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Home » US Law » 2022 Colorado Code » Title 25 - Public Health and Environment » Article 37 - Contracts With Health-Care Providers

§ 25-37-101. Applicability of Article

A person or entity that contracts with a health-care provider shall comply with this article and shall include the provisions required by this article in the contract. Source: L. 2010: Entire article amended with relocations, (HB 10-1332), ch. 300, p. 1413, § 1, effective May 26. L. 2016: Entire section amended, (SB 16-127), ch. 68, […]

§ 25-37-102. Definitions

As used in this article, unless the context otherwise requires: “Category of coverage” means one of the following types of coverage offered by a person or entity: Health maintenance organization plans; Any other commercial plan or contract that is not a health maintenance organization plan; Medicare; Medicaid; or Workers’ compensation. “CMS” means the federal centers […]

§ 25-37-103. Health-Care Contracts – Required Provisions – Permissible Provision

A person or entity shall provide, with each health-care contract, a summary disclosure form disclosing, in plain language, the following: The terms governing compensation and payment; Any category of coverage for which the health-care provider is to provide service; The duration of the contract and how the contract may be terminated; The identity of the […]

§ 25-37-104. Material Change in Health-Care Contract – Written Advance Notice

A material change to a contract shall occur only if the person or entity provides in writing to the health-care provider the proposed change and gives ninety days’ notice before the effective date of the change. The writing shall be conspicuously entitled “notice of material change to contract”. If the health-care provider objects in writing […]

§ 25-37-105. Contract Modification by Operation of Law

Notwithstanding section 25-37-103 (3), a contract may be modified by operation of law as required by any applicable state or federal law or regulation, and the person or entity may disclose this change by any reasonable means. Source: L. 2010: Entire article amended with relocations, (HB 10-1332), ch. 300, p. 1418, § 1, effective May […]

§ 25-37-107. Claim Adjudication Information – Balance Owing

Upon completion of processing of a claim, the person or entity shall provide information to the health-care provider stating how the claim was adjudicated and the responsibility for any outstanding balance of any party other than the person or entity. Source: L. 2010: Entire article amended with relocations, (HB 10-1332), ch. 300, p. 1423, § […]

§ 25-37-108. Assignment of Rights – Requirements

A person or entity shall not assign, allow access to, sell, rent, or give the person’s or entity’s rights to the health-care provider’s services pursuant to the person’s or entity’s contract unless the person or entity complies with the requirements of this section. A person or entity may assign, allow access to, sell, rent, or […]

§ 25-37-109. Waiver of Rights Prohibited

Except as permitted by this article, a person or entity shall not require, as a condition of contracting, that a health-care provider waive or forego any right or benefit to which the health-care provider may be entitled under state or federal law, rule, or regulation that provides legal protections to a person solely based on […]

§ 25-37-110. Provider Declining Service to New Patients – Notice – Definition

Upon sixty days’ notice, a health-care provider may decline to provide service pursuant to a contract to new patients covered by the person or entity. The notice shall state the reason or reasons for this action. As used in this section, “new patients” means those patients who have not received services from the health-care provider […]

§ 25-37-112. Disclosure to Third Parties – Confidentiality

A contract shall not preclude its use or disclosure to a third party for the purpose of enforcing the provisions of this article or enforcing other state or federal law. The third party shall be bound by the confidentiality requirements set forth in the contract or otherwise. Source: L. 2010: Entire article amended with relocations, […]

§ 25-37-113. Article Inapplicable – When

This article shall not apply to: An exclusive contract with a single medical group in a specific geographic area to provide or arrange for health-care services; however, this article shall apply to contracts for health-care services between the medical group and other medical groups; A contract or agreement for the employment of a health-care provider […]

§ 25-37-114. Enforcement

With respect to the enforcement of this article, including arbitration, there shall be available: Private rights of action at law and in equity; Equitable relief, including injunctive relief; Reasonable attorney fees when the health-care provider is the prevailing party in an action to enforce this article, except to the extent that the violation of this […]

§ 25-37-115. Providers Obligated to Comply With Law

No provision of this article shall be used to justify any act or omission by a health-care provider that is prohibited by any applicable professional code of ethics or state or federal law prohibiting discrimination against any person. Source: L. 2010: Entire article amended with relocations, (HB 10-1332), ch. 300, p. 1426, § 1, effective […]

§ 25-37-116. Copyrights Protected

Nothing in this article, including the designation of standards, code sets, rules, edits, or related specifications, divests copyright holders of their copyrights in any work referenced in this article. Source: L. 2010: Entire article amended with relocations, (HB 10-1332), ch. 300, p. 1426, § 1, effective May 26.