Carrier to Notify Provider Material Change Contract

Second Regular Session Seventy-fifth General Assembly STATE OF COLORADO REENGROSSED This Version Includes All Amendments Adopted in the House of Introduction HOUSE BILL 26-1241 LLS NO. 26-0791.01 Renee Leone x2695 HOUSE SPONSORSHIP Marshall and Bradley, Bacon, Duran, Gonzalez R., Hamrick, Joseph, Slaugh, Soper SENATE SPONSORSHIP Marchman, House Committees Senate Committees Health & Human Services A BILL FOR AN ACT CONCERNING THE NOTICE REQUIRED TO MAKE A MATERIAL CHANGE TO A CONTRACT ENTERED INTO WITH A HEALTH-CARE PROVIDER.

In current law concerning contracts with health-care providers, an entity wishing to make a material change to such a contract must provide written notice of the change to the health-care provider at least 90 days before the effective date of the change. The bill adds language requiring a person to give such written notice by registered mail and by email to the Shading denotes HOUSE amendment. Double underlining denotes SENATE amendment.

Capital letters or bold & italic numbers indicate new material to be added to existing law. Dashes through the words or numbers indicate deletions from existing law.

March 24, 2026 HOUSE HOUSE Amended 2nd Reading March 23, 2026 (Note: This summary applies to this bill as introduced and does not reflect any amendments that may be subsequently adopted. If this bill passes third reading in the house of introduction, a bill summary that applies to the reengrossed version of this bill will be available at http://leg.colorado.gov.) 3rd Reading Unamended Bill Summary health-care provider or administrator who signed the contract and adds a reference to this language in the area of the Colorado Revised Statutes concerning health-care insurance carriers.

Be it enacted by the General Assembly of the State of Colorado: SECTION 1. In Colorado Revised Statutes, 10-16-121, add (1)(g) as follows: 10-16-121. Required contract provisions in contracts between carriers and providers - definitions. (1) A contract between a carrier and a provider or its representative concerning the delivery, provision, payment, or offering of care or services covered by a managed care plan must make provisions for the following requirements:

(g) (I) A PROVISION THAT REQUIRES THE CARRIER TO PROVIDE NOTICE TO THE PROVIDER IF THE CARRIER MAKES A MATERIAL CHANGE TO THE CONTRACT, IN ACCORDANCE WITH SECTION 25-37-104.

(II) AS USED IN THIS SUBSECTION (1)(g), "MATERIAL CHANGE" HAS THE MEANING SET FORTH IN SECTION 25-37-102 (9).

SECTION 2. In Colorado Revised Statutes, 25-37-104, amend (1) as follows: 25-37-104. Material change in health-care contract - written advance notice.

(1) A material change to a contract shall occur IS AUTHORIZED only if the person or entity provides NOTICE OF THE MATERIAL CHANGE in writing, BY STANDARD ELECTRONIC MEANS, to the health-care provider the proposed change and gives HEALTH-CARE PROVIDER HAS NOT AFFIRMATIVELY RESPONDED, A THIRD TIME BY REGISTERED MAIL OR PERSONAL SERVICE TO THE HEALTH-CARE TWO SEPARATE TIMES AND, IF THE PROVIDER OR THE HEALTH-CARE PROVIDER'S ADMINISTRATOR WHO WAS THE INDIVIDUAL WHO SIGNED THE CONTRACT AT LEAST ninety days notice before the effective date of the change. The writing shall WRITTEN NOTICE MUST be conspicuously entitled "notice of material change to contract" AND MUST CLEARLY SET FORTH THE PROPOSED MATERIAL CHANGE. THE PERSON OR ENTITY PROVIDING NOTICE MAY CHARGE THE ACTUAL COST INCURRED FOR THE REGISTERED MAIL OR PERSONAL SERVICE TO THE HEALTH-CARE PROVIDER.

SECTION 3.

Act subject to petition - effective date - applicability. (1) This act takes effect January 1, 2027, except that, if a referendum petition is filed pursuant to section 1 (3) of article V of the state constitution against this act or an item, section, or part of this act within the ninety-day period after final adjournment of the general assembly, then the act, item, section, or part will not take effect unless approved by the people at the general election to be held in November 2026 and, in such case, will take effect January 1, 2027, or on the date of the official declaration of the vote thereon by the governor, whichever is later.

(2) This act applies to contracts entered into or renewed on or after the applicable effective date of this act.