Colorado’s General Assembly concluded its legislative session Wednesday, May 8, 2024.
In the 120-day aftermath of opening day speeches, this session brought about significant changes to water policy, attempted to address housing availability and affordability, increased environmental regulations, and shifted policies in education, healthcare, property tax, and public safety.
Faced with a tight budget and the expiration of federal American Recovery and Reinvestment Act funding, a $40.6 billion budget was approved including a 2% rate increase for all Medicaid providers, the continuation of the Senior Dental Advisory Program, and a substantial funding increase for 28 selected Medicaid dental codes.
Oral Health Screening
One of the CDA’s top priorities was the passage of a pilot program to provide oral health screenings in Colorado public schools. After extensive conversations with the Colorado Department of Public Health and Environment (CDPHE) and an extraordinary budget process, the CDA successfully negotiated financing for the bill’s passage in a tight budget year.
The new policy expands an existing program within CDPHE. CDPHE will award a minimum of five grants to public schools to provide oral health screening for kindergartners and third graders in the 2024/2025 school year. Oral health screenings will be performed by existing providers or “screeners” already working with CDPHE within existing oral health programs. Additionally, CDPHE must provide a report to the legislature in January 2027 and the new policy requires the Department of Education to develop a plan to implement oral health screenings in all public schools by December 2027. The continuation of the pilot program is subject to available appropriations.
Interstate Dental Licensure Compact
The CDA also worked closely with the Colorado Dental Hygienists’ Association to pass legislation allowing Colorado to participate in an interstate compact. Once fully operational, licensure applications among the compact states, including Colorado, will be standardized and dentists and dental hygienists who are approved through an application and review process will be granted compact privileges.
For a detailed chart of how licensing will work once the compact is fully operational, download this helpful document.
Colorado is already engaged in multiple interstate compacts (e.g., nursing, physical therapy, occupational therapy, medicine, licensed professional counselors, etc.). Work on the dentist and dental hygienist interstate compact started in 2022 and involved The Council of State Governments, Department of Defense, American Dental Association and American Dental Hygienists’ Association. It is a nationwide effort to support the mobility of licensed dentists and dental hygienists to create reciprocity among participant states and reduce the barriers to license portability.
Colorado was the eighth state to join the compact. At the time of this publication, nine states have joined the compact and three additional states have pending legislation. Next steps include establishing an interstate commission with representation from each of the compact states to develop rules, regulations, forms, standards, etc. by which the compact will operate. The implementation process for the compact will take 18 to 24 months before compact privileges can be issued.
Answers to frequently asked questions regarding the Dentist and Dental Hygienist Interstate Compact can be found at ddhcompact.org/faq.
Noneconomic Damages Caps
HB 1472, a bipartisan proposal backed by legislative leadership and the governor’s office, increases the limit on how much individuals can collect if they win a lawsuit, while still protecting healthcare for millions of Coloradans. It also positions Colorado to continue attracting and retaining talented healthcare providers, preserving access to healthcare (including specialty care), and protects patients from skyrocketing costs.
Earlier this year, the Colorado Trial Lawyers Association introduced a series of ballot initiatives that would eliminate the cap on non-economic damages, meaning that if a healthcare provider (including a dentist) were to get sued by a patient, there would be no limit on how much could be collected in a successful judgement for things like pain and suffering. This would not only deter providers from doing more complicated procedures but could also bankrupt smaller solo practices, causing more of an access to care shortage in remote areas. To counter this, the CDA worked with the Coloradans Protecting Patient Access (CPPA) advocacy group to negotiate a solution that would take these dangerous ballot measures off the table by crafting a legislative solution.
Noneconomic damage caps have gone unchanged in Colorado for over 20 years. HB 1472 raises the noneconomic damage caps for healthcare malpractice suits from $300,000 to $875,000 over five years. It creates a new claim specifically for wrongful death and raises the damage cap for that to $1.575 million over the next five years. Both caps will rise biennially by the rate of inflation beginning in 2030.
HB 1472 also raises the caps for general liability lawsuits from the current level of $250,000 to $1.5 million and boosts the $642,000 cap on noneconomic damages in wrongful-death lawsuits to $2.125 million, with both caps rising by inflation every two years beginning in 2028.
The new caps apply to lawsuits that are filed on or after Jan. 1, 2025.
Insurance Reform – Reigning in Prior Authorization
Another win for healthcare was legislation establishing new limitations on prior authorization by health insurers and pharmacy benefit managers. The CDA worked with the Colorado Medical Society, the Colorado Academy of Family Physicians and over 35 other organizations to strongly support this measure. Despite passage, these policies will require significant engagement by providers with their respective insurers where they are in network. Additionally, the CDA will be involved in the rulemaking process to ensure we understand the rules of engagement for our members.
This bill places responsibility on insurance companies to significantly reduce the use of prior authorization and requires insurance companies to establish a binding arbitration process for failing to include a provider in the program. The bill also includes the following requirements for health insurers:
- Publicly disclose information on prior authorization requirements and restrictions including a list of drugs that require prior authorization, clinical criteria for reauthorization, standard forms, data on prior authorization request determinations, exemptions, and prescription drug formularies.
- Yearly review and elimination of prior authorization requirements for services and drugs that do not promote healthcare quality or equity, or do not reduce healthcare spending.
- Provide relevant alternative services or treatments that may be covered when a claim is denied.
- Establish streamlined computer interface accessibility by providers seeking prior authorization. Insurers must accept and respond to prior authorization requests using the interface the request was submitted.
After seeking to resolve any issues with an insurer through conventional means, a provider may access the arbitration process, which is binding. The bill also requires the Colorado Insurance Commissioner to create rules of implementation and enforcement of these new limitations on health insurers.
Go here for a complete list of bills monitored by the CDA.