NOTE: The governor signed this measure on 5/24/2013.
      
      
      SENATE BILL 13-166
      
      
      BY SENATOR(S) Aguilar, Kefalas;
      also REPRESENTATIVE(S) Schafer, Fields, Ginal, Hullinghorst, Labuda,
      Pettersen, Primavera, Ryden, Young.
      
      
      Concerning the development of standardized rules for use in
           processing medical claims, and, in connection therewith,
           extending the deadlines for development and
           implementation of the standardized rules, authorizing an
           appropriation of state moneys to help fund the development
           of the rules, and making an appropriation.
      
      
      Be it enacted by the General Assembly of the State of Colorado:
      
           SECTION 1.  In Colorado Revised Statutes, 25-37-106, amend (2)
      (d) (III) (B), (2) (d) (V), and (6) (a); and repeal (7) as follows:
      
           25-37-106.  Clean claims - development of standardized payment
      rules and code edits - task force to develop - legislative
      recommendations - short title - applicability. (2) (d) (III)  If, at the time
      the task force submits its report, the national initiative work group has not
      reached consensus on a complete or partial set of standardized payment
      rules and claim edits:
      
           (B)  The task force shall continue working to develop a complete set
      of uniform, standardized payment rules and claim edits and, by December
      31, 2013 2014, shall submit a report and may recommend implementation
      of a set of uniform, standardized payment rules and claim edits to be used
      by payers and health care providers.
      
           (V)  Payers shall implement the standardized payment rules and
      claim edits developed pursuant to subparagraph (III) of this paragraph (d)
      shall be implemented by payers as follows:
      
           (A)  For payers that are commercial health plans, shall implement
      the standardized set of payment rules and claim edits within their claims
      processing systems according to a schedule outlined in the task force
      recommendations or by January 1, 2015 2016, whichever occurs first; and
      
           (B)  For payers that are domestic, nonprofit health plans, shall
      implement the standardized set of payment rules and claim edits within their
      claims processing systems by January 1, 2016 2017.
      
           (6) (a) (I)  The executive director of the department of health care
      policy and financing shall designate a nonprofit or private organization as
      the custodian of funds for the task force. The designated organization is
      authorized to accept and expend funds as necessary for the operation of the
      task force and may solicit and accept monetary and in-kind gifts, grants, and
      donations for use in furtherance of the task force's duties and
      responsibilities. Any moneys donated or awarded to the designated
      organization for the benefit of the task force are not subject to appropriation
      by the general assembly, and the designated organization shall
      return any such moneys that are unexpended or unencumbered at the time
      the task force is dissolved or this section repeals pursuant to subsection (7)
      of this section shall be returned to the donors or grantors on a pro rata basis,
      as determined by the designated organization.
      
           (II)  The general assembly may appropriate moneys to the
      department of health care policy and financing for use by the
      task force in implementing this section.
      
           (7)  This section is repealed, effective June 30, 2012, unless the
      executive director of the department of health care policy and financing
      notifies the revisor of statutes, in writing, that the organization designated
      pursuant to subsection (6) of this section has certified that, as of June 30,
      2012, it has received or has available sufficient moneys to implement this
      section.
      
           SECTION 2.  Appropriation. In addition to any other
      appropriation, there is hereby appropriated, out of any moneys in the
      general fund not otherwise appropriated, to the department of health care
      policy and financing, for the fiscal year beginning July 1, 2013, the sum of
      $100,000, or so much thereof as may be necessary, for allocation to the task
      force established pursuant to section 25-37-106 (2), Colorado Revised
      Statutes, for use in developing a standardized set of payment rules and
      claim edits related to the implementation of this act.
      
           SECTION 3.  Safety clause. The general assembly hereby finds,
      determines, and declares that this act is necessary for the immediate
      preservation of the public peace, health, and safety.
      
      
      
      
      ____________________________  ____________________________
      John P. Morse                         Mark Ferrandino
      PRESIDENT OF                     SPEAKER OF THE HOUSE
      THE SENATE                         OF REPRESENTATIVES
      
      
      
      
      
      
      ____________________________  ____________________________
      Cindi L. Markwell                      Marilyn Eddins
      SECRETARY OF                 CHIEF CLERK OF THE HOUSE
      THE SENATE                         OF REPRESENTATIVES
      
      
      
      
                  APPROVED________________________________________
      
      
      
      
      
                                    _________________________________________
                                    John W. Hickenlooper
                                    GOVERNOR OF THE STATE OF COLORADO