Notice of Adoption - New Regulations on HIV PrEP Coverage and Carrier Out-of-Network Reporting Requirements

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The Division would like to provide notice that the Commissioner has adopted the following  regulations:

Regulation 4-2-73 Concerning Human Immunodeficiency Virus Pre-Exposure Prophylaxis Prescription Drugs - This regulation will become effective on January 1, 2021.

The purpose of this regulation is to establish the requirements for health benefit plans to provide coverage for human immunodeficiency virus (HIV) pre-exposure prophylaxis (PrEP) as PrEP is an A recommendation of the United States Preventive Services Taskforce (USPSTF).

Regulation 4-2-74 - Concerning Data Reporting Requirements For Carriers’ Out-Of-Network Reimbursements - This regulation will become effective on December 15, 2020.

The purpose of this regulation is to establish data reporting requirements for carriers concerning the use of out-of-network providers and facilities and the impact on premium affordability as required by HB 19-1174, 10-16-704(14), C.R.S.

Find this regulation and other regulations that have been adopted, but are not yet effective at Regulations Adopted But Not Yet Effective.

Division bulletins and regulations can be found at Statutes, Regulations & Bulletins.

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