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Section 10-22-107, C.R.S., establishes the Colorado Health Insurance Exchange Oversight Committee (oversight committee) for guiding the implementation of the Colorado Health Benefit Exchange, which currently does business under the name Connect for Health Colorado (exchange), and making recommendations to the General Assembly.

Many pieces of legislation regarding health care and health insurance made their way through the 74^th General Assembly. Most of the legislation fell into the following categories: removing barriers to treatment, and licensing requirements.

Health insurance is a method of paying or receiving reimbursement for health care costs from covered services. Health insurance companies spread the costs and risk of covered health care services across all members of a plan in exchange for premiums and other cost-sharing mechanisms, such as deductibles and copayments. These rates are actuarially determined and set at a level that covers the estimated health care costs incurred by all members of the group. This issue brief provides an overview of the health insurance market in Colorado and federal and state health insurance regulations.

Addressing the substance use disorder epidemic and providing behavioral health resources to communities throughout Colorado were the two major behavioral health care themes that emerged during the Second Regular Session of the 74th General Assembly. Important behavioral health bills are discussed below.

Prior authorization—sometimes referred to as preauthorization or precertification—is a process by which an insurer reviews a request for health care services or drugs before consenting to cover the costs of the proposed treatment. Upon receiving a request, an insurer can approve or deny the request, or request additional information from the patient or their health care provider. Health insurers may require prior authorization for a variety of reasons, including cost control and verification of medical necessity.

The committee studies the implementation of Colorado's health exchange. It reviews and approves grants applied for by the exchange's board of directors to implement the exchange, approves the exchange's executive director, and recommends legislation on the operation of the exchange.

Colorado currently administers ten Home- and Community-Based Services Medicaid (HCBS) Waivers. This issue brief discusses the four waivers available to children.

Colorado currently administers ten Home and Community-Based Services Medicaid (HCBS) Waivers. This issue brief discusses the six waivers available to adults.

The Interim Committee on Opiod and other Substance Use Disorders was created pursuant to Section 10-22.3-101.  

Report No. 2023-TE18

Pursuant to Section 10‑16-221, C.R.S., the Statewide Health Care Review Committee was created to study health care issues across the state.

Medicaid is a joint federal and state program that provides health benefits and services to Coloradans who meet eligibility requirements. Each state administers its own Medicaid program, and the federal Centers for Medicare and Medicaid Services (CMS) set standards for the program to receive federal financial participation. The Department of Health Care Policy and Financing (HCPF) oversees Colorado’s Medicaid. This issue brief summarizes the process to add benefits under Medicaid.

Many bills were introduced this year addressing health care and the insurance industry in Colorado. Recurring topics this session including reproductive health care, hospital and facility policies, prescription drugs, and consumer protections.

Report No. 2023-TE11

Behavioral health continued to be a focus of the General Assembly in 2023.  Several bills addressing behavioral health services, mental health providers, step therapy requirements for mental health drugs, substance use, and disordered eating were considered during the legislative session.

Submitted herewith is the final report of Colorado Health Insurance Exchange Oversight Committee.  This committee was created pursuant to Article 22 of Title 10, Colorado Revised Statutes.  The purpose of this committee is to guide Colorado's health insurance exchange, including reviewing the financial and operational plans of the exchange and approving the appointment of the executive director of the exchange.

To date, Colorado and ten other states have enacted paid family and medical leave laws.  The other states include California, Connecticut, Delaware, Massachusetts, New Hampshire, New Jersey, New York, Oregon, Rhode Island, and Washington.  However, the New Hampshire is voluntary for employers and relies on tax incentives for businesses to contribute.  In addition, Hawaii has a paid medical leave law that does not extend to family leave.  This memorandum provides a summary of the major components of the paid family and medical leave laws in each of these states.

This memorandum provides information about FY 2022-23 appropriations for state-funded behavioral health programs.  Information for this memorandum was taken from:

• the FY 2022-23 Long Bill, House Bill 22-1329;
• other bills that include funding for behavioral health programs;
• Joint Budget Committee (JBC) staff FY 2022-23 figure-setting documents and the JBC Appropriations Report FY 2022-23; and
• department staff.

Report No. 2023-TE1

This issue brief provides an overview of minors’ rights to deny others access to medical records under the federal Health Insurance Portability and Accountability Act of 1996 (HIPAA) and Colorado state law.  It also discusses state law pertaining to the ability of minors to consent to medical care.

The opioid epidemic, the COVID-19 pandemic, and the rise of homelessness strained Colorado’s behavioral health system.  This memorandum covers the actions the Colorado General Assembly has taken to strengthen Colorado’s behavioral health care system, including creating the Behavioral Health Administration, strengthening the behavioral health care workforce, increasing rural health care access, and treating and preventing substance abuse issues.

Pursuant to Section 10-16-221, Colorado Revised Statutes, the Statewide Health Care Review Committee was created to study health care issues across the state.

The health care system frequently distinguishes between physical and behavioral health.  Physical health refers to the condition of the body. Behavioral health refers to the condition of cognitive processing systems.  Behavioral health services include, among others: individual and group therapy; psychiatric care; assertive community treatment; substance use disorder services; and prevention and early intervention activities.

Report No. 2022-TE37