A Bill for an Act
Page 1, Line 101Concerning medicaid reimbursement for outpatient
Page 1, Line 102procedures related to drug-resistant epilepsy.
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.)
Beginning July 1, 2025, the bill requires the department of health care policy and financing to reimburse acute care hospitals and ambulatory surgery facilities that provide vagus nerve stimulation therapy to members diagnosed with drug-resistant epilepsy at a rate that is equal to 75% of the cost for acquiring the vagus nerve stimulator device, which reimbursement is in addition to and does not supplant the reimbursement for any necessary surgical procedure associated with implanting the device.
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 25.5-4-434 as follows:
Page 2, Line 325.5-4-434. Reimbursement for vagus nerve stimulator device
Page 2, Line 4- rule. (1) (a) No later than January 1, 2026, the state department
Page 2, Line 5shall seek federal authorization to reimburse acute care
Page 2, Line 6hospitals and ambulatory surgery facilities that provide vagus
Page 2, Line 7nerve stimulation therapy to members diagnosed with
Page 2, Line 8drug-resistant epilepsy at a rate that is equal to sixty percent of the cost for acquiring the vagus nerve stimulator device.
Page 2, Line 9(b) Beginning January 1, 2029, the state department shall
Page 2, Line 10increase the reimbursement provided pursuant to subsection
Page 2, Line 11(1)(a) of this section to a rate that is equal to seventy-five
Page 2, Line 12percent of the cost for acquiring the vagus nerve stimulator device.
Page 2, Line 13(2) Upon receiving federal authorization pursuant to
Page 2, Line 14subsection (1) of this section, the state department shall implement this section.
Page 2, Line 15(3) The reimbursement described in subsection (1) of this
Page 2, Line 16section is in addition to and does not supplant the reimbursement
Page 2, Line 17for any necessary surgical procedure associated with implanting the vagus nerve stimulator device.
Page 2, Line 18(4) The state department shall adopt any rules necessary to implement this section.
Page 2, Line 19SECTION 2. Safety clause. The general assembly finds,
Page 3, Line 1determines, and declares that this act is necessary for the immediate
Page 3, Line 2preservation of the public peace, health, or safety or for appropriations for
Page 3, Line 3the support and maintenance of the departments of the state and state institutions.