CO SB017

Health insurance carriers must provide remittance advice with each out-of-network payment that identifies whether the patient's plan is regulated by state or federal law (ERISA)

Division of Insurance Commissioner gains authority to order carriers to pay providers the correct reimbursement amount, plus any additional amounts owed and fines, when underpayment is identified through the complaint process

Carriers must annually submit data to the Commissioner by January 1 (starting 2027) on patient use of out-of-network providers and facilities and impacts on premium affordability

Division of Insurance must publish an annual report by July 1 (starting 2027) summarizing out-of-network utilization data and complaint statistics, including number of complaints filed, settled, arbitrated, and dismissed, and outcomes favoring carriers versus providers

Addresses legislative finding that the current claim-by-claim arbitration process is prohibitively expensive, creating "de facto immunity" for carriers to systematically underpay claims since arbitration costs often exceed disputed amounts