The act caps at $400 the amount that a health-care entity or health-care provider may charge for a record request made by a patient's attorney or the attorney of the patient's personal representative pursuant to an authorization in compliance with the federal 'Health Insurance Portability and Accountability Act of 1996', a valid subpoena, or a valid court order, if the requested record exceeds 664 pages. The health-care entity or health-care provider may charge a reasonable fee above the cap if the record request requires the health-care facility or health-care provider to segregate, withhold, or redact protected health information in order to comply with applicable law or the scope or limitations of the authorization in compliance with the federal 'Health Insurance Portability and Accountability Act of 1996', a valid subpoena, or a valid court order. Beginning January 1, 2028, and every even-numbered year thereafter, the act requires the $400 limit to be adjusted for inflation. The act requires the requested medical records to be delivered in electronic format if the requestor requests electronic format, the original records are stored in electronic format, and the records are readily producible in electronic format. The act requires the health-care facility or health-care provider to provide the requestor with an invoice for the records provided in response to the record request within 30 days of receiving the request, and the health-care facility or health-care provider must provide the records upon payment of the invoice. If the health-care facility or health-care provider is unable to comply with the request for records within 30 days after the request, the health-care facility or health-care provider must send written notice of a 30-day extension to the requestor. The health-care facility or health-care provider must provide the records to the requestor at no cost if the records were not provided within 30 days or without written notice of an extension, unless the delay is due to a force majeure event. In the case of a force majeure event, the health-care facility or health-care provider must provide written notice to the requestor within 5 business days of becoming aware of the force majeure event. The 30-day time frame to respond to a request for records commences upon resolution of the force majeure event.(Note: This summary applies to this bill as enacted.)
The act requires the nonemergency medical transportation broker (broker) to establish the transportation community advisory board (TCAB) and requires the state department of health care policy and financing (state department) to collaborate with the TCAB prior to establishing rules and processes for the safety and oversight of nonmedical transportation services and nonemergency medical transportation (NEMT) services. The act requires, in collaboration with the TCAB, certain rules for NEMT the state department must adopt. The state department may impose trip caps or market-share restrictions on a transportation provider (provider) as part of corrective action plan. The act requires providers to use vehicles equipped with 2-way video cameras and a video recording system when transporting members. The act establishes how the broker must roll out their implementation and requires the broker to provide all providers with software, a communication toolkit, training, and technical assistance to facilitate NEMT services. The broker may encourage medicaid members (members) to book transportation services at least 2 days before their requested transportation date, and the broker shall accept and make reasonable efforts to fulfill same-day and next-day transportation requests. The act requires providers, only after all service regions have been implemented, to accommodate member requests for preferred or alternate drivers when operationally feasible. The act requires the broker, and, if there is no broker, the providers to verify that individuals using the transportation services are eligible members during the scheduling of transportation services. The act prohibits the broker from operating, owning, or controlling a provider in Colorado. The act requires the broker to provide their trip assignment rules and procedures to the state department for approval and for publication on the state department's website. The act allows a transportation network company to provide NEMT services when a provider is unavailable. The state department shall ensure all transportation providers, drivers, and vehicles are credentialed, and services provided by noncredentialed drivers or in noncredentialed vehicles are not eligible for reimbursement. The act prohibits the state department from denying payment of services to providers if the provider provides scheduled transportation services in good faith based on the information provided by the broker or if the provider had no knowledge of an inaccuracy and the provider followed all applicable rules and procedures. Subject to available appropriations, the act requires the state department to audit providers and audit the broker annually. The act requires the state department to categorize all NEMT expenditures as medical services and make changes to the NEMT program as necessary to obtain medical services federal match rates for NEMT services. The act also eliminates the requirement that the state department provide transportation services as an administrative cost. The act reduces appropriations to the state department from the general fund by $76,639 and from the healthcare affordability and sustainability hospital provider fee cash fund by $20,941,853.(Note: This summary applies to this bill as enacted.)
If the executive director of the department of health care policy and financing (state department) receives gifts, grants, and donations for the purpose of providing support for the development and funding of an enhanced reimbursement model for nursing facilities that serve residents with behavioral health needs, the state department is required to use the gifts, grants, and donations for that purpose. Receiving gifts, grants, and donations for this purpose does not commit the state to an expenditure of general fund money, and the general assembly shall not reduce any appropriation made to the state department for the same purpose. If requested by the joint budget committee, the state department is required to report the state department's use of the gift, grants, and donations received.(Note: This summary applies to this bill as enacted.)
The act requires each covered social media platform (covered platform) to impose a fee on each add-on transaction that occurs on the covered platform. The act creates the youth mental health services access enterprise in the behavioral health administration (BHA) to use the fee revenue to operate and fund programs that provide youth mental health services. The youth mental health services access enterprise constitutes an enterprise for purposes of section 20 of article X of the state constitution. The act defines a 'covered platform' as a sole proprietorship, a partnership, a limited liability company, a corporation, an association, or another legal entity, or an affiliate thereof, that:Conducts business in this state;Generates revenue directly from add-on transactions conducted in an online gaming service, product, or feature;Generates a majority of its annual revenue from online gaming services, products, or features;Publishes one or more online gaming services, products, or features that are reasonably likely to be accessed by a youth;Collects users' personal data or has users' personal data collected on its behalf; andDetermines the purposes and means of the processing of users' personal data. The act defines an 'add-on transaction' as a transaction through which a player or participant in a video game accessed via an online gaming service, product, or feature acquires:An item or ability that provides the player or participant an advantage over other players or participants of the video game; orA feature that alters or enhances the video game as accessed by the online gaming service, product, or feature. The act creates the youth mental health services access enterprise fund, consisting of money credited to the fund as fee revenue, any money received from the issuance of revenue bonds, and any other money that the general assembly may appropriate or transfer to the youth mental health services access enterprise fund. Money in the youth mental health services access enterprise fund is continuously appropriated to the youth mental health services access enterprise. After deducting its administrative expenses, the youth mental health services access enterprise is required to allocate the remaining fee revenue credited to the fund as follows:40% to operate and fund the youth mental health peer navigator grant program, which program is created in the act;35% to operate and fund the crisis resolution team program, which program is created in the act; and25%, beginning January 1, 2028, to operate the existing youth mental health services program. The initial amount of the fee is 5% of the amount of the add-on transaction. On and after October 1, 2027, the youth mental health services access enterprise may adjust the amount of the fee. The act creates the youth mental health peer navigator grant program to award grants to entities that recruit and train young adults to provide prevention services, peer support, and system navigation to youth in schools or community-based settings. The act creates the crisis resolution team program to provide community-based de-escalation and stabilization services to youth who are experiencing high-acuity behavioral health crises and to their caregivers. Under current law, the BHA operates the youth mental health services program to facilitate access to mental health services, including substance use disorder services, for youth in response to mental health needs identified in an initial mental health screening through the program's web-based portal. The youth mental health services program reimburses providers for up to 3 mental health sessions with a youth. The act directs the youth mental health services access enterprise, rather than the BHA, to operate and fund the youth mental health services program beginning January 1, 2028. The act also allows the youth mental health services access enterprise to reimburse a provider for up to 6 mental health sessions with a youth. The act creates the youth programming and protections enterprise to:Award grants through the existing out-of-school time program grant program; andSupport the department of education's enforcement of educational rights on behalf of children. The youth programming and protections enterprise constitutes an enterprise for purposes of section 20 of article X of the state constitution. The act creates the youth programming and protections enterprise fund. In each state fiscal year, after the state treasurer has credited $8 million to the youth mental health services access enterprise fund, the state treasurer must credit any other money received as fees to the youth programming and protections enterprise fund. Under current law, the department of education administers the out-of-school time program grant program and the state board of education awards grants from the program, subject to available appropriations. The act directs the department of education to consult with the youth programming and protections enterprise in administering the out-of-school time program grant program, and the act directs the youth programming and protections enterprise to award grants from the program in consultation with the state board of education. The act also requires the out-of-school time program grant program to provide programming and services that support the mental health and well-being of children and youth. The act requires a covered platform to ensure that the purchase price for an online gaming service, product, or feature that is reasonably likely to be accessed by a minor to be listed in United States dollars at the point of sale. For the 2026-27 state fiscal year, the act appropriates:$294,984 to the department of revenue from the general fund;$26,500 to the department of law from reappropriated funds;$145,750 to the department of law from the youth mental services access enterprise fund created in the act; and$79,500 to the department of law from the youth programming and protections enterprise fund created in the act.(Note: This summary applies to this bill as enacted.)
The bill creates the large employer health-care support enterprise (enterprise) to impose, assess, and collect the large employer health-care support fee (enterprise fee) in the amount of $2,300 for each supported worker for the calendar year in an amount determined by the enterprise board (enterprise board) that reflects the costs of the services provided by the enterprise . A worker who is receiving medical assistance benefits under the state medical assistance program, except for a worker eligible for medical assistance benefits based on disability, is a supported worker (supported worker). An employer is subject to the enterprise fee if the employer is a large employer, which is defined in the bill as an employer that has 500 or more supported workers (large employer). An employer is exempted from paying the enterprise fee if the employer:Provides affordable health coverage to all workers working 20 or more hours per week or 80 or more hours per month;Is a franchisee of the employer;Is a nonprofit employer;Is a public employer; orHas a collective bargaining agreement with its employees that includes health-care coverage. The business purpose s of the enterprise are to use enterprise fee revenue to help large employers retain supported workers who are not provided employer-sponsored affordable health coverage by using enterprise fee revenue to:Help finance the costs for medical assistance benefits for large employers' supported workers ; and Provide reimbursement grants to large employers for some or all of an employer's costs incurred for allowing a worker to buy into an employer-sponsored health benefit plan, should the employer choose to participate in the worker buy-in program created in the bill.This These business service s reduce s lost productivity due to worker illness and training costs to replace workers who may otherwise seek employment that provides affordable health coverage. Starting with a review of the 2027 calendar year, the department of health care policy and financing (HCPF) every employer that employed 500 or more workers in the state shall prepare an annual employer report on or before January 31, 2028, and on or before the same date each year thereafter, that includes information about the employer's employees, including the employee's name, date of birth, hours worked, and dates of employment for the preceding calendar year. An employer may seek an exemption from the requirement to file the annual employer report by demonstrating that it provides affordable health coverage to all workers working 20 or more hours per week or 80 or more hours per month. Upon receipt of the annual employer report, the enterprise shall determine whether an employer is a large employer and shall issue a report by March of the following same calendar year that identifies large employers by their number of supported workers for the preceding calendar year and impose the enterprise fee on each large employer . An employer may contest the employer's identification as a large employer. Once identified, a large employer shall either pay the enterprise fee for each of the large employer's supported workers or demonstrate that it provides will offer affordable health coverage to all workers working 20 or more hours per week or 80 or more hours per month. The enterprise may adjust the amount of the enterprise fee to reflect the cost of the services, for inflation, or for other reasons. A large employer commits a petty offense and is subject to a civil penalty for The enterprise shall contract with the department of revenue to collect and enforce the payment of the enterprise fee on behalf of the enterprise, including the failure to provide information necessary to calculate the enterprise fee or to either timely pay the enterprise fee or demonstrate that the large employer offers affordable health coverage as specified in the bill. The department of revenue may collect interest and penalties and institute collection actions on behalf of the enterprise. Enterprise revenue is used to support the pay for payment of medical assistance benefits for working-age adults under the state medical assistance program, and to increase reimbursement rates for ensure access to health-care providers providing medical assistance program services, to ensure worker access to medical services and to pay for large employer reimbursement grants under the worker buy-in program for large employers that pay the enterprise fee. The enterprise is governed by the enterprise board, and the enterprise board shall report annually to the general assembly on the enterprise revenue and the enterprise's use of the enterprise revenue in support of large employers. If the enterprise determines that the enterprise to would receive more than $100 million dollars in its first 5 fiscal years, the state treasurer shall credit the additional fee revenue to the large employer fee cash fund created in the state treasury for administration by HCPF, and that fee revenue is subject to the state fiscal year spending limit imposed by section 20 of article X of the state constitution and the excess revenues cap. The money in the large employer fee cash fund shall be used by HCPF to pay for costs for medical assistance benefits to support large employers' supported workers enterprise shall reduce the amount of the enterprise fee.(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.)
