Bill > HB1033

This bill modifies Colorado's Medicaid third-party liability payment regulations by establishing new requirements for third-party payers (such as insurance companies) when responding to state inquiries about healthcare claims. Specifically, the bill mandates that third parties must respond within 60 days of receiving an inquiry from the state department, either by paying the claim or providing a written denial. The bill also prevents third parties from denying claims based on submission date, claim form type, or documentation issues, as long as the state department initiates enforcement actions within six years of claim submission. Additionally, the bill introduces a provision that allows the state department's payment of a claim to be considered equivalent to obtaining prior authorization from the third party. These changes aim to streamline the claims process, reduce administrative barriers, and ensure more efficient healthcare reimbursement for Medicaid services in Colorado. The bill includes a safety clause indicating its immediate necessity for public health and state operations.

Health and Social Services

https://leg.colorado.gov/bills/hb25-1033