In a recent announcement by Governor Jared Polis, Colorado has solidified its place as a forerunner in health care price transparency, outpacing the rest of the nation by gathering extensive pricing information from insurance carriers. The move follows the passage of SB24-080 last year, a piece of legislation that builds upon the federal Transparency in Coverage mandate established back in 2022. "Being able to easily find out pricing is an important part of giving consumers the information we need to make the best choices, and puts downward pressure on prices by boosting competition," Polis stated, according to the Colorado Governor's Office.
While the initial federal rule was notable for requiring health insurance carriers to post price rates and machine-readable files on their websites, the complexity and lack of standardization made the information less accessible to consumers. Colorado has aimed to rectify this by not only requiring state-specific information but also demanding cleaner datasets. "This law gives consumers, employers and advocates the data needed to better understand pricing for drugs and services, and negotiate better prices for Coloradans," Polis explained, as per the Colorado Governor's Office.
Colorado's strategy focuses on removing so-called "ghost codes," medical billing codes for unlikely or unperformed services, and limiting files to codes that providers actively utilize. Additionally, the state requires carriers to provide information on the most frequently used prescription drugs. Colorado Insurance Commissioner Michael Conway lauded this step, saying, "Colorado’s law will dramatically improve data quality and allow the Division of Insurance, as well as academics and researchers, to better understand health care trends, and barriers to lower prices," as obtained by the Colorado Governor's Office.
