Senate Bill 25-196 Reengrossed

A Bill for an Act

• Page 1, Line 101Concerning measures to protect insurance coverage for

• Page 1, Line 102preventive health-care 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.)

Current law mandates mandatory insurance coverage of certain preventive health-care services (preventive services) in accordance with the recommendations of the United States preventive services task force, recommendations established by the advisory committee on immunization practices, or preventive care or screening as provided in the comprehensive guidelines supported by the health resources and services administration in the United States department of health and human services (authorities).

The bill requires that, in the event that any of these authorities is repealed, modified, or otherwise no longer in effect, the commissioner of insurance may adopt rules to require compliance with the recommendations and comprehensive guidelines regarding the coverage of those preventive services as the recommendations and guidelines existed in January 2025.

• 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 (18)(b) introductory portion and (18)(f); and add (18)(g) as follows:

• Page 2, Line 310-16-104.  Mandatory coverage provisions - definitions - rules

• Page 2, Line 4- applicability. (18)  Prevention health-care services - rules -

• Page 2, Line 5definitions. (b)  The coverage required by this subsection (18) must

• Page 2, Line 6include coverage for the following preventive health-care services listed

• Page 2, Line 7in subsections (18)(b)(I) to (18)(b)(XI) of this section in accordance

• Page 2, Line 8with the A or B recommendations of the task force, recommendations

• Page 2, Line 9established by the ACIP, or preventive care and screening as provided for

• Page 2, Line 10in the comprehensive guidelines. as applicable If the A or B

• Page 2, Line 11recommendations of the task force, the ACIP, or the

• Page 2, Line 12comprehensive guidelines are repealed, modified, or otherwise no

• Page 2, Line 13longer in effect, the commissioner may adopt rules to require

• Page 2, Line 14compliance with the guidelines or recommendations that were

• Page 2, Line 15in effect in January 2025, or that comply with the

• Page 2, Line 16recommendations of the nurse-physician advisory task force for

• Page 2, Line 17Colorado health care created in section 12-30-105 and

• Page 2, Line 18developed in compliance with the requirements set forth in

• Page 2, Line 19section 12-30-105 (5), that apply to coverage of the following

• Page 2, Line 20preventive health-care services:

• Page 3, Line 1(f)  The commissioner may promulgate adopt rules as necessary

• Page 3, Line 2to implement and enforce this subsection (18), including rules that

• Page 3, Line 3require coverage of additional preventive health-care services

• Page 3, Line 4not listed in subsections (18)(b)(I) to (18)(b)(XI) of this section as

• Page 3, Line 5recommended by the task force, ACIP, comprehensive guidelines,

• Page 3, Line 6or nurse-physician advisory task force for Colorado health care.

• Page 3, Line 7(g)  A health insurance policy that qualifies for a health

• Page 3, Line 8savings account pursuant to 26 U.S.C. sec. 223 is exempt from

• Page 3, Line 9subsections (18)(b) and (18)(f) of this section to the extent the

• Page 3, Line 10exemption is necessary to allow the policy to qualify for a

• Page 3, Line 11health savings account pursuant to the requirements in the federal law.

• Page 3, Line 12SECTION 2.  In Colorado Revised Statutes, 12-30-105, add (5)(o) as follows:

• Page 3, Line 1312-30-105.  Nurse-physician advisory task force for Colorado

• Page 3, Line 14health care - creation - duties - definition - repeal. (5)  The NPATCH

• Page 3, Line 15shall prioritize consideration of and make recommendations on the following topics:

• Page 3, Line 16(o)  Updates or modifications, as necessary, to preventive

• Page 3, Line 17health-care services set forth in section 10-16-104 (18)(b). In recommending the updates and modifications, the NPATCH must:

• Page 3, Line 18(I)  Consult with the national clinical society for the relevant disease state or population, if one exists; and

• Page 3, Line 19(II)  Provide opportunities for experts in the relevant

• Page 3, Line 20disease state or population at issue, if any exist; relevant

• Page 3, Line 21patient groups, if any exist, representing the relevant disease

• Page 4, Line 1state or population at issue; and insurers offering commercial

• Page 4, Line 2coverage in the state to provide input on the evidence and recommendations at the NPATCH meetings.

• Page 4, Line 3SECTION 3.  Safety clause. The general assembly finds,

• Page 4, Line 4determines, and declares that this act is necessary for the immediate

• Page 4, Line 5preservation of the public peace, health, or safety or for appropriations for

• Page 4, Line 6the support and maintenance of the departments of the state and state institutions.