SB 26-138

Senate Bill 26-138 aims to reduce administrative burdens on healthcare by conducting regular performance audits and modifying certain requirements for health insurance carriers and healthcare providers. The bill removes some federal transparency law compliance requirements for insurance companies and changes the training hours needed for dentists and veterinarians regarding drug prescribing. It also updates how uninsured patients are screened for public health insurance eligibility, allowing more flexible methods like third-party resources or questionnaires. Additionally, it adjusts reporting deadlines and review periods for hospitals' financial statements and transparency reports. Since the bill has been signed into law, these changes will now be implemented as outlined in the legislation.

Official Summary

Section 2 of the bill requires the commissioner of insurance (commissioner) to conduct a performance audit of all division of insurance (division) rules related to health care on or before January 1, 2029, and at least once every 5 years thereafter. Commencing January 2029, and every 5 years thereafter, the division shall report on the findings of the audit during its 'SMART Act' hearing.      Section 3 repeals provisions that require health insurance carriers (carriers) to comply with federal price transparency laws and to make available an internet-based self-service tool that provides real-time responses to a covered person's questions concerning carrier prices that are based on cost-sharing information.      Section 3 also repeals a requirement that carriers submit information required by federal pharmacy benefit and drug cost reporting laws to the commissioner and make certain information regarding price transparency publicly available.      Section 4 2 repeals a requirement that health-care profession regulators adopt rules that require each licensed health-care provider, as a condition of renewing, reactivating, or reinstating a license, to complete up to 4 credit hours of training per licensing cycle in order to demonstrate competency regarding topics related to prescribing drugs and treatment.      Section 3 authorizes the Colorado dental board to adopt rules that require every dentist, dental therapist, and dental hygienist, as a condition of renewing, reactivating, or reinstating a license, to complete up to 4 credit hours of training per licensing cycle regarding topics related to prescribing drugs and treatment.       Section 4 requires a licensed veterinarian to complete at least 1 hour of training per renewal period regarding topics related to prescribing drugs and treatment.       Section 5 changes the frequency that specific health-care facilities are required to apply for a license issued by the department of public health and environment from annually to every 2 years.      Section 6 requires the department of health care policy and financing (state department) to conduct a performance audit of all state department rules related to health care on or before January 1, 2029, and at least once every 5 years thereafter. Commencing January 2029, and every 5 years thereafter, the state department shall report on the findings of the audit during its 'SMART Act' hearing.     Under current law, a health-care facility is required to screen each uninsured patient for eligibility for public health insurance programs and discounted care (screening) utilizing a single uniform application developed by the state department. Sections 7 6 through 12 11 change these requirements in the following ways:Changing the method used to conduct the screening from a uniform application to use of a third-party resource, such as a major credit bureau, or use of a uniform screening questionnaire (questionnaire) developed by the state department;Allowing a health-care facility the option of screening a patient for eligibility for the health-care facility's financial assistance program;Requiring a health-care facility to provide specified notifications upon completion of the screening;Creating an application for discounted care (application) for use by a health-care facility upon completion of the screening through which additional information is requested from a patient to enable the health-care facility to determine whether the patient has qualified or is likely to qualify for public health-care coverage or discounted care;Requiring a health-care facility to provide specified notice and appeal rights to a patient upon completion and review of the application; andRequiring the state department to adopt rules regarding the questionnaire and application.      Section 12 11 also narrows state department review requirements of health-care facilities' and licensed health-care professionals' billing for patients who are indigent. The bill prohibits the state department from making changes to regulatory documents or imposing new requirements unless the changes or new requirements are adopted by rule by specified dates and are subject to stakeholder engagement.      Section 13 12 requires the state department to establish the content and format of the information each hospital must provide to the state department for a hospital transparency report by rule at least 30 days prior to the hospital's fiscal year. The bill changes the deadline for a hospital to submit to the state department an annual audited financial statement from 120 days to 150 days after the end of the hospital's fiscal year. Current law requires that each hospital has a minimum of 15 days to review the hospital transparency report; the bill requires that a statewide hospital association must also have a minimum of 15 days to review the report.      Sections 14 13 through 17 make conforming amendments.(Note: Italicized words indicate new material added to the original summary; dashes through words indicate deletions from the original summary.)(Note: This summary applies to the reengrossed version of this bill as introduced in the second house.)

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