New law takes effect January 2026, reducing red tape and improving access to care in Colorado.

Cecilia Comerford, CMS Communications and Marketing Manager

When a patient’s treatment plan gets stuck waiting for insurance approval, the consequences can be serious — missed medications, delayed surgeries, and even preventable hospitalizations. Colorado physicians have long called for change. Now, that change is here. 

Beginning Jan. 1, 2026, a new Colorado law — House Bill 24-1149 — will take effect, transforming how health insurers manage prior authorization, and it is critical that Colorado physicians and practices understand your rights under the law. The bipartisan measure, sponsored by Colorado Rep. Shannon Bird, [then Rep., now] Sen. Lisa Frizell, Sen. Barbara Kirkmeyer, and Sen. Dylan Roberts, was championed by the Colorado Medical Society (CMS) and its physician members. It is designed to make the process fairer, faster, and more transparent for patients and physicians alike. 

“This law is about restoring common sense and fairness to health care,” said Rep. Bird. “Too often, patients face unnecessary delays or denials for the care their doctor knows they need. By making the process more transparent and efficient, we’re making it easier for Coloradans to get timely, medically appropriate treatment.” 

The new statute modernizes prior authorization in several critical ways, improving both access and accountability 

Extends approval durations: Prior authorizations for medical services will now last one year or the full course of treatment. For chronic medications, approvals extend to three years (one year for high-cost drugs). 

Prevents harmful denials during surgery: If an approved surgical procedure requires an additional or related covered service during the operation, insurers cannot deny coverage for that procedure when a delay would risk the patient’s health. 

Requires transparency: Health plans must post all prior authorization requirements, clinical criteria, and outcome data — including the number of requests, approvals, and denials — on a public-facing, searchable website. 

Creates exemptions for trusted providers: Insurers must establish alternative programs that reduce or eliminate prior authorization for physicians who consistently provide high-quality, evidence-based care. 

Streamlines electronic submissions: Carriers must comply with federal electronic standards for prior authorization requests and, by 2027, develop APIs that integrate with electronic health records so physicians can check requirements and submit requests directly. 

“Physicians see firsthand the stress and harm caused when care is delayed by red tape,” said Brigitta Robinson, MD, FACS, President of the Colorado Medical Society. “This law will allow patients start treatment sooner, continue medications without disruption, and spend less time waiting for insurance approval. It’s a win for both patients and providers.” 

Impact on surgical care  

Under the new law, surgeons gain a crucial safeguard: when a medically necessary related procedure is discovered during an approved surgery, insurers can no longer deny coverage because the additional service wasn’t separately pre-approved. This protection ensures that care decisions remain in the hands of physicians and allows them to act in the patient’s best interest — especially in cases where a delay could lead to harm. Practices should ensure documentation of intraoperative findings and timely post-procedure notification to carriers. 

Impact on medical and prescription care 

For physicians managing chronic illness and complex treatment plans, the law brings long-overdue relief. Longer approval durations mean less time spent resubmitting identical requests. Carriers must also review their prior authorization lists annually and remove requirements that fail to improve quality, equity, or cost savings. For patients managing long-term conditions, the change is significant. Prior authorizations for chronic medications will now be valid for three years, providing stability and reducing treatment interruptions — a change that directly addresses widespread patient frustration and harm. 

Greater accountability
and equity 

The legislation also tackles inequities in access to care. Studies have shown that prior authorization delays disproportionately affect historically marginalized communities, including patients of color and those with disabilities or lower incomes. By mandating public reporting and requiring insurers to justify and remove unnecessary barriers, HB24-1149 aims to create a more transparent and equitable health system. 

What practices should do now  

While the law takes effect in January 2026, practices can begin preparing by reviewing internal workflows to track one-year and three-year approval periods, identifying chronic medications most affected by the new timelines, confirming electronic health record systems can support automated prior authorization once APIs become available, and watching for carrier communications on provider exemption programs to ensure eligibility documentation is accurate. CMS will provide additional guidance, templates, and educational materials to help physicians and administrators implement these changes smoothly.

For years, prior authorization has symbolized one of the most frustrating administrative burdens in health care. Colorado’s reform represents a meaningful step toward a better balance — maintaining accountability in coverage decisions while prioritizing patients’ access to timely, medically necessary care. 

“I’m proud to support this law because it puts patients first,” said Sen. Kirkmeyer. “By streamlining the approval process and reducing unnecessary hurdles, we are ensuring that Coloradans receive the care their doctors recommend – without delay or confusion.” 

The law takes effect Jan. 1, 2026.