Colorado Regulator Issues Draft Rules on Transparency in Coverage and Prior Authorization

The Colorado Division of Insurance (DOI) recently issued draft regulations and held stakeholder meetings on state-level transparency in coverage reporting and prior authorization. The transparency in coverage rules, which implement Senate Bill 80 from 2024, outline carrier and PBM requirements on Colorado-specific data reporting drawn from the federal Transparency in Coverage regulations.

The prior authorization rules, which implement House Bill 1149 from 2024, include reporting templates and public posting guidance on certain prior authorization metrics as well as revising requirements on prescription drug prior authorizations.

State Government Affairs and representatives from both Cigna Healthcare and Evernorth participated in the stakeholder meetings and provided comments on the drafts. Official regulations on both issues are expected to be noticed for rulemaking hearings in the coming weeks.