Colorado ~ Last month, Colorado reached a significant milestone in its efforts to increase transparency in healthcare pricing. Following the passage of SB24-080 in 2024, the state became the first in the country to successfully collect state-specific federal Transparency in Coverage data.

Governor Jared Polis emphasized the importance of this achievement, stating that access to pricing information is crucial for consumers to make informed decisions and can also drive competition and lower prices. The federal Transparency in Coverage standards were implemented in 2022, requiring health insurance carriers to disclose negotiated rates for all healthcare services and items, including prescription drugs, on their websites. However, due to lack of standardization and de-duplication requirements, the data was difficult for consumers to navigate.

In response, Colorado passed SB24-080 which strengthens the federal rules and improves data collection in three key ways. Firstly, it requires carriers to provide Colorado-specific information. This will result in cleaner and more relevant data for consumers. Secondly, it mandates that carriers limit the files based on actual codes used by providers to remove any "ghost codes" - medical billing codes for services or procedures that were likely never performed. And finally, it requires carriers to disclose pricing information for the most commonly used prescription drugs on their plans.

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Colorado Insurance Commissioner Michael Conway praised this development as a significant step towards demystifying healthcare pricing for consumers. He also highlighted how this law will improve data quality and allow for better understanding of healthcare trends and barriers to lower prices by the Division of Insurance as well as researchers and academics.

With the first round of transparency data now collected by Colorado's Division of Insurance, it will be compiled and made available on their Transparency in Coverage webpage by early next year. Additionally, researchers interested in using this data for academic purposes can email dora_ins_data@state.co.us for more information.

This achievement solidifies Colorado's position as a trailblazer in improving consumer protections in healthcare. By prioritizing transparency in coverage, the state is taking a crucial step towards empowering consumers and promoting fair competition in the healthcare industry.

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