HB 25-1213 CO

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Became Law

The act exempts an assisted living residence that has not undergone new construction or major renovations from complying with the facility guideline institute guidelines. The department of health care policy and financing (state department) must establish a process for reviewing and updating the general billing manual on an annual basis and ensure that the general billing manual includes all necessary CPT codes or links to the state department's list of CPT codes. The act allows the Colorado healthcare affordability and sustainability enterprise to receive public funds. Beginning January 1, 2026, for claims that must be reprocessed as a result of updating the provider rates, the act requires a managed care organization to issue payment to a contracted provider within one year after the provider rate is updated. The state department must notify the managed care organizations of changes to the provider rates within 60 days of changing the provider rates. The act requires the state department to include in each new contract with, or renewal of a contract with, a managed care entity (MCE) a provision requiring the MCE to submit to the state department, on an annual basis, the amount the MCE is paid and the MCE's medical loss ratio. The state department is required to publish this information, as well as historical medical loss ratio data for each MCE, and publish on an annual basis audit findings regarding an MCE's most recently completed medical loss ratio audit on the state department's website. The act prohibits the state department from imposing signature requirements on a physician or practitioner certifying a medicaid member's (member) plan of care that involves physical therapy, occupational therapy, or speech therapy. The act requires that for members receiving home- and community-based services, if a service the member receives is discontinued or no longer a covered service, the state department must confirm the timeline for the continuity of treatment with the federal centers for medicare and medicaid during the transition period of the benefit or service being discontinued and must communicate that timeline to the member impacted by the benefit or service being discontinued. (Note: This summary applies to this bill as enacted.)

• Lisa Feret Democratic · primary
• Ron Weinberg Republican · primary
• Lindsey Daugherty Democratic · primary
• Matt Ball Democratic · primary

1. May 28, 2025 Governor Signed · executive
2. May 14, 2025 Sent to the Governor · executive
3. May 14, 2025 Signed by the President of the Senate · upper
4. May 14, 2025 Signed by the Speaker of the House · lower
5. May 1, 2025 House Considered Senate Amendments - Result was to Concur - Repass · lower
6. Apr 30, 2025 Senate Third Reading Passed with Amendments - Floor · upper
7. Apr 29, 2025 Senate Second Reading Passed with Amendments - Committee, Floor · upper
8. Apr 24, 2025 Senate Committee on Health & Human Services Refer Amended to Senate Committee of the Whole · upper
9. Apr 1, 2025 Introduced In Senate - Assigned to Health & Human Services · upper
10. Mar 26, 2025 House Third Reading Passed - No Amendments · lower
11. Mar 25, 2025 House Second Reading Special Order - Passed with Amendments - Committee · lower
12. Mar 25, 2025 House Committee on Appropriations Refer Amended to House Committee of the Whole · lower
13. Mar 4, 2025 House Committee on Health & Human Services Refer Amended to Appropriations · lower
14. Feb 11, 2025 Introduced In House - Assigned to Health & Human Services · lower