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CO HB1151
Bill
Status
4/10/2025
Primary Sponsor
Anthony Hartsook
Click for details
AI Summary
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Requires Colorado's arbitration process for out-of-network emergency services claims to include a batching process, allowing multiple claims to be considered jointly under a single arbitration fee, aligned with federal No Surprises Act requirements
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Mandates the Commissioner of Insurance adopt rules specifying information carriers must provide to providers with initial claim payments, including network adequacy data and whether services were in-network or out-of-network
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Requires carriers to disclose claims adjustment reason codes and remittance advice remark codes using the federal EDI 835 electronic payment format with each initial payment
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Requires all health plans and carriers to use one of two specific remittance codes (N871 or N859) to identify whether state or federal rules apply to each claim
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Commissioner must annually report on batching process usage to the legislature as part of SMART Government Act hearings
Legislative Description
Arbitration of Health Insurance Claims
Health Care & Health Insurance
Last Action
Senate Committee on Health & Human Services Postpone Indefinitely
4/10/2025