CMS Virtual Grand Rounds webinar: CMS decodes the Colorado Option for physicians
(1 hr 1 min)

VIDEO: Colorado Option Update for physicians with Mark Johnson, MD, MPH


Watch a two-minute video outlining the latest on what physicians need to know before signing a contract if you choose to participate in a Colorado Option network. If you have concerns about a conversation you have had with a health plan, please contact Amy Goodman, CMS senior director of policy, at amy_goodman@cms.org. We will catalogue all member experiences for use in advocacy on your behalf.


April 2022 update; reminders for physicians:

  • You can negotiate contracts for carriers' Colorado Option standardized plans in the same way you would negotiate other contracts with insurers. 
  • You are under no obligation to discount your rates for Colorado Option plans—the law’s rate reduction requirements are for premium rates patients pay for their plans, not providers’ reimbursement rates. 
  • These plans still have to meet network adequacy standards, and there are additional requirements for their networks. 
  • The Division of Insurance cannot “require” a physician to participate in a Colorado Option plan or accept a specific reimbursement rate unless the plan proves in a public hearing that the physician is needed for the plan to meet network adequacy requirements or premium rate reduction targets. Even then the Insurance Commissioner does not have the authority to force participation. CMS successfully removed license-related punishments for physicians from the bill. 
  • Because one of the Colorado Option’s goals is to ensure networks are culturally responsive, physicians who choose to participate in a Colorado Option standardized plan will have to report annually on anti-bias, cultural competency, or similar training they and their front office staff have taken in the last year. There is no requirement to complete any specific training. Watch for information from CMS. 

Representatives from the Colorado Medical Society attended all stakeholder meetings hosted by the Division of Insurance (recordings available on the DOI website) to help inform the framework for the Colorado Option standardized plan.

Rest assured that CMS is keeping physicians at the table, protecting hard-fought amendments. We will continue to attend these meetings on your behalf, and stand up for you as the Colorado Option is implemented.

Important dates

Get involved

Want to get more involved in CMS's advocacy on the Colorado Option? Email amy_goodman@cms.org.


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