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CO HB1002

CO HB1002
Medical Necessity Determination Insurance Coverage


summary

Introduced
01/08/2025
In Committee
02/20/2025
Crossed Over
03/13/2025
Passed
03/13/2025
Dead
Signed/Enacted/Adopted
03/20/2025

Introduced Session

2025 Regular Session

Bill Summary

CONCERNING THE DETERMINATION OF HEALTH BENEFITS COVERAGE FOR MENTAL HEALTH SERVICES.

AI Summary

This bill amends Colorado law to strengthen insurance coverage requirements for behavioral, mental health, and substance use disorder treatments by establishing more rigorous standards for health benefit plans. The bill requires insurers to provide coverage for mental health and substance use disorder services that is equivalent to coverage for physical illnesses, prohibiting discriminatory benefit designs. It mandates that utilization review criteria must be consistent with current generally accepted standards of care, and insurers must use criteria from unaffiliated, nationally recognized not-for-profit clinical specialty associations when reviewing mental health and substance use disorder treatments. The bill introduces new definitions for terms like "medically necessary treatment" and "generally accepted standards of care," and requires insurers to provide meaningful benefits for mental health conditions in every classification where medical or surgical benefits are provided. Additionally, the bill prevents insurers from reversing medical necessity determinations through claim reviews, establishes procedures for accessing out-of-network providers when necessary, and gives the insurance commissioner authority to adopt rules ensuring compliance. The legislation aims to reduce barriers to mental health and substance use disorder treatment by creating more transparent and equitable insurance coverage standards. The bill is set to take effect on January 1, 2026, subject to potential referendum.

Committee Categories

Health and Social Services

Sponsors (56)

Judy Amabile (D)* Kyle Brown (D)* Lindsay Gilchrist (D)* Dusty Johnson (R)* Karen McCormick (D)* Byron Pelton (R)* Cleave Simpson (R)* Ty Winter (R)* Jennifer Bacon (D),  Matt Ball (D),  Shannon Bird (D),  Andrew Boesenecker (D),  Jeff Bridges (D),  Sean Camacho (D),  Chad Clifford (D),  James Coleman (D),  Lisa Cutter (D),  Lindsey Daugherty (D),  Monica Duran (D),  Regina English (D),  Tony Exum (D),  Meg Froelich (D),  Lorena García (D),  Julie Gonzales (D),  Eliza Hamrick (D),  Nick Hinrichsen (D),  Jamie Jackson (D),  Iman Jodeh (D),  Junie Joseph (D),  Cathy Kipp (D),  Chris Kolker (D),  Sheila Lieder (D),  Mandy Lindsay (D),  Meghan Lukens (D),  Javier Mabrey (D),  Janice Marchman (D),  Bob Marshall (D),  Julie McCluskie (D),  Dafna Michaelson Jenet (D),  Kyle Mullica (D),  Amy Paschal (D),  Naquetta Ricks (D),  Manny Rutinel (D),  Gretchen Rydin (D),  Emily Sirota (D),  Lesley Smith (D),  Marc Snyder (D),  Katie Stewart (D),  Rebekah Stewart (D),  Tammy Story (D),  Rick Taggart (R),  Brianna Titone (D),  Alex Valdez (D),  Michael Weissman (D),  Faith Winter (D),  Steven Woodrow (D), 

Last Action

Governor Signed (on 03/20/2025)

bill text


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bill summary

Document Type Source Location
State Bill Page https://leg.colorado.gov/bills/hb25-1002
Fiscal Note FN2 https://leg.colorado.gov/sites/default/files/documents/2025A/bills/fn/2025a_hb1002_f1.pdf
BillText https://leg.colorado.gov/sites/default/files/documents/2025A/bills/2025a_1002_enr.pdf
BillText https://leg.colorado.gov/sites/default/files/documents/2025A/bills/2025a_1002_rer.pdf
BillText https://leg.colorado.gov/sites/default/files/documents/2025A/bills/2025a_1002_rev.pdf
Senate Health & Human Services Amendment L.018 https://s3-us-west-2.amazonaws.com/leg.colorado.gov/2025A/amendments/81CB869CFF77DB8087258C36007BC042/HB1002_L.018.pdf
BillText https://leg.colorado.gov/sites/default/files/documents/2025A/bills/2025a_1002_ren.pdf
BillText https://leg.colorado.gov/sites/default/files/documents/2025A/bills/2025a_1002_eng.pdf
Second Reading Amendment L.013 https://s3-us-west-2.amazonaws.com/leg.colorado.gov/2025A/amendments/C0F9CDB66D9889D787258C2A00585AB5/HB1002_L.013.pdf
Second Reading Amendment L.008 https://s3-us-west-2.amazonaws.com/leg.colorado.gov/2025A/amendments/3207891C17B14DD987258C2900589682/HB1002_L.008.pdf
Second Reading Amendment L.014 https://s3-us-west-2.amazonaws.com/leg.colorado.gov/2025A/amendments/4FC76EF0256B49CE87258C2A00590704/HB1002_L.014.pdf
Second Reading Amendment L.012 https://s3-us-west-2.amazonaws.com/leg.colorado.gov/2025A/amendments/C76F77245BB74D4D87258C2A00593EAE/HB1002_L.012.pdf
House Health & Human Services Amendment L.001 https://s3-us-west-2.amazonaws.com/leg.colorado.gov/2025A/amendments/A188DF144ABB6EFE87258C2100563BB9/HB1002_L.001.pdf
Fiscal Note FN1 https://leg.colorado.gov/sites/default/files/documents/2025A/bills/fn/2025a_hb1002_00.pdf
BillText https://leg.colorado.gov/sites/default/files/documents/2025A/bills/2025a_1002_01.pdf
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