HB 25-1002

  • Colorado House Bill
  • 2025 Regular Session
  • Introduced in House Feb 12, 2025
  • Passed House Feb 10, 2025
  • Passed Senate Feb 26, 2025
  • Signed by Governor Mar 20, 2025

Medical Necessity Determination Insurance Coverage

Abstract

The act clarifies that the health benefits coverage for the prevention of, screening for, and treatment of behavioral, mental health, and substance use disorders must be no less extensive than the coverage provided for any physical illness. The act requires that every health benefit plan provide coverage for medically necessary treatment of covered behavioral, mental health, and substance use disorder benefits, consistent with specified criteria. The act also specifies criteria to be used for conducting utilization review, service intensity, and the level of care for covered persons. In addition, the act prohibits: A health benefit plan from limiting coverage for chronic behavioral, mental health, or substance use disorders to short-term symptom reduction; and A health insurance carrier from reversing or altering a determination of medical necessity except in the case of fraud. The act requires carriers that provide benefits for mental health conditions or substance use disorders to offer meaningful benefits for mental health conditions and substance use disorders. The act describes how to determine whether the benefits provided are meaningful benefits. The commissioner of insurance is authorized to adopt rules to: Establish carrier utilization review compliance; Specify data testing requirements for plan design and application of parity compliance; Set standard definition for coverage requirements; Establish timelines for carriers to provide comparative analysis information to the division of insurance; and Establish time periods for visits with a provider for treatment of a behavioral, mental health, or substance use disorder after an initial visit with a provider.(Note: This summary applies to this bill as enacted.)

Bill Sponsors (56)

Votes


Actions


Mar 20, 2025

Office of the Governor

Governor Signed

Mar 13, 2025

Office of the Governor

Sent to the Governor

Senate

Signed by the President of the Senate

Mar 12, 2025

House

Signed by the Speaker of the House

Feb 28, 2025

House

House Considered Senate Amendments - Result was to Concur - Repass

Feb 27, 2025

House

House Considered Senate Amendments - Result was to Laid Over Daily

Feb 26, 2025

Senate

Senate Third Reading Passed - No Amendments

Feb 25, 2025

Senate

Senate Second Reading Passed with Amendments - Committee

Feb 20, 2025

Senate

Senate Committee on Health & Human Services Refer Amended - Consent Calendar to Senate Committee of the Whole

  • Committee-Passage
Health & Human Services

Feb 12, 2025

Senate

Introduced In Senate - Assigned to Health & Human Services

  • Introduction
Health & Human Services

Feb 10, 2025

House

House Third Reading Passed - No Amendments

Feb 07, 2025

House

House Second Reading Special Order - Passed with Amendments - Committee, Floor

Jan 31, 2025

House

House Second Reading Laid Over Daily - No Amendments

Jan 29, 2025

House

House Committee on Health & Human Services Refer Amended to House Committee of the Whole

  • Committee-Passage
  • Referral-Committee
House Committee of the Whole Health & Human Services

Jan 08, 2025

House

Introduced In House - Assigned to Health & Human Services

  • Introduction
Health & Human Services

Bill Text

Bill Text Versions Format
Signed Act (03/20/2025) PDF
Final Act (03/13/2025) PDF
Rerevised (02/26/2025) PDF
Revised (02/25/2025) PDF
Reengrossed (02/10/2025) PDF
Engrossed (02/07/2025) PDF
Introduced (01/08/2025) PDF
PA2 (02/21/2025) PDF
PA1 (01/30/2025) PDF
Committee Amendment PDF

Related Documents

Document Format
Fiscal Note FN1 (01/27/2025) PDF
Fiscal Note FN2 (07/21/2025) PDF

Sources

Data on Open States is updated periodically throughout the day from the official website of the Colorado General Assembly.

If you notice any inconsistencies with these official sources, feel free to file an issue.