the carrier from providing the information.
By September 1, 2027, and by September 1 each year thereafter, the director is required to provide a report to the governor's office, the state treasurer's office, and the joint budget committee that states the amount of calculated savings in general fund expenditures (calculated savings), if any, for health plan reimbursement for the prior fiscal year as a result of the reimbursement limits for state group benefit plans. The director is also required to include in the report the cost to the department in determining the calculated savings. By September 15, 2027, and by September 15 each year thereafter, of the money from the calculated savings, the state treasurer is required to transfer an amount equal to the department's costs in determining the calculated savings to the group benefit plans expenditure savings cash fund (expenditure savings cash fund), which is created in the bill, and specified percentages of the calculated savings from the general fund to the primary care fund and to the expenditure savings cash fund.
The bill also requires the executive director of the department of health care policy and financing (state department) to conduct a study, in collaboration with specified state agencies, to determine the feasibility of establishing a similar reimbursement limit for group benefit plans offered to school district, higher education, and local government employees. The executive director is required to complete the study and report the findings to the general assembly on or before January 1, 2028. The bill allocates $500,000 from the calculated savings to a health care reimbursement feasibility study cash fund created in the bill and authorizes the state department to use the money to conduct the study.
This Unofficial Version Includes Committee
Amendments Not Yet Adopted on Second Reading
Page 2, Line 1Be it enacted by the General Assembly of the State of Colorado:
Page 2, Line 2SECTION 1. In Colorado Revised Statutes, add 10-16-711 as follows:
Page 3, Line 110-16-711. Group health benefit plans - small employer
Page 3, Line 2carriers - reimbursement to providers and facilities - limitations -
Page 3, Line 3required participation in small group market - penalties - definitions.
Page 3, Line 4(1) As used in this section, unless the context otherwise requires:
Page 3, Line 5(a) "Affiliated health facility" means a health facility
Page 3, Line 6that is affiliated with a hospital or health system under a
Page 3, Line 7professional services agreement, faculty agreement, or
Page 3, Line 8management agreement that permits the hospital or health system to bill on behalf of the health facility.
Page 3, Line 9(b) (I) "Equivalent rate" means the payment or
Page 3, Line 10reimbursement rate determined by rule of the commissioner
Page 3, Line 11for a hospital that is part of a pediatric specialty hospital
Page 3, Line 12system where over ninety percent of the hospital system's
Page 3, Line 13population served is under eighteen years of age and that has a level I pediatric trauma center.
Page 3, Line 14(II) The "equivalent rate" is:
Page 3, Line 15(A) Calculated by multiplying the medicaid fee schedule
Page 3, Line 16for the hospital by a conversion factor equal to the ratio of the
Page 3, Line 17statewide payment-to-cost ratio for medicare to the hospital's specific payment-to-cost ratio, which is 1.52; and
Page 3, Line 18(B) Adjusted annually for cumulative inflation by a
Page 3, Line 19factor equal to the average percentage increase in the medicare
Page 3, Line 20inpatient and outpatient prospective payment systems over the previous three years.
Page 3, Line 21(c) "Essential access hospital" means a critical access
Page 4, Line 1hospital or a general hospital that is located in a rural area and that has twenty-five or fewer licensed beds.
Page 4, Line 2(d) "Health facility" means a facility licensed or certified
Page 4, Line 3pursuant to section 25-1.5-103 or established pursuant to part 5 of article 21 of title 23 or article 29 of title 25.
Page 4, Line 4(e) "Health system" means a corporation or other
Page 4, Line 5organization that owns, contains, or operates three or more hospitals.
Page 4, Line 6(f) (I) "Hospital" means a hospital that is licensed or
Page 4, Line 7certified by the department of public health and environment
Page 4, Line 8pursuant to the department's authority under section 25-1.5-103
Page 4, Line 9(1)(a) or that is established pursuant to part 5 of article 21 of title 23 or article 29 of title 25.
Page 4, Line 10(II) "Hospital" does not include a hospital or other
Page 4, Line 11medical facility created by and operated under the authority of section 25-29-101.
Page 4, Line 12(g) "Medicare reimbursement rate" means the
Page 4, Line 13facility-specific reimbursement rate for a particular
Page 4, Line 14health-care service provided under the "Health Insurance for
Page 4, Line 15the Aged Act", title XVIII of the federal "Social Security Act",
Page 4, Line 1642 U.S.C. sec. 1395 et seq. For hospitals that medicare reimburses
Page 4, Line 17under the hospital inpatient prospective payment system and the
Page 4, Line 18hospital outpatient prospective payment system, the "medicare
Page 4, Line 19reimbursement rate" means the rate based on the applicable
Page 4, Line 20prospective payment system fee schedule that is effective as of
Page 4, Line 21the quarter in which the carrier will file rates pursuant to
Page 4, Line 22section 10-16-107.
Page 5, Line 2(h) "Small group market" means the market for small group health benefit plans.
Page 5, Line 3(i) "Small group health benefit plan" means a health benefit plan offered or issued to a small employer.
Page 5, Line 4(2) (a) Except as otherwise provided in subsection (2)(b) of
Page 5, Line 5this section, beginning January 1, 2027, each carrier offering
Page 5, Line 6coverage in the small group market shall reimburse providers in accordance with the following requirements:
Page 5, Line 7(I) For inpatient and outpatient services, excluding
Page 5, Line 8professional services, received at an in-network hospital or at
Page 5, Line 9an in-network affiliated health facility, the reimbursement
Page 5, Line 10must not exceed, and the hospital or affiliated health facility
Page 5, Line 11shall not charge more than, the lesser of: The carrier's
Page 5, Line 12contracted rate for the service in the 2024 plan year; or one
Page 5, Line 13hundred sixty-five percent of the medicare reimbursement rate
Page 5, Line 14or one hundred sixty-five percent of the equivalent rate, whichever is applicable, for the same or similar services;and
Page 5, Line 15(II) For inpatient and outpatient services, excluding
Page 5, Line 16professional services, received at an out-of-network hospital or
Page 5, Line 17at an out-of-network affiliated health facility, the
Page 5, Line 18reimbursement must not exceed, and the hospital or affiliated
Page 5, Line 19health facility shall not charge more than, one hundred fifty
Page 5, Line 20percent of the medicare reimbursement rate or one hundred
Page 5, Line 21fifty percent of the equivalent rate, whichever is applicable, for the same or similar services.
Page 6, Line 1(b) Subsection (2)(a) of this section does not apply to an essential access hospital.
Page 6, Line 2(3) This section does not prohibit a carrier offering
Page 6, Line 3coverage in the small group market from reimbursing a hospital
Page 6, Line 4or an affiliated health facility through an alternative
Page 6, Line 5payment model that is not paid on a fee-for-services or per-claim
Page 6, Line 6basis so long as the payments incentivize the hospital or
Page 6, Line 7affiliated health facility to achieve higher quality or improved
Page 6, Line 8health outcomes and the carrier continues to comply with the reimbursement requirements of this section.
Page 6, Line 9(4) A hospital or an affiliated health facility that is
Page 6, Line 10reimbursed in accordance with subsection(2)(a)of this section
Page 6, Line 11shall not bill or collect payment from a covered person for any
Page 6, Line 12outstanding balance for covered services not paid by the
Page 6, Line 13carrier, except for the applicable in-network coinsurance,
Page 6, Line 14deductible, or copayment amount required, pursuant to the
Page 6, Line 15small group health benefit plan, to be paid by the covered person.
Page 6, Line 16(5) At the request of the commissioner, a carrier offering
Page 6, Line 17coverage in the small group market shall provide cost and
Page 6, Line 18quality of care information to the commissioner, including
Page 6, Line 19negotiated reimbursement rate data. A carrier shall not enter
Page 6, Line 20into an agreement with a hospital, health facility, provider, or
Page 6, Line 21third party that would restrict the carrier from providing cost and quality of care information to the commissioner.
Page 6, Line 22(6) (a) In establishing and filing rates for small group
Page 6, Line 23plans pursuant to section 10-16-107, a carrier must take into
Page 7, Line 1account any anticipated reduction in the cost of services
Page 7, Line 2provided at a hospital or affiliated health facility that may result from the application of this section.
Page 7, Line 3(b) (I) The commissioner may require a hospital or
Page 7, Line 4affiliated health facility to participate in a small group health
Page 7, Line 5benefit plan offered in the small group market and to accept the
Page 7, Line 6reimbursement rate specified in this section. If the commissioner
Page 7, Line 7requires a hospital or affiliated health facility to participate
Page 7, Line 8in a small group health benefit plan and to accept the
Page 7, Line 9reimbursement rate specified in this section and receives notice
Page 7, Line 10that a hospital or affiliated health facility refuses to
Page 7, Line 11participate in a small group market health benefit plan and
Page 7, Line 12accept the reimbursement rate specified in this section, the
Page 7, Line 13commissioner shall issue a warning to the hospital or affiliated
Page 7, Line 14health facility. If the hospital or affiliated health facility
Page 7, Line 15refuses to participate in a small group market health benefit
Page 7, Line 16plan and accept the reimbursement rate specified in this section
Page 7, Line 17after receipt of the warning, the commissioner shall fine the
Page 7, Line 18hospital or affiliated health facility up to ten thousand
Page 7, Line 19dollars per day for the first thirty days that the hospital or
Page 7, Line 20affiliated health facility refuses to participate and accept the
Page 7, Line 21reimbursement rate specified in this section and up to forty
Page 7, Line 22thousand dollars per day for each day beyond the first thirty
Page 7, Line 23days that the hospital or affiliated health facility refuses to
Page 7, Line 24participate and accept the reimbursement rate specified in this section.
Page 7, Line 25(II) In determining the appropriate fine pursuant to
Page 8, Line 1subsection (6)(b)(I) of this section, the commissioner shall
Page 8, Line 2consider any recommendations from the department of public
Page 8, Line 3health and environment, the hospital's financial circumstances, and other circumstances the commissioner deems relevant.
Page 8, Line 4(7) The commissioner may adopt rules in accordance with article 4 of title 24 to implement this section.
Page 8, Line 5SECTION 2. In Colorado Revised Statutes, 10-16-704, amend (5.5)(b)(I) introductory portion; and add (5.5)(b)(IV) as follows:
Page 8, Line 610-16-704. Network adequacy - required disclosures - balance
Page 8, Line 7billing - rules - legislative declaration - definitions. (5.5) (b) (I) If a
Page 8, Line 8covered person receives emergency services at an out-of-network facility,
Page 8, Line 9other than any out-of-network facility operated by the Denver health and
Page 8, Line 10hospital authority pursuant to article 29 of title 25,
thePage 8, Line 11provided in subsection (5.5)(b)(IV) of this section, a carrier shall
Page 8, Line 12reimburse the out-of-network provider in accordance with subsection
Page 8, Line 13(3)(d)(II) of this section and reimburse the out-of-network facility directly in accordance with section 10-16-106.5 the greater of:
Page 8, Line 14(IV) For a covered person enrolled in a small group plan
Page 8, Line 15who receives emergency services at an out-of-network facility
Page 8, Line 16other than an essential access hospital, as defined in section
Page 8, Line 1710-16-711 (1)(c), the carrier shall reimburse the out-of-network
Page 8, Line 18facility directly in accordance with sections 10-16-106.5 and 10-16-711 (2)(a)(II).
Page 8, Line 19SECTION 3. In Colorado Revised Statutes, 25-3-122, amend (3)(a) as follows:
Page 8, Line 2025-3-122. Out-of-network facilities - emergency medical
Page 8, Line 21services - billing - payment - deceptive trade practice. (3) (a) (I) An
Page 9, Line 1out-of-network facility, other than any out-of-network facility operated
Page 9, Line 2by the Denver health and hospital authority pursuant to article 29 of title
Page 9, Line 325, must send a claim for emergency services to the carrier within one
Page 9, Line 4hundred eighty days after the receipt of insurance information in order to receive reimbursement as specified in this subsection (3)(a).
Page 9, Line 5(II) Except as provided in subsection (3)(a)(III) of this section, the reimbursement rate is the greater of:
Page 9, Line 6(A) One hundred five percent of the carrier's median in-network
Page 9, Line 7rate of reimbursement for that service provided in a similar facility or setting in the same geographic area; or
Page 9, Line 8(B) The median in-network rate of reimbursement for the same
Page 9, Line 9service provided in a similar facility or setting in the same geographic
Page 9, Line 10area for the prior year based on claims data from the all-payer health claims database created in section 25.5-1-204.
Page 9, Line 11(III) For emergency services provided by an
Page 9, Line 12out-of-network facility, other than an essential access
Page 9, Line 13hospital, as defined in section 10-16-711 (1)(c), to a covered
Page 9, Line 14person enrolled in a small group plan, as defined in section
Page 9, Line 1510-16-102 (63), the reimbursement rate is determined in accordance with section 10-16-711 (2)(a)(II).
Page 9, Line 16SECTION 4. In Colorado Revised Statutes, 24-50-605, add (1)(g) as follows:
Page 9, Line 1724-50-605. Group benefit plans - specifications - contracts.
Page 9, Line 18(1) (g) The specifications drawn by the director for any group
Page 9, Line 19benefit plans shall include the parameters for provider reimbursements specified in section 24-50-621.
Page 9, Line 20SECTION 5. In Colorado Revised Statutes, add 24-50-621 as follows:
Page 10, Line 124-50-621. Group benefit plans - reimbursement limits for
Page 10, Line 2health plans - hospital services - health plan expenditure savings
Page 10, Line 3distribution - group benefit plans expenditure savings cash fund -
Page 10, Line 4report - short title - rules - definitions. (1) The short title of this
Page 10, Line 5section is the "Support Colorado's Health-Care Safety Net Act of 2025".
Page 10, Line 6(2) As used in this section, unless the context otherwise requires:
Page 10, Line 7(a) "Affiliated health facility" means a health facility
Page 10, Line 8that is affiliated with a hospital or health system under a
Page 10, Line 9professional services agreement, faculty agreement, or
Page 10, Line 10management agreement that permits the hospital or health system to bill on behalf of the health facility.
Page 10, Line 11(b) (I) "Equivalent rate" means the payment or
Page 10, Line 12reimbursement rate determined by rule of the commissioner of
Page 10, Line 13insurance for a hospital that is part of a pediatric specialty
Page 10, Line 14hospital system where over ninety percent of the hospital
Page 10, Line 15system's population served is under eighteen years of age and that has a level I pediatric trauma center.
Page 10, Line 16(II) The "equivalent rate" is:
Page 10, Line 17(A) Calculated by multiplying the medicaid fee schedule
Page 10, Line 18for the hospital by a conversion factor equal to the ratio of the
Page 10, Line 19statewide payment-to-cost ratio for medicare to the hospital's specific payment-to-cost ratio, which is 1.52; and
Page 10, Line 20(B) Adjusted annually for cumulative inflation by a
Page 10, Line 21factor equal to the average percentage increase in the medicare
Page 11, Line 1inpatient and outpatient prospective payment systems over the previous three years.
Page 11, Line 2(c) "Essential access hospital" means a critical access
Page 11, Line 3hospital or a general hospital that is located in a rural area and that has twenty-five or fewer licensed beds.
Page 11, Line 4(d) "Health facility" means a facility licensed or certified
Page 11, Line 5pursuant to section 25-1.5-103 or established pursuant to part 5 of article 21 of title 23 or article 29 of title 25.
Page 11, Line 6(e) "Health system" means a corporation or other
Page 11, Line 7organization that owns, contains, or operates three or more hospitals.
Page 11, Line 8(f) "Hospital" means a hospital that is licensed or
Page 11, Line 9certified by the department of public health and environment
Page 11, Line 10pursuant to the department's authority under section 25-1.5-103
Page 11, Line 11(1)(a) or that is established pursuant to part 5 of article 21 of title 23 or article 29 of title 25.
Page 11, Line 12(g) "Medicare reimbursement rate" means the
Page 11, Line 13facility-specific reimbursement rate for a particular
Page 11, Line 14health-care service provided under the "Health Insurance for
Page 11, Line 15the Aged Act", title XVIII of the federal "Social Security Act",
Page 11, Line 1642 U.S.C., sec. 1395 et seq. For hospitals that medicare reimburses
Page 11, Line 17under the hospital inpatient prospective payment system and the
Page 11, Line 18hospital outpatient prospective payment system, the "medicare
Page 11, Line 19reimbursement rate" means the rate based on the applicable
Page 11, Line 20prospective payment system fee schedule that is effective as of each January of the applicable plan year.
Page 12, Line 1(3) (a) Except as otherwise provided in subsection (3)(b) of
Page 12, Line 2this section, beginning July 1, 2026, each carrier that provides or
Page 12, Line 3administers a group benefit plan pursuant to this part 6 shall
Page 12, Line 4reimburse providers in accordance with the following
Page 12, Line 5requirements for the following services provided to an employee or dependent enrolled in the group benefit plan:
Page 12, Line 6(I) For inpatient and outpatient services, excluding
Page 12, Line 7professional services, received at an in-network hospital or at
Page 12, Line 8an in-network affiliated health facility, the reimbursement
Page 12, Line 9must not exceed, and the hospital or affiliated health facility
Page 12, Line 10shall not charge more than, the lesser of: The carrier's
Page 12, Line 11contracted rate for the service in the annual group benefit plan
Page 12, Line 12year that commences in the 2024-25 state fiscal year; or one
Page 12, Line 13hundred sixty-five percent of the medicare reimbursement rate
Page 12, Line 14or one hundred sixty-five percent of the equivalent rate, whichever is applicable, for the same or similar services; and
Page 12, Line 15(II) For inpatient and outpatient services, excluding
Page 12, Line 16professional services, received at an out-of-network hospital or
Page 12, Line 17at an out-of-network affiliated health facility, the
Page 12, Line 18reimbursement must not exceed, and the hospital or affiliated
Page 12, Line 19health facility shall not charge more than, one hundred fifty
Page 12, Line 20percent of the medicare reimbursement rate or one hundred
Page 12, Line 21fifty percent of the equivalent rate, whichever is applicable, for the same or similar services.
Page 12, Line 23(b) Subsection (3)(a) of this section does not apply to an
Page 12, Line 24essential access hospital.
Page 13, Line 1(4) This section does not prohibit a carrier from reimbursing a hospital or affiliated health facility through an
Page 13, Line 2alternative payment model that is not paid on a fee-for-services
Page 13, Line 3or per-claim basis so long as the payments incentivize the
Page 13, Line 4hospital or affiliated health facility to achieve higher quality
Page 13, Line 5or improved health outcomes and the carrier continues to comply with the reimbursement requirements of this section.
Page 13, Line 6(5) A hospital or an affiliated health facility that is
Page 13, Line 7reimbursed in accordance with subsection(3)(a)of this section
Page 13, Line 8shall not bill or collect payment from a plan enrollee for any
Page 13, Line 9outstanding balance for covered services not paid by the
Page 13, Line 10carrier, except for the applicable in-network coinsurance,
Page 13, Line 11deductible, or copayment amount required, pursuant to the group benefit plan, to be paid by the plan enrollee.
Page 13, Line 12(6) At the request of the director, a carrier shall provide
Page 13, Line 13cost and quality of care information to the director, including
Page 13, Line 14negotiated reimbursement rate data. A carrier shall not enter
Page 13, Line 15into an agreement with a hospital, health facility, provider, or
Page 13, Line 16third party that would restrict the carrier from providing cost and quality of care information to the director.
Page 13, Line 17(7) (a) By September 1, 2027, and by September 1 each year
Page 13, Line 18thereafter, the director shall provide a report to the
Page 13, Line 19governor's office, the office of the state treasurer, and the
Page 13, Line 20joint budget committee of the general assembly that specifies
Page 13, Line 21the calculated savings, if any, in general fund expenditures
Page 13, Line 22that result from reduced provider reimbursements under group
Page 13, Line 23benefit plans in the immediately preceding fiscal year pursuant
Page 14, Line 1to this section. The director shall include in the report the cost
Page 14, Line 2to the department to determine the calculated savings, if any,
Page 14, Line 3in general fund expenditures that result from reduced provider
Page 14, Line 4reimbursements under group benefit plans in the immediately
Page 14, Line 5preceding state fiscal year as pursuant to this section, as reported pursuant to this subsection (7)(a).
Page 14, Line 7(b) By September 15, 2027, of the calculated general fund
Page 14, Line 8expenditure savings identified in the report required by
Page 14, Line 9subsection (7)(a) of this section, the state treasurer shall transfer from the general fund:
Page 14, Line 10(I) Five hundred thousand dollars to the health care
Page 14, Line 11reimbursement feasibility study cash fund, created in section
Page 14, Line 1225.5-1-135 (5), to be used by the department of health care policy
Page 14, Line 13and financing for the feasibility study required in section 25.5-1-135;
Page 14, Line 14(II) five hundred thousand nine hundred fifteen dollars
Page 14, Line 15to the supplier database cash fund created in section
Page 14, Line 1624-102-202.5 (2)(a), to reimburse the department for paying the
Page 14, Line 17actual expenses incurred by the division of insurance to
Page 14, Line 18implement the requirements of section 10-16-711 pursuant to section 24-102-202.5 (2)(c); and
Page 14, Line 19(III) The amount specified in the report submitted for the
Page 14, Line 202026-27 state fiscal year pursuant to subsection (7)(a) of this
Page 14, Line 21section that is remaining after the state treasurer transfers
Page 14, Line 22the amounts required by subsections (7)(b)(I) and (7)(b)(II) of this
Page 14, Line 23section to the group benefit plans expenditure savings cash fund
Page 15, Line 1created in subsection (8) of this section to be used as specified in subsection (8)(c) of this section.
Page 15, Line 2(c) By September 15, 2028, and by September 15 each year
Page 15, Line 3thereafter, the state treasurer shall transfer from the
Page 15, Line 4general fund to the group benefit plans expenditure savings
Page 15, Line 5cash fund created in subsection (8) of this section an amount
Page 15, Line 6equal to the calculated general fund expenditure savings
Page 15, Line 7identified in the report required by subsection (7)(a) of this section, to be used as specified in subsection (8)(c) of this section.
Page 15, Line 8(8) (a) The group benefit plans expenditure savings cash
Page 15, Line 9fund is created in the state treasury. The fund consists of money
Page 15, Line 10transferred to the fund pursuant to subsections(7)(b)(III)
Page 15, Line 11and (7)(c) of this section and any other money that the general assembly may appropriate or transfer to the fund.
Page 15, Line 12(b) The state treasurer shall credit all interest and
Page 15, Line 13income derived from the deposit and investment of money in the group benefit plans expenditure savings cash fund to the fund.
Page 15, Line 15(c) Subject to annual appropriation by the general assembly, the money in the fund shall be used as follows:
Page 15, Line 16(I) For the 2027-28 state fiscal year and each state fiscal
Page 15, Line 17year thereafter, the department shall expend money from the
Page 15, Line 18fund to reimburse the department for its costs in determining
Page 15, Line 19the calculated savings, if any, in general fund expenditures
Page 15, Line 20that result from reduced provider reimbursements under group
Page 15, Line 21benefit plans in the immediately preceding state fiscal year
Page 15, Line 22pursuant to this section. After money in the fund is used for the
Page 16, Line 1purpose specified in this subsection (8)(c)(I), the general assembly
Page 16, Line 2shall appropriate the money remaining in the fund as specified in subsection (8)(c)(II) of this section.
Page 16, Line 3(II) For the 2027-28 state fiscal year and each state fiscal
Page 16, Line 4year thereafter, of the amount remaining after the requirement
Page 16, Line 5of subsection (8)(c)(I) of this section has been satisfied, the
Page 16, Line 6general assembly shall appropriate, based on the estimates
Page 16, Line 7prepared pursuant to subsection (8)(d) of this section, the following:
Page 16, Line 8(A) An amount equal to twenty percent of the remaining
Page 16, Line 9amount to the group benefit plans reserve fund created in
Page 16, Line 10section 24-50-613 to be used by the department to reduce group
Page 16, Line 11benefit plan premium costs for state employees for the remainder of the applicable state fiscal year;
Page 16, Line 12(B) An amount equal to sixty percent of the remaining
Page 16, Line 13amount to the primary care fund created in section 24-22-117
Page 16, Line 14(2)(b) to be used by the department of health care policy and financing for the purposes specified in that section; and
Page 16, Line 15(C) An amount equal to twenty percent of the remaining
Page 16, Line 16amount to the behavioral health safety net cash fund created
Page 16, Line 17in section 27-50-306 to be used by the department of human services for the purposes specified in that section.
Page 16, Line 18(d) By January 15, 2026, and by January 15 each year
Page 16, Line 19thereafter, the office of state planning and budgeting shall
Page 16, Line 20submit to the joint budget committee an estimate of the amount
Page 16, Line 21that will remain in the fund after the requirement of subsection
Page 16, Line 22(8)(c)(I) of this section has been satisfied.
Page 17, Line 1(9) (a) Each carrier that provides or administers a group
Page 17, Line 2benefit plan pursuant to this part 6 shall ensure that all
Page 17, Line 3savings that the carrier realizes as a result of this section are
Page 17, Line 4passed on to the state. Upon request of the director, a carrier
Page 17, Line 5shall provide all documentation that demonstrates that the savings were passed on to the state.
Page 17, Line 6(b) If there is an overage where a carrier retains any
Page 17, Line 7portion of the savings specified in subsection (9)(a) of this
Page 17, Line 8section, the carrier is required to transfer an amount equal to the overage to the state.
Page 17, Line 9(10) The director may adopt rules in accordance with
Page 17, Line 10article 4 of this title 24 to implement this section, including
Page 17, Line 11rules for levying fines and taking other contract actions deemed necessary to enforce compliance with this section.
Page 17, Line 12SECTION 6. In Colorado Revised Statutes, add 25.5-1-135 as follows:
Page 17, Line 1325.5-1-135. Feasibility study - requirements for health plan
Page 17, Line 14reimbursement for public employee group benefit plans - school
Page 17, Line 15districts - higher education institutions - local governments - health
Page 17, Line 16plan reimbursement feasibility study cash fund - repeal. (1) The
Page 17, Line 17executive director shall conduct a study to determine the
Page 17, Line 18feasibility of establishing specifications for health plan
Page 17, Line 19reimbursements, similar to the requirements established for
Page 17, Line 20state employee group benefit plans pursuant to section
Page 17, Line 2124-50-621, in collaboration with the following state agencies for benefit plans offered to the following public employees:
Page 17, Line 22(a) In collaboration with the department of education, for employees of school districts;
Page 18, Line 1(b) In collaboration with the Colorado commission on
Page 18, Line 2higher education, for employees of institutions of higher education; and
Page 18, Line 3(c) In collaboration with the department of local affairs, for employees of local governments.
Page 18, Line 4(2) School districts, institutions of higher education, and
Page 18, Line 5local governments shall submit the data and information
Page 18, Line 6requested of them by the executive director, in the format and
Page 18, Line 7timeline requested, as necessary to complete the feasibility study.
Page 18, Line 8(3) The executive director shall complete the study
Page 18, Line 9required by subsection (1) of this section and submit the report to the general assembly on or before January 1, 2028.
Page 18, Line 10(4) The state department shall use the money in the
Page 18, Line 11health care reimbursement feasibility study cash fund, created
Page 18, Line 12in subsection (5) of this section, to conduct the study and prepare the report required in this section.
Page 18, Line 13(5) (a) The health care reimbursement feasibility study
Page 18, Line 14cash fund is created in the state treasury. The fund consists of
Page 18, Line 15money transferred to the fund pursuant to section 24-51-621
Page 18, Line 16(7)(b)(I)and any other money that the general assembly may appropriate or transfer to the fund.
Page 18, Line 17(b) The state treasurer shall credit all interest and
Page 18, Line 18income derived from the deposit and investment of money in the
Page 18, Line 19health care reimbursement feasibility study cash fund to the
Page 18, Line 20fund.
Page 19, Line 1(c) The money in the health care reimbursement feasibility
Page 19, Line 2study cash fund is continuously appropriated to the state
Page 19, Line 3department to be used to conduct the study and prepare the report required in this section.
Page 19, Line 4(d) The state treasurer shall transfer all unexpended
Page 19, Line 5and unencumbered money in the health care reimbursement feasibility study cash fund on June 30, 2028, to the general fund.
Page 19, Line 6(6) This section is repealed, effective July 1, 2028.
Page 19, Line 7SECTION 7. In Colorado Revised Statutes, 24-22-117, amend (2)(b)(I) as follows:
Page 19, Line 824-22-117. Tobacco tax cash fund - accounts - creation -
Page 19, Line 9legislative declaration. (2) There are hereby created in the state treasury the following funds:
Page 19, Line 10(b) (I) The primary care fund to be administered by the department
Page 19, Line 11of health care policy and financing. The state treasurer and the controller
Page 19, Line 12shall transfer an amount equal to nineteen percent of the
moneysPage 19, Line 13deposited into the cash fund, plus nineteen percent of the interest and
Page 19, Line 14income earned on the deposit and investment of
those moneysPage 19, Line 15money, to the primary care fund; except that, for the 2008-09, 2009-10,
Page 19, Line 162010-11, and 2011-12 fiscal years, the state treasurer and the controller
Page 19, Line 17shall transfer to the primary care fund only an amount equal to nineteen
Page 19, Line 18percent of the
moneysPage 19, Line 19in the 2027-28 state fiscal year, the primary care fund also
Page 19, Line 20consists of money transferred to the primary care fund
Page 19, Line 21pursuant to section 24-50-621(8)(c)(II)(B). All interest and income
Page 19, Line 22derived from the deposit and investment of
moneysPage 19, Line 23care fund shall be credited to the primary care fund; except that all
Page 20, Line 1interest and income derived from the deposit and investment of
moneysPage 20, Line 2money in the primary care fund during the 2008-09, 2009-10, 2010-11,
Page 20, Line 3and 2011-12 fiscal years shall be credited to the general fund. Any
Page 20, Line 4unexpended and unencumbered
moneysPage 20, Line 5care fund at the end of a fiscal year
shall remainPage 20, Line 6SECTION 8. In Colorado Revised Statutes, 24-102-202.5, add (2)(c) as follows:
Page 20, Line 724-102-202.5. Supplier database - fees - cash fund - program
Page 20, Line 8account. (2) (c) (I) Notwithstanding the provisions of subsection
Page 20, Line 9(2)(a) of this section, for the 2025-26 and 2026-27 state fiscal
Page 20, Line 10years, money in the supplier database cash fund may be used to
Page 20, Line 11reimburse the actual expenses incurred by the division of
Page 20, Line 12insurance created in section 10-1-103 to implement section 10-16-711.
Page 20, Line 13(II) (A) On or before July 1, 2025, the state treasurer
Page 20, Line 14shall transfer two hundred forty thousand seven hundred
Page 20, Line 15thirty-two dollars from the supplier database cash fund to the division of insurance cash fund created in section 10-1-103 (3).
Page 20, Line 16(B) On or before July 1, 2026, the state treasurer shall
Page 20, Line 17transfer two hundred sixty thousand one hundred eighty-three
Page 20, Line 18dollars from the supplier database cash fund to the division of insurance cash fund created in section 10-1-103 (3).
Page 20, Line 19SECTION 9. In Colorado Revised Statutes, add 27-50-306 as follows:
Page 20, Line 2027-50-306. Behavioral health safety net cash fund. (1) The
Page 20, Line 21behavioral health safety net cash fund is created in the state
Page 21, Line 1treasury. The fund consists of money appropriated to the fund
Page 21, Line 2pursuant to section 25-50-621 (8)(c)(II)(C) and any other money
Page 21, Line 3that the general assembly may appropriate or transfer to the fund.
Page 21, Line 4(2) The state treasurer shall credit all interest and
Page 21, Line 5income derived from the deposit and investment of money in the behavioral health safety net cash fund to the fund.
Page 21, Line 6(3) Subject to annual appropriation by the general
Page 21, Line 7assembly, the department may expend money from the fund to
Page 21, Line 8support the capacity of comprehensive community behavioral
Page 21, Line 9health providers to deliver behavioral health safety net services, as specified in section 27-50-301, to priority populations.
Page 21, Line 10SECTION 10. Safety clause. The general assembly finds,
Page 21, Line 11determines, and declares that this act is necessary for the immediate
Page 21, Line 12preservation of the public peace, health, or safety or for appropriations for
Page 21, Line 13the support and maintenance of the departments of the state and state institutions.