CO HB1136

Requires health insurance coverage for additional prosthetic devices when a treating physician determines they are necessary to enable a covered person to engage in physical and recreational activities, including running, bicycling, swimming, climbing, skiing, snowboarding, and team and individual sports.

Limits initial prosthetic device coverage to the most appropriate model that meets the medical needs of the covered person as determined by the treating physician, with the new provision allowing additional devices for activity-specific use.

Applies to large employer policies and contracts issued or renewed on or after January 1, 2025, and to individual and small group policies issued on or after January 1, 2025, contingent on federal confirmation that the coverage does not require the state to defray additional costs.

Requires the Division of Insurance to submit a determination to the federal Department of Health and Human Services regarding whether the benefit constitutes an additional essential health benefit requiring state cost-sharing, with a 60-day response deadline.

Appropriates $6,108 to the Department of Regulatory Agencies for the Division of Insurance for fiscal year 2023-24, based on an assumption of 0.1 additional FTE needed for implementation.