CO laws let physicians contest health plan rating systems, establish system reforms

The state of Colorado has enacted new rules which will allow doctors to review and challenge health plan rating systems, a move that comes as part of a larger package of state healthcare reforms. The bill, signed earlier this month by Gov. Bill Ritter (D), also includes provisions allowing patients to have standardized health plan IDs and giving insurance companies the ability to develop new types of plans that the state may help consumers purchase. In addition to giving doctors the ability to review and question health insurance ratings of their performance, the new bills require health plans to disclose their systems for profiling or rating doctors. These rules arose partly out of discussions held between insurers and physicians in 2006 when UnitedHealth Group and PacifiCare Health merged. However, they were also influenced by health plan rating reforms pushed through by New York Attorney General Andrew Cuomo.

The new health plans authorized by the state are intended to expand access to care for the state's approximately 800,000 insureds. They allow for the development of "Centennial Care Choices," a program under which private health plans could provide basic coverage to the uninsured at a target premium of about $200 per month for individuals. This, of course, resembles plans already in existence in Massachusetts, where reforms have been in place for about one year.

To learn more about health system changes in Colorado:
- read this AMNews article

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