Prior Authorization in Colorado
Colorado enacted HB 1370 (2022) establishing comprehensive PA reform. The law requires PA decisions within 7 calendar days for standard requests and 24 hours for urgent requests. Colorado also mandates step therapy override rights and continuity of care protections when patients switch plans.
Key Facts About PA in Colorado
- ✓ Standard PA decisions required within 7 calendar days; urgent within 24 hours
- ✓ Step therapy override rights codified in state law
- ✓ Continuity of care protections for patients switching health plans
- ✓ Colorado Division of Insurance provides external review for adverse determinations
Quick Stats
- Typical Appeal Filing Window: 30 days
- External Review Available: Yes
- Major Payers: 4
Top Payers in Colorado
RxCheckUp generates payer-specific Letters of Medical Necessity for each of these Colorado carriers:
Anthem BCBS ColoradoKaiser PermanenteUnitedHealthcareCigna