The Division would like to provide notice that the Commissioner has adopted the following emergency regulations.
- Emergency Regulation 22-E-18 Concerning Coverage and Reimbursement for Transfer of Covered Persons Between Facilities and Treatment of Covered Persons at a Receiving Facility During the COVID-19 and Other Respiratory Illnesses Disaster Recovery
- Emergency Regulation 22-E-19 Concerning Suspension of Utilization Review Requirements for Transfers or Discharges from Hospitals as a Result of COVID-19, Respiratory Syncytial Illness, Influenza and Other Respiratory Illnesses
While both regulations apply to carriers offering individual, small group, large group plans, student health plans, and managed care plans subject to the insurance laws of Colorado, insurance carriers who are third-party administrators for self-funded plans are strongly encouraged to follow the requirements of these regulations. Following the regulations will allow for uniform billing structures. Similarly, publicly funded ambulances that are not subject to C.R.S. § 10-16-704(5.5) are also strongly encouraged to follow the requirements of the regulations order to protect consumers. Third-party administrators following the regulations will create uniformity regarding utilization reviews for hospital transfers or discharges.
The purpose of emergency regulation 22-E-18 is to require carriers to cover the costs of patient transfers between facilities and treatment at the receiving facilities during the Governor’s Executive Order No. D 2022 044, Colorado COVID-19 and Other Respiratory Illnesses Disaster Recovery Order Amendment, as amended and extended, to address the pediatric intensive care unit capacity and anticipated bed shortage across all hospitals in Colorado as our state experiences a rise in COVID-19, influenza, and RSV hospitalizations simultaneously.
The Division of Insurance finds, pursuant to § 24-4-103(6)(a), C.R.S., and in accordance with Executive Order D 2022 044, that immediate adoption of this regulation is imperatively necessary for the preservation of public health, safety, or welfare as ensuring facilities have adequate resources and bed capacity to treat patients with COVID-19 and other respiratory illnesses is imperative to preserve the health of the citizens of Colorado. Therefore, compliance with the requirements of § 24-4-103, C.R.S., would be contrary to the public interest.
The purpose of emergency regulation 22-E-19 is to increase the number of available providers in hospitals that are experiencing capacity and staffing shortages due to COVID-19 and other respiratory illnesses, including Respiratory Syncytial Virus (RSV) and influenza, an associated decrease in pediatric intensive care unit capacity, and an anticipated bed shortage across all hospitals in Colorado. It will increase the availability of providers for patient care by temporarily suspending utilization review requirements and streamlining the approval process for transfers and discharges from hospitals.
The Division of Insurance finds, pursuant to § 24-4-103(6)(a), C.R.S., and pursuant to Executive Order No. D 2022 044, that immediate adoption of this regulation is imperatively necessary for the preservation of public health, safety, or welfare as ensuring hospitals have adequate resources and provider availability to treat patients is imperative to preserve the health of the citizens of Colorado. Therefore, compliance with the requirements of § 24-4-103, C.R.S., would be contrary to the public interest.
Both emergency regulations are effective November 11, 2022.
These emergency regulations, and other Division emergency regulations, can be found on the Division's website via the following link.