CO| The New Regulation 4-2-102, issued by the Colorado Department of Regulatory Agencies’ Division of Insurance, concerning prior authorization annual attestation requirements for health benefit plans. This regulation, effective March 30, 2025, requires carriers offering health benefit plans to attest compliance with annual reviews and reporting requirements as per Colorado statutes. The regulation applies to health benefit plans issued or renewed on or after January 1, 2026, and mandates carriers to submit a compliant annual prior authorization attestation to the Commissioner by specific dates in 2025 and thereafter.
Key points:
- Carriers must submit a Prior Authorization Attestation Form electronically via SERFF, attesting to completed reviews and elimination of certain prior authorization requirements.
- The attestation must include compliance with provisions for chronic health maintenance drugs and be signed by an authorized officer of the carrier.
- Non-compliance may result in sanctions, including civil penalties, cease and desist orders, or license suspensions/revocations.