On Sep. 5, COL INS drafted proposal re continuity of care obligations.
COL INS drafted Amended Reg. 4-2-56 to provide carriers with continuity of care rules.
For Affordable care act (ACA)-compliant individual and/or group health benefit plans.
Regulation under Code of Colorado regulationsCOL INS 3-702-4, life, accident, health.
Continuity of Care Obligations
Applies when provider leaves or is terminated from a plans network, Medicaid enrollee transfers to a commercial plan, or enrollee coverage not renewed because ineligible.
Amends active course of treatment definition to cover when provider leaves or is terminated from the network or transferring enrollees from pregnancy to postpartum.
Transferring enrollee has same meaning as found at COL INS 10-16-705(4.5)(a)(IV).
Amends the notice requirements for non-renewal, or for a transferring enrollee.
Carrier will review requests for continuity of care by covered person/transferring enrollee or authorized rep and ensure a timely transfer after continuity of care period.
Continuity of care request may only occur when the out-of-network provider agrees in writing to accept in-network, terms and not to take payment from covered person.
Request for Comments
Comments to proposal re continuity of care, ACA benefit plans due by Sep. 12, 2024.
Sep. 2024 COL INS Notice of Hearing
On Sep. 27, 2024, COL INS published hearing notice re Amended Regulation 4-2-56.
Changes clarify enrollees covered from entire pregnancy through postpartum period.
The hearing will be held on Oct. 31, 2024, where oral comments can be presented.
Comments are due by Nov. 5. 2024, and regulation becomes effective on Jan. 1, 2025.
