Colorado Legislative Council Staff

NO FISCAL IMPACT

TITLE:            CONCERNING THE RESPONSIBILITY OF HEALTH CARE COVERAGE CARRIERS FOR THE SOLVENCY OF ENTITIES THROUGH WHICH CARRIERS CONTRACT FOR COVERED HEALTH CARE SERVICES.

Summary of Assessment

            This bill requires health care coverage carriers to assume responsibility for the payment of all providers that have provided covered health care services under a health plan if any contractor, subcontractor, or intermediary of the carrier does not pay for such services or otherwise becomes insolvent. The bill provides specific exemptions. The bill allows the Commissioner of Insurance, Department of Regulatory Agencies, to promulgate necessary rules. The bill will become effective ninety days after the General Assembly adjourns, unless a referendum petition is approved by the voters.

            The bill creates an exemption from the current "double pay" requirement for carriers with respect to providers who have provided services under a managed care contract. If carriers perform specified due diligence and take over the administration of the intermediary contract when payment or solvency issues surface, the carriers would be exempt from the current "double pay" requirement. The bill will have a minimal impact on the workload of the Division of Insurance and will not impact any other state agency or unit of local government. Therefore, this bill is assessed as having no fiscal impact.

Departments Contacted

            Regulatory Agencies