CO SB163

Requires Colorado's insurance commissioner to promulgate rules implementing a batching process that allows multiple out-of-network health insurance claims to be considered jointly under a single arbitration fee as part of one payment determination, aligning with federal law.

Mandates that insurance carriers provide specified information to providers with initial claim payments, including claims adjustment reason codes and remittance advice remark codes from the federal EDI 835 electronic health care claim payment/advice system.

Requires carriers to use one of two mutually exclusive remittance advice remark codes (N871 or N859) with initial payments or denials to clearly identify whether state law or the federal "No Surprises Act" applies to claim processing.

Prohibits carriers from recalculating a covered person's cost-sharing amount based on additional payments required or made as a result of an arbitration decision.

Takes effect 12:01 a.m. the day after the ninety-day period following final adjournment of the general assembly, or if subject to a referendum petition, on the date of official vote declaration by the governor following the November 2024 general election, and applies to claims submitted for arbitration on or after the effective date.