Colorado Legislation

The bill creates certain coverage requirements for insurers. These coverage requirements include: Providing parity-compliant MH and SUD coverage for preventative services, screening; establishing minimum coverage requirements for preventative and screening services and treatment services; and ensuring network adequacy of mental health and SUD providers. Additionally, the law creates guidelines for denial notifications of MH and SUD services. Additionally, the bill creates guidelines for denial notifications of MH and SUD services.
Furthermore, the bill prohibits insurers that offer prescription drug benefits for the treatment of SUD from:
• Excluding coverage of such drugs or SUD services because the drugs or services are prescribed pursuant to a court order, and
• Applying prior authorization or step therapy requirements to such FDA approved medications.
The bill specifies that such insurers must place at least one FDA-approved MAT medication on the lowest tier of the drug formulary.
Moreover, the law creates reporting requirements that require insurers to submit a detailed, annual parity compliance report to the Commissioner. This report must also be made available to the public.
Additionally, the bill requires the Commissioner to submit an annual parity compliance report to the legislature.
Finally, the bill creates additional requirements for all Medicaid plans to follow as well in order to be compliant with the Federal Parity Law and promote mental health and SUD care.

Among many things, this bill amends state law so that all insurers must provide coverage for a five day supply of first requests for Buprenorphine without prior authorization. Additionally, the bill prohibits the use of financial incentives to providers based solely on patient satisfaction surveys relating to pain treatment. Finally, the bill requires state agencies to establish rules that standardize utilization management authority timelines for non-pharmaceutical components of MAT.