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CO HB1151

Bill

Status

Failed

4/10/2025

Primary Sponsor

Anthony Hartsook

Click for details

Origin

House of Representatives

2025 Regular Session

AI Summary

  • 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

  • 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

  • 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

  • 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

  • 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

Committee Referrals

Health and Human Services3/5/2025
Committee of the Whole2/19/2025
Health and Human Services1/29/2025

Full Bill Text

No bill text available