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Colorado Becomes First State to Limit Price of a Specific Drug
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Colorado Politics, Approved, State

Colorado Becomes First State to Limit Price of a Specific Drug

By Marissa Ventrelli | Colorado Politics Colorado became the first state in the nation to set a price cap on a specific medication last week, following a unanimous decision by the Prescription Drug Affordability Review Board to limit the cost of a drug used to treat inflammatory conditions. On Oct. 3, the board voted to set an Upper Payment Limit, or UPL, of $600 per 50mg unit of Enbrel, an injectable medication used to treat conditions like rheumatoid arthritis, ankylosing spondylitis, and plaque psoriasis. That comes out to about $30,000 a year, more than $20,000 less than the average insurance plan paid for the drug per person in 2023, according to the Colorado Consumer Health Initiative. “This decision is a victory for hardworking Colorado families who have been stretched thin...
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Feds launch investigation into Colorado’s healthcare spending on illegal immigrants
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DENVER7, Approved, State

Feds launch investigation into Colorado’s healthcare spending on illegal immigrants

By Brandon Richard | Denver7 Denver7 took a closer look at the investigations, which critics call politically-charged and baseless. DENVER — The Trump administration and now Congress have launched investigations into Colorado’s spending on health care for undocumented immigrants. Earlier this year, the Centers for Medicare and Medicaid Services (CMS) announced that it was increasing oversight of states that misuse federal Medicaid funds to provide healthcare coverage to undocumented immigrants. “Medicaid is not, and cannot be, a backdoor pathway to subsidize open borders,” said CMS Administrator Dr. Mehmet Oz. “States have a duty to uphold the law and protect taxpayer funds. We are putting them on notice — CMS will not allow federal dollars to be diverted to cove...
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Polis Orders $252 Million in Cuts After Years of Overspending Strain State Finances
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State, Approved, The Gazette

Polis Orders $252 Million in Cuts After Years of Overspending Strain State Finances

By Marianne Goodland | The Gazette Lawmakers balk at some cuts, particularly reductions to health care provider rates. Gov. Jared Polis on Thursday signed an executive order, initiating the process to cut $252.5 million in cash and general funds from this year's budget, with the most significant impact on the Department of Health Care Policy and Financing, which administers Medicaid. Polis also signed into law a measure from the recently concluded special session that requires him to meet with the Joint Budget Committee to review the spending reduction plan.  That meeting was often tense, with the legislators who craft the state budget indicating they aren't going along with some of his cuts, particularly for Medicaid providers. Policymakers said the actions taken durin...
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Holistic health practitioners fight back against HB25-1220’s threat to medical freedom
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Approved, Rocky Mountain Voice, State, Top Stories

Holistic health practitioners fight back against HB25-1220’s threat to medical freedom

By Tori Ganahl, Rocky Mountain Voice A new bill moving through the Colorado General Assembly, HB25-1220, is drawing sharp criticism from holistic health practitioners and nutritionists, who argue it amounts to government overreach that could criminalize alternative health practices and limit consumer choice. Proponents say the bill is necessary to protect public health by ensuring only qualified professionals provide medical nutrition therapy (MNT). The legislation would create the State Board of Dietetics and Nutrition, with the authority to license, regulate, and discipline professionals practicing medical nutrition therapy. Under the bill, individuals offering nutrition services must obtain a state license by September 1, 2026, or face penalties, including a class two misdemean...
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Legislative health-care debates commence in the 75th General Assembly
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Approved, State, The Sum & Substance

Legislative health-care debates commence in the 75th General Assembly

By Ed Sealover | The Sum & Substance Several health-care bills — including two scheduled for their first hearings this week — are set to reignite the debate this legislative session on whether the benefits of greater coverage mandates are equal to the greater costs they’ll bring. And it won’t be just insurance issues that will occupy legislators’ discussions on health care this year. Regulation of a federal drug-pricing program, Medicaid-generated budget problems and the fate of the state’s largest workers’ compensation insurer all are on the table, causing legislators to have to think deeply about why health-care spending is rising and what impacts they can have on businesses and consumers. On Wednesday, a House committee will discuss a bill that seeks to require health benef...
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Front Range hospitals grow while Colorado’s rural hospitals, Denver Health struggle financially
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Approved, CBS Colorado, State

Front Range hospitals grow while Colorado’s rural hospitals, Denver Health struggle financially

By Christa Swanson | CBS Colorado On Sunday, the Department of Health Care Policy and Financing (HCPF) released a report on the financial health of Colorado's hospitals. While some are showing financial strength, others appear to be struggling. The department's annual report measures hospital profits, reserves, costs, expenses and the level of community benefit that tax-exempt hospitals offer their communities in place of paying taxes. "These reports provide valuable insights for Coloradans into where their money is going within health care. Hospital revenue growth represents a rapidly increasing part of the overall health care dollar," HCPF Executive Director Kim Bimestefer said. "The billion-dollar annual increase shown in this report is reflected in the insurance prem...
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UnitedHealthcare covers double mastectomies for 17-year-olds with gender dysphoria
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Approved, National, The Daily Signal

UnitedHealthcare covers double mastectomies for 17-year-olds with gender dysphoria

By Elizabeth Troutman Mitchell  | The Daily Signal America’s largest health insurance company covers double mastectomies for some 17-year-old girls who identify as transgender. UnitedHealthcare’s “Gender Dysphoria Treatment” guide, which took effect Dec. 1, says: “For mastectomy or breast reduction, individuals must be at least 18 years of age; however, individuals within one calendar year of turning 18 can be considered on a case-by-case basis.” UnitedHealthcare didn’t immediately respond to The Daily Signal’s request for comment on the circumstances in which the health insurance company would cover double mastectomies for minors or how often it makes exceptions. READ THE FULL STORY AT THE DAILY SIGNAL
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Denver considers $1M contract with Denver Health for homeless response
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Approved, coloradopolitics.com, Local

Denver considers $1M contract with Denver Health for homeless response

By Noah Festenstein | Colorado Politics, via Denver Gazette The Denver City Council on Monday will consider a $1 million contract to better utilize the city’s hospital system for homeless response efforts. If approved on second reading Monday, Denver Health will receive $990,900 from the city to become more involved with homeless response efforts and Roads to Recovery until at least Sept. 30, 2026. The money is planned to “support and strengthen existing internal infrastructure focused on partnerships with Denver homelessness resolution partners and the Roads to Recovery project to better align housing and health supports for some of the most at-risk persons experiencing homelessness,” city officials said in the council’s resolution request. READ THE FULL STORY AT COLORADO POLI...
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Health insurance prices for some in Colorado will go up next year, an average of 5.6%
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Approved, State, The Colorado Sun

Health insurance prices for some in Colorado will go up next year, an average of 5.6%

By John Ingold | The Colorado Sun Health insurance prices in Colorado are set to climb again next year on the whole, but by a below-average amount, according to final, approved rates released Thursday. But, as is often the case in health insurance, that doesn’t necessarily mean your insurance prices are going to go up for 2025. In fact, Thursday’s rates apply only to a subset of people who have private insurance coverage. READ THE FULL STORY AT THE COLORADO SUN
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Report on hospital facility fees could stir new health-care regulatory efforts
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Approved, State, The Sum & Substance

Report on hospital facility fees could stir new health-care regulatory efforts

By Ed Sealover | The Sum & Substance A legislatively mandated report on hospital-system facility fees that was released Tuesday appears likely to spark a new round of debate on whether the state should limit the fees that opponents call costly and unclear and that hospitals say are vital to offsite operations. The Hospital Facility Fee Report concluded that the fees, added for services in nonacute-care settings, drive up health-care costs by more than $50 million annually, are opaque and confusing and incentivize independent physicians to affiliate with larger hospital systems. However, the report also notes that a reduction in fee revenue could drastically cut the federal matching money that’s been used to expand Medicaid eligibility, and it noted several times that the task for...
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