Health Law Monitor
Creating Cultural Responsiveness in the Colorado Healthcare Network
May 6, 2022
By: Nicole B. Grimmesey
Beginning January 1, 2023, the Colorado Option Plan will go into effect. Under the Colorado Option Plan, private insurers will be required to offer a standardized insurance plan that offers certain health care services and dictates the services that insureds could receive without paying towards the deductible to the counties in which insurers already sell plans to the individual and small group market.[1] Insurers participating in the Colorado Option Plan will also be required to offer a provider network that reflects the diversity of its enrollees. To achieve this goal, the newly enacted House Bill 22-115 will require insurers to collect demographic information from providers and patients concerning ethnicity, race, disability status, sexual orientation and gender. Providing such information is voluntary, but insurers must ask providers for the same. The demographic information collected by insurers will be reported to the state in the aggregate and will eventually be accessible to the public. The Department of Public Health and Environment will publish a biannual report concerning health disparities and inequities in Colorado based upon the information received. However, the demographic information that providers report to insurers will be confidential and there will be no way to identify the individuals who choose to report their demographic information. For this recent legislation, Colorado has been called a leader and example to the nation because, unlike California and Washington, demographic information includes sexual orientation and gender.
House Bill 22-1157 is intended to connect patients with providers who identify similarly; however, healthcare providers have suggested the Bill falls short from achieving its stated goal. Patients can obtain cumulative demographic information for providers in their community, but not information for individual providers from whom patients could receive care. For that reason, providers anticipate the Bill will eventually lose its confidentiality and aggregate reporting characteristics to allow greater opportunity for patients to connect with providers. Additionally, although the Bill is well-intentioned, some healthcare providers fear the potential unintended consequences that may result when communities who are less receptive to individuals of different demographics learn of the providers in their community with whom they differ. Privacy concerns and safety concerns will remain key considerations when evaluating the success of the Colorado Option Plan following its effective date, January 1, 2023.
House Bill 22-1157 will also require providers who choose to participate in the Colorado Option Plan and their front office staff to annually report on the anti-bias, cultural competency, or similar training that providers and their front office staff took in the previous year. Such training is designed to assist patients who experience higher rates of health disparities and inequities. By January 1, 2020, 50% of a plan's providers and front-office staff must have completed the training. By January 1, 2024, 75% of a plan's providers and front-office staff must have completed the training. By January 1, 2025, 90% of a plan's providers and front-office staff must have completed the training. Further, the health plan directories of insurers who participate in the Colorado Option Plan will be required to list: the languages spoken by providers and their office staff, specify whether providers’ offices are accessible for individuals with disabilities, and disclose whether the provider offers evening or weekend hours.
As the Colorado Option Plan continues to evolve, we will provide updates to ensure healthcare providers and insurance carriers are knowledgeable of the changes in the law.
https://leg.colorado.gov/bills/hb22-1157
https://www.denverpost.com/2022/04/25/colorado-health-care-diversity-data/
https://www.cms.org/articles/cms-is-working-for-you-as-the-colorado-option-takes-shape
[1] For more information on the Colorado Option Plan, see Going Public? Colorado’s “Public” Health Insurance Plan, posted on Jackson Kelly PLLC’s Health Law Monitor on June 9, 2021.