2024 Legislative Wrap-up
Now that the 2024 Legislative Session is over and the Governor’s timeframe within which he must act has expired we wanted to provide you with a recap of what CO ACEP has done for you and how it impacts your practice.
The number of bills introduced this year topped 700. While not quite a record for the Colorado Legislature, it is certainly close. Of those, CO ACEP was involved in 77.
We protected you from an elimination of non-economic medical liability damage caps and a breach of confidentiality of peer review activities. The Colorado Trial Lawyers Association (CTLA) filed for six ballot initiatives. CTLA knew that they could not pass legislation to increase caps or pierce peer review so, with a war chest of over $40 million, they were headed to the November ballot. Their initiatives would have:
- Removed all non-economic damage caps for medical liability claims
- Opened peer review records to plaintiff lawyer’s discovery
- Redefined “adverse medical incidents” to include any incident that caused or could have caused injury to or death of a patient
- Defined “wrongful death” to include dismemberment, permanent injury of the body or mind, or a severe injury that seriously limits activities of normal daily life
C joined a coalition of health care providers, facilities, insurers, etc. (Coloradans Protecting Patient Access) to combat the CTLA effort. We garnered the support of the legislature and the administration in order to bring CTLA to the table. After months of intense and fragile negotiations, and with four days left in the legislative session, we were able to strike a compromise. That compromise became HB24-1472.
HB24-1472 increases the medical non-economic damages cap over a five-year period from the current $300,000 to $875,000 and establishes a new, wrongful death cap at $1.575 million. General Liability will be increased over a 5-year period to: $1.5M NED/$2.125M WD.
Here is how the new cap will be implemented:
Year 1: $415k NED – $540k WD
Year 2: $530k NED – $780k WD
Year 3: $645k NED – $1.02M WD
Year 4: $760k NED – $1.26M WD
Year 5: $875k NED – $1.575M WD
Year 6: CPI adjustments start and are calculated every two years.
This compromise, which benefitted both sides yet left each unhappy, was introduced into the 2024 Legislative Session on day 117 of the 120-day session and passed both chambers unanimously. In exchange for these increases, CTLA has agreed to drop all ballot initiatives related to increasing caps, wrongful death, and piercing peer review protections.
We saved you from exposure to a new type of lawsuit which carried treble damages. We defeated HB24-1014 which would have eliminated the requirement that a significant number of consumers be harmed before claims may be made under the “Colorado Consumer Protection Act” (CCPA). With the removal of this requirement, a patient/consumer of healthcare could have brought forth a medical malpractice claim along with a CCPA claim. As noted, a violation of the CCPA comes with treble damages, for which, medical liability insurers do not provide coverage.
We saved you from having to complete an additional 40 hours of CME every two years, with 12 of those hours dedicated to reproductive, sexual and gender-based health care and explicit and implicit bias. Instead, through amendments, HB24-1153 now includes 30 required hours of CME that can now be met through national board certification. If the Colorado Medical Board ever contemplates requiring topic specific CME, the bill requires they conduct stakeholder meetings to consider determine if the topic-specific CME is necessary and if so to which specialties such CME should apply.
We were able to hold off HB24-1079 which would have required law enforcement to hold individuals taken into protective custody with behavioral health disorders in an emergency medical facility. With amendments, the issue of appropriate facilities in which to hold persons with behavioral health disorders while in the criminal or juvenile justice system will be studied prior to the 2025 Legislative Session. The intent of the legislation is to prevent persons from being held in jail when behavioral health care is needed. However, with a shortage of treatment facility beds, the proposed alternative would have been holding them in the emergency department, thereby exacerbating the boarding issue. Stay tuned. This issue will be back in 2025.
We protected your patients by blocking the ability of naturopaths from prescribing any Schedule III-IV drugs. HB24-1171 would have given naturopaths the ability to prescribe most Schedule III-V drugs. We opposed this scope expansion because naturopaths simply do not have adequate education and training in pharmacology.
We simplified your administrative burdens related to prior authorizations. HB24-1149 is three-year effort culminated in a law that will place more health care decisions in the hands of patients and physicians, including extending prior auth approvals from 180 days to six months and increasing approval time frames for chronic medications to three years for certain situations, prohibiting denials that were approved but require additional care during surgery, and requiring the development of alternative programs for prior auth for medical services and medications.
Key bills were passed to support continued work on the opioid epidemic, including getting Naloxone into schools (HB24-1003), creating more harm reduction policies to support better health by those with substance use disorders (HB24-1037), and expanding treatment for substance use disorders (HB24-1045).
No legislative session comes without a few losses. This year we fought for new Colorado policies that did not make it across the finish line. We will continue to pursue these issues in upcoming sessions.
- CO ACEP worked to have SB24-163 introduced. This bill would have allowed claims to be batched when taken to arbitration under Colorado’s out-of-network statute. Colorado’s out-of-network law solved some of the concerns surrounding “surprise” medical bills, but it left out the ability for a physician to batch out-of-network claims. This provided the huge health plans the opening they needed to game the system. Many plans are already either forcing take-it-or-leave-it or severely discounted contracts (20%-40%) or purposely terminating contracts with practices to send them out-of-network knowing that the current arbitration process unfairly hurts physicians. The importance of this
issue remains despite the demise of the bill.
- SB24-082 is another bill we supported that was postponed indefinitely. Over the past few years there has been an alarming increase in inappropriate attempts to expand the scope of practice for non-physician providers. This bill aimed to help patients understand what type of provider was treating them. As CMS President Omar Mubarak, MD, MBA, noted in testimony before the Senate Health & Human Services Committee, “Patients deserve the right to know who is treating them and what their qualifications and levels of training are before they can safely consent to treatment.” While the bill failed to pass this year, ensuring transparency about care to inform patient decision-making will continue to be important.
- SB24-082 is another bill we supported that was postponed indefinitely. Over the past few years there has been an alarming increase in inappropriate attempts to expand the scope of practice for non-physician providers. This bill aimed to help patients understand what type of provider was treating them. As CMS President Omar Mubarak, MD, MBA, noted in testimony before the Senate Health & Human Services Committee, “Patients deserve the right to know who is treating them and what their qualifications and levels of training are before they can safely consent to treatment.” While the bill failed to pass this year, ensuring transparency about care to inform patient decision-making will continue to be important.