200. Health Insurance Benefits and Coverage

200.996 Ensuring compliance with Substance Use Disorders Essential Health Benefits Provision of the


CMS supports the Executive Branch in efforts to ensure that:

  • The Colorado Division of Insurance (DOI) is evaluating and proactively monitoring whether payers are providing the substance use disorder essential health benefits (EHB).
  • DOI is enforcing against payers that are not providing this EHB to patients.
  • That payer networks provide adequate access to treatment from an addiction and mental health specialist(s) for patients with substance use disorders in compliance with the EHB.

Review current policies in Medicaid and the criminal justice system to determine whether patients with substance use disorders are receiving necessary, evidence-based treatment.
(BOD action, March 10, 2017)


200.997 Consumer Comparative Data


(RES-62, AM 1996; Sunset, BOD-1, AM 2014)


200.998 Insurance Aspects of Comprehensive Pediatric Care


(RES-39, AM 1987; Sunset, BOD-1, AM 2014)


200.999 Reimbursement for Voluntary Home Treatment of Terminally Ill


(RES-15, AM 1980; Sunset, BOD-1, AM 2014)