Colo. Rev. Stat. § 10-16-113.5. Independent external review of adverse determinations – legislative declaration – definitions – rules: Colorado Health Care Coverage Act – Colorado

Status: Enacted
Year Enacted: 1999
Year Amended: 2016
File: Download

Any adverse determinations made by an insurance company must be independently reviewed by a member of the company not party to the orginal determination. They must use medical and scientific evidence, including peer reviewed standards, to make the determination.

Key Issues: Benefit Design PRICE AND QUALITY TRANSPARENCY Utilization Review Quality Measure Prior Authorization HEALTHCARE COSTS Cost Containment

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Colo. Rev. Stat. § 10-16-113.5. Independent external review of adverse determinations – legislative declaration – definitions – rules: Colorado Health Care Coverage Act – Colorado

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