SB 22-078

  • Colorado Senate Bill
  • 2022 Regular Session
  • Introduced in Senate Feb 24, 2022
  • Passed Senate Feb 24, 2022
  • House
  • Governor

Prior Authorization Exemption Health-care Provider

Abstract

With regard to health-care services, section 1 of starting January 1, 2024, the bill requires a health insurance carrier (carrier) or private utilization review organization (organization) , as applicable, to offer a qualified provider with at least a 95% approval rate of prior authorization requests over the prior 12 months an alternative to prior authorization requirements, including an exemption from the requirements or incentive awards or other innovative programs to reward provider compliance designed by the carrier or organization that reduce patient wait times or administrative burdens to receiving the requested health-care service . To be a "qualified provider", a provider must: Be, and have been continuously for at least the immediately preceding 12 months, a participating provider; and Have, over the immediately preceding 12 months: At least a 95% approval rate on prior authorization requests submitted for the same health-care service; and submitted at least 24 prior authorization requests for the same health-care service. A carrier or organization is required to inform a provider of the provider's status as a qualified provider and, at least annually, to reevaluate whether a provider satisfies the requirements of a qualified provider.With regard to drug benefits, section 2 requires a carrier or pharmacy benefit management firm, as applicable, to offer the same types of alternatives to prior authorization requirements to a provider who has at least a 95% approval rate of prior authorization requests over the prior 12 months. (Note: Italicized words indicate new material added to the original summary; dashes through words indicate deletions from the original summary.) (Note: This summary applies to the reengrossed version of this bill as introduced in the second house.)

Bill Sponsors (4)

Votes


Feb 24, 2022

Actions


May 09, 2022

House

House Second Reading Special Order - Laid Over Daily - No Amendments

House

House Committee on Appropriations Refer Unamended to House Committee of the Whole

  • Committee-Passage
  • Referral-Committee
Appropriations House Committee of the Whole

May 02, 2022

House

House Committee on Health & Insurance Refer Amended to Appropriations

  • Referral-Committee
Appropriations

Feb 24, 2022

House

Introduced In House - Assigned to Health & Insurance

  • Introduction
Health & Insurance

Senate

Senate Third Reading Passed - No Amendments

Feb 22, 2022

Senate

Senate Third Reading Laid Over to 02/24/2022 - No Amendments

Feb 18, 2022

Senate

Senate Third Reading Laid Over Daily - No Amendments

Feb 17, 2022

Senate

Senate Second Reading Passed with Amendments - Committee, Floor

Feb 15, 2022

Senate

Senate Committee on Appropriations Refer Unamended - Consent Calendar to Senate Committee of the Whole

  • Committee-Passage
Appropriations

Feb 07, 2022

Senate

Senate Committee on Health & Human Services Refer Amended to Appropriations

  • Referral-Committee
Appropriations Health & Human Services

Jan 19, 2022

Senate

Introduced In Senate - Assigned to Health & Human Services

  • Introduction
Health & Human Services

Bill Text

Bill Text Versions Format
Reengrossed (02/24/2022) PDF
Engrossed (2) (02/17/2022) PDF
Introduced (01/19/2022) PDF
PA2 (05/03/2022) PDF
PA1 (02/08/2022) PDF
Committee Amendment PDF

Related Documents

Document Format
Fiscal Note SA1 (02/14/2022) PDF
Fiscal Note SA2 (05/09/2022) PDF
Fiscal Note FN1 (02/04/2022) PDF
Fiscal Note FN2 (02/14/2022) PDF

Sources

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