HB23-1200 Summary

• Requires managed care entities (MCEs) in Colorado's Medicaid program to enter into single case agreements with willing behavioral health providers when network gaps exist and members need medically necessary services.

• MCEs must consider any behavioral health provider enrolled in the Medical Assistance Program for single case agreements if they cannot provide the covered service through their contracted network.

• Mandates MCE staff receive training on the single case agreement process and prohibits MCEs from requiring out-of-network providers to serve additional members beyond the single case agreement.

• MCEs may refuse single case agreements based on provider cost and quality concerns but must offer assistance to both members and out-of-network providers in navigating the process and complete agreements within state-established timelines.

• Takes effect 12:01 a.m. on the day following the 90-day period after final adjournment of the general assembly, unless subject to a referendum petition requiring voter approval in November 2024.