Signed by Governor Jared Polis

Vote Smart's Synopsis:

Vote to pass a bill that requires insurance carriers to provide coverage for the treatment of substance use disorders, among other provisions.

Highlights:

• Requires every health benefit plan to provide treatment for substance use disorders in accordance with the American Society of Addiction Medicine (ASAM) criteria for placement, medical necessity, and utilization management determination, as outlined in the most recent edition of “The ASAM Criteria for Addictive, Substance-Related, and Co-Occurring Conditions” (Sec 1).

• Requires the terms and conditions for providing substance use disorder treatment services to be specified in the contract entered between the Office of Behavioral Health and the designated managed service organization (Sec 2).

• Requires contracts entered between the Office of Behavioral Health and the designated managed service organization to include terms and conditions prohibiting a managed service organization treatment provider from denying or prohibiting access to medication-assisted treatment for a substance use disorder (Sec 2).

• Requires an insurance carrier to report the following information to the county commissioner (Sec 9):

• The number of in-network providers who are federally licensed to prescribe medication-assisted treatment for substance disorders, including buprenorphine;

• The number of prescriptions filled by enrollees for medication-assisted treatment for substance use disorders; and 

• The carrier’s efforts to ensure sufficient capacity for and access to medication-assisted treatment for substance use disorders.

• Authorizes a person with substance use disorder, including a minor, to apply for voluntary treatment directly to an approved treatment facility (Sec 18).

Full Bill Text

Vote Smart's Synopsis:

Vote to pass a bill that requires insurance carriers to provide coverage for the treatment of substance use disorders, among other provisions.

Highlights:

• Requires every health benefit plan to provide treatment for substance use disorders in accordance with the American Society of Addiction Medicine (ASAM) criteria for placement, medical necessity, and utilization management determination, as outlined in the most recent edition of “The ASAM Criteria for Addictive, Substance-Related, and Co-Occurring Conditions” (Sec 1).

• Requires the terms and conditions for providing substance use disorder treatment services to be specified in the contract entered between the Office of Behavioral Health and the designated managed service organization (Sec 2).

• Requires contracts entered between the Office of Behavioral Health and the designated managed service organization to include terms and conditions prohibiting a managed service organization treatment provider from denying or prohibiting access to medication-assisted treatment for a substance use disorder (Sec 2).

• Requires an insurance carrier to report the following information to the county commissioner (Sec 9):

• The number of in-network providers who are federally licensed to prescribe medication-assisted treatment for substance disorders, including buprenorphine;

• The number of prescriptions filled by enrollees for medication-assisted treatment for substance use disorders; and 

• The carrier’s efforts to ensure sufficient capacity for and access to medication-assisted treatment for substance use disorders.

• Authorizes a person with substance use disorder, including a minor, to apply for voluntary treatment directly to an approved treatment facility (Sec 18).

Full Bill Text