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Second Regular Session
Seventy-fifth General Assembly
STATE OF COLORADO
INTRODUCED
LLS NO. 26-0559.01 Renee Leone x2695 HOUSE BILL 26-1122
House Committees Senate Committees
Health & Human Services
A BILL FOR AN ACT
CONCERNING MANDATORY HEALTH-CARE COVERAGE FOR HORMONE101
REPLACEMENT THERAPY FOR WOMEN.102
Bill Summary
(Note: This summary applies to this bill as introduced and does
not reflect any amendments that may be subsequently adopted. If this bill
passes third reading in the house of introduction, a bill summary that
applies to the reengrossed version of this bill will be available at
http://leg.colorado.gov.)
The bill requires all health benefit plans in the state and the
medicaid program to provide coverage for hormone replacement therapy,
as prescribed by licensed physicians, for women who are experiencing
menopause or perimenopause.
Coverage for hormone replacement therapy will be implemented
for all large employer health benefit plans issued or renewed in this state
HOUSE SPONSORSHIP
Keltie,
SENATE SPONSORSHIP
(None),
Shading denotes HOUSE amendment. Double underlining denotes SENATE amendment.
Capital letters or bold & italic numbers indicate new material to be added to existing law.
Dashes through the words or numbers indicate deletions from existing law.
on or after January 1, 2027. Coverage for hormone replacement therapy
will be implem ented for all individual and small group health benefit
plans issued or renewed in this state on or after January 1, 2028, as long
as the state is not required to defray the cost of the coverage of the
hormone replacement therapy.
The state medicaid program is required to provide hormone
replacement therapy beginning on July 1, 2027.
Be it enacted by the General Assembly of the State of Colorado:1
SECTION 1. In Colorado Revised Statutes, 10-16-104, add (31)2
as follows:3
10-16-104. Mandatory coverage provisions - applicability -4
rules - definitions.5
(31) Hormone replacement therapy - definition - rules.6
(a) A S USED IN THIS SUBSECTION (31), UNLESS THE CONTEXT7
OTHERWISE REQUIRES, "HORMONE REPLACEMENT THERAPY":8
(I) MEANS A MEDICAL TREATMENT THAT REPLACES A HORMONE9
THAT AN INDIVIDUAL 'S BODY IS NO LONGER MAKING OR NO LONGER10
MAKING ENOUGH OF , AS DETERMINED BY A PHYSICIAN LICENSED11
PURSUANT TO ARTICLE 240 OF TITLE 12; AND12
(II) MAY INCLUDE PRESCRIBING A CREAM, AN ORAL MEDICATION,13
A PELLET MEDICATION , A VAGINAL DEVICE , OR ANOTHER METHOD14
APPROVED BY THE FDA.15
(b) IN ACCORDANCE WITH SUBSECTION (31)(e) OF THIS SECTION,16
ALL HEALTH BENEFIT PLANS MUST PROVIDE COVERAGE FOR HORMONE17
REPLACEMENT THERAPY FOR A WOMAN WHO IS EXPERIENCING MENOPAUSE18
OR PERIMENOPAUSE AS A RESULT OF NATURAL AGING OR ANY OTHER19
CAUSE, TO BE ADMINISTERED IN THE METHOD , DOSE , AND FREQUENCY20
PRESCRIBED BY A PHYSICIAN LICENSED PURSUANT TO ARTICLE 240 OF21
TITLE 12.22
HB26-1122-2-
(c) A HEALTH BENEFIT PLAN MUST NOT:1
(I) D ENY OR LIMIT HORMONE REPLACEMENT THERAPY THAT IS2
PRESCRIBED IN ACCORDANCE WITH GENERALLY ACCEPTED STANDARDS OF3
CARE FOR THE PRESCRIPTION OF HORMONE REPLACEMENT THERAPY; OR4
(II) REQUIRE PRIOR AUTHORIZATION FOR HORMONE REPLACEMENT5
THERAPY.6
(d) T HE COMMISSIONER SHALL ADOPT RULES CONSISTENT WITH7
AND AS NECESSARY TO IMPLEMENT THIS SUBSECTION (31).8
(e) (I) ALL LARGE EMPLOYER HEALTH BENEFIT PLANS ISSUED OR9
RENEWED IN THIS STATE ON OR AFTER JANUARY 1, 2027, SHALL PROVIDE10
COVERAGE FOR HORMONE REPLACEMENT THERAPY PURSUANT TO THIS11
SUBSECTION (31).12
(II) E XCEPT AS PROVIDED IN SUBSECTION (31)(e)(III) OF THIS13
SECTION, AND TO THE EXTENT THAT SUCH COVERAGE IS NOT IN ADDITION14
TO BENEFITS PROVIDED PURSUANT TO THE STATE BENCHMARK PLAN15
REQUIRED PURSUANT TO 45 CFR 156.111, ALL INDIVIDUAL AND SMALL16
GROUP HEALTH BENEFIT PLANS ISSUED OR RENEWED IN THIS STATE ON OR17
AFTER JANUARY 1, 2028, SHALL PROVIDE COVERAGE FOR HORMONE18
REPLACEMENT THERAPY PURSUANT TO THIS SUBSECTION (31).19
(III) SUBSECTION (31)(e)(II) OF THIS SECTION IS INOPERATIVE, AND20
THE STATE SHALL NOT ASSUME AN OBLIGATION FOR THE COVERAGE21
REQUIRED PURSUANT TO SUBSECTION (31)(e)(II) OF THIS SECTION, IF:22
(A) THE DIVISION DETERMINES THAT THE COVERAGE SPECIFIED IN23
SUBSECTION (31)(e)(II) OF THIS SECTION REQUIRES STATE DEFRAYAL OF24
THE COST OF COVERAGE PURSUANT TO A PROVISION OF THE FEDERAL ACT,25
INCLUDING 42 U.S.C. SEC. 18031 (d)(3)(B) OR A SUCCESSOR PROVISION26
AND THE IMPLEMENTING REGULATIONS; OR27
HB26-1122-3-
(B) THE STATE IS OTHERWISE REQUIRED TO DEFRAY THE COST OF1
COVERAGE REQUIRED PURSUANT TO SUBSECTION (31)(e)(II) OF THIS2
SECTION.3
SECTION 2. In Colorado Revised Statutes, add 25.5-5-332.5 as4
follows:5
25.5-5-332.5. Hormone replacement therapy - federal6
authorization - definition.7
(1) S UBJECT TO FEDERAL AUTHORIZATION AND FEDERAL8
FINANCIAL PARTICIPATION, ON OR AFTER JULY 1, 2027, THE MEDICAL9
ASSISTANCE PROGRAM SHALL INCLUDE HORMONE REPLACEMENT THERAPY10
FOR A WOMAN WHO IS EXPERIENCING MENOPAUSE OR PERIMENOPAUSE AS11
A RESULT OF NATURAL AGING OR ANY OTHER CAUSE, TO BE ADMINISTERED12
IN THE METHOD , DOSE , AND FREQUENCY PRESCRIBED BY A PHYSICIAN13
LICENSED PURSUANT TO ARTICLE 240 OF TITLE 12.14
(2) AS USED IN THIS SECTION, UNLESS THE CONTEXT OTHERWISE15
REQUIRES, "HORMONE REPLACEMENT THERAPY " HAS THE MEANING SET16
FORTH IN SECTION 10-16-104 (31)(a).17
SECTION 3. Act subject to petition - effective date. This act18
takes effect at 12:01 a.m. on the day following the expiration of the19
ninety-day period after final adjournment of the general assembly (August20
12, 2026, if adjournment sine die is on May 13, 2026); except that, if a21
referendum petition is filed pursuant to section 1 (3) of article V of the22
state constitution against this act or an item, section, or part of this act23
within such period, then the act, item, section, or part will not take effect24
unless approved by the people at the general election to be held in25
November 2026 and, in such case, will take effect on the date of the26
official declaration of the vote thereon by the governor.27
HB26-1122-4-