Title 10, Insurance
0 chapters · 1,354 sections in this title.
Colo. Rev. Stat. § 10-16-704 Network adequacy - required disclosures - balance billing - rules - legislative declaration - definitions
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(1) A carrier providing a managed care plan shall maintain a network that is sufficient in numbers and types of providers to assure that all covered benefits to covered persons will be accessible without unreasonable delay. In the case of emergency services, covered persons shall…
Colo. Rev. Stat. § 10-16-705 Requirements for carriers and participating providers - definitions - rules
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(1) In addition to any other applicable requirements of this part 7, a carrier offering a managed care plan shall satisfy all the requirements of this section. (2) A carrier shall maintain a mechanism by which providers can access information on the covered health services for wh…
Colo. Rev. Stat. § 10-16-705.5 Participating provider networks - definitions - selection standards - informal reconsideration - enforcement - legislative declaration
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(1) The general assembly finds and declares that: (a) Carriers create networks of providers that ensure consumers have access to an adequate number of providers to meet their needs; (b) In the current marketplace, carriers offer consumers a multitude of plan options, some of whic…
Colo. Rev. Stat. § 10-16-705.7 Timely credentialing of physicians by carriers - notice of receipt required - notice of incomplete applications required - delegated credentialing agreements - discrepancies - denials of claims prohibited - disclosures - recredentialing - enforcement - rules - definitions
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(1) As used in this section, unless the context otherwise requires: (a) “Applicant” means a physician who submits an application to a carrier to become a participating physician in the carrier’s network. (b) “Application” means an applicant’s application to become credentialed by…
Colo. Rev. Stat. § 10-16-706 Intermediaries
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(1) In addition to any other applicable requirements of this part 7, a contract between a carrier and an intermediary shall satisfy all the requirements of this section. (2) Intermediaries and participating providers with whom they contract shall comply with all the applicable re…
Colo. Rev. Stat. § 10-16-707 Enforcement
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(1) If it is determined that a carrier has not contracted with enough participating providers to assure that covered persons have accessible health-care services in a geographic area, that a carrier's access plan does not assure reasonable access to covered benefits, that a carri…
Colo. Rev. Stat. § 10-16-708 Rule-making authority of commissioner
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The commissioner may promulgate rules as necessary for carrying out the commissioner's duties under this part 7. Source: L. 97: Entire part added, p. 1332, � 2, effective July 1. 10-16-709. Evaluation - nonparticipating health-care providers - legislative declaration - rules. (1)…
Colo. Rev. Stat. § 10-16-709 Evaluation - nonparticipating health-care providers - legislative declaration - rules
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(1) (a) The general assembly hereby finds and determines that not all health-care providers contract with all health insurers and therefore not all are participating providers. Health-care providers who do not contract with a carrier are considered to be nonparticipating provider…
Colo. Rev. Stat. § 10-16-710 Reporting to commissioner - medication-assisted treatment - rules
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(1) A carrier shall report to the commissioner: (a) The number of in-network providers who are federally licensed to prescribe medication-assisted treatment for substance use disorders, including buprenorphine; and (b) The number of prescriptions filled by enrollees for medicatio…
Colo. Rev. Stat. § 10-16-801 (Repealed)
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Source: L. 2003: Entire part repealed, p. 1785, � 17, effective July 1. Editor's note: This part 8 was added in 2001 and was not amended prior to its repeal in 2003. For the text of this part 8 prior to 2003, consult the 2002 Colorado Revised Statutes.