Regulatory Compliance

CorVel is a national provider of industry-leading workers’ compensation solutions to Colorado payors. Connecting patients with appropriate, quality care is the cornerstone of our risk management solution. We are the only claims administrator to offer proprietary, in-house Advocacy 24/7, using our integrated risk management system to offer first aid treatment, referral to telehealth or medical provider as appropriate.

Our comprehensive return to work program ensures collaboration and communication with all interested parties including the injured worker, employer, human resources, medical and safety teams, and healthcare providers.  We use technology, compassionate case management for employees and cost containment measures, to give Colorado employers a superior program.

Colorado Regulatory Updates 07/28/2025

EFFECTIVE DATE 01/01/2028

Summary:  The Colorado legislature enacted House Bill 1300, which addresses significant reforms to Colorado’s workers’ compensation system, focusing on improving medical
care and benefits for injured workers. The legislative declaration of the bill recognizes that workers are the backbone of Colorado and asserts that the state has a “workers’ compensation system weighted heavily against injured workers and in favor of insurance companies.” Key provisions of the bill include allowing employees to designate their own treating physician from a list of accredited physicians, requiring employers and insurers to use the state’s utilization standards when reviewing medical authorization requests, and providing more flexibility for workers to change physicians. The bill also increases the timeframe for changing physicians from 90 to 120 days and mandates that employers quickly notify injured workers of their right to choose a treating physician. Additionally, the bill aims to hold third-party administrators to the same standards as insurers and requires more transparent reporting about physician changes. The legislative declaration emphasizes that the workers’ compensation system has become increasingly difficult for injured workers to navigate since 1991 amendments, and this bill seeks to restore the original intent of providing quick and efficient medical benefits.

Provisions for Emergency Situations

Colorado House Bill 1300 replaces rules on limited provider availability with new provisions for emergency situations. Injured workers may receive care from any provider during an emergency. Once the emergency ends, the standard physician selection rules apply. Employers or insurers must notify the employee in writing of their right to choose a treating physician and how to access the list of accredited providers within seven days of learning the emergency care has ended.

Repeals Regarding Provider Lists
Colorado House Bill 1300 repeals provisions that allowed employers to limit physician options in areas with few providers. It removes the ability to offer shortened provider lists, eliminates disclosure rules on provider ownership, and ends expedited hearings on list compliance. The bill also repeals exceptions that let certain employers assign in-house providers as treating physicians.

Expands Worker’s Right to Change Physicians
Colorado House Bill 1300 gives injured employees more time—120 days after the first physician is designated—to request a one-time change of treating physician, as long as it is before reaching maximum medical improvement. It also removes the requirement to choose from the employer’s provider list, allowing selection of any Level I or II accredited physician licensed in Colorado. Employees must still submit a written request using a form from the Director, and medical records must be transferred promptly. If the new physician declines to treat, the employee can choose another qualified provider.
The bill stipulates that if the newly selected physician declines treatment, the employee may request an alternative physician who meets the same accreditation and licensure criteria. The bill also allows injured workers to continue seeing their treating physician if that doctor relocates to a different facility, with medical records to be transferred within seven days upon request.
The bill updates the process for requesting treatment by a personal physician or chiropractor beyond the one-time change. Employees must still submit a written request on a Director-approved form, and employers or insurers have 20 days to object. If they do not respond, it is considered a waiver. The bill also updates language, improves reporting procedures, and confirms that employees can seek the division’s approval for alternative care providers, including nonmedical treatments that are legally recognized.

 

Colorado Medical Fee Schedule update 01/01/2025

Effective January 1, 2025, Colorado has updated its Medical Fee Schedule to review and establish maximum fees for healthcare services. The rule also defines standard terminology, administrative procedures, and dispute resolution procedures required to implement the Division’s Medical Treatment Guidelines and Medical Fee Schedule.

Link: Fee Schedule (Rule 18) | Department of Labor & Employment

Colorado Regulatory Updates 07/11/2024

HB 1220 – Workers’ Compensation Disability Benefits

Summary:

This measure makes several changes to workers’ compensation benefits and procedures.

This measure allows a claimant for workers’ compensation benefits to refuse an offer of modified employment if employment requires the claimant to drive to and from work and the treating physician has restricted driving.

This measure adds the loss of an ear to the list of body parts for which an injured worker can receive whole person permanent impairment benefits.

This measure changes the limit for the amount of money that a claimant for workers’ compensation benefits may depend on the claimant’s impairment rating from $75,000 to $185,000, adjusted annually beginning July 1, 2025. This applies to injuries sustained on and after January 1, 2025.

This measure requires a workers’ compensation insurer to pay benefits to a claimant via direct deposit, if requested.

This measure takes effect 91 days after adjournment generally, unless specified otherwise.

Most Recent Update:

• 06/04/2024 – Signed by Governor Jared Polis (D)

 

 

Colorado Services

• Workers’ compensation claims management
• Medical bill review in compliance with state requirements
• Full visibility of pharmacy data to manage costs
• Local PPO network development and management
• Case management services

 

Colorado Resources

Colorado Worker’s Compensation Website

Colorado Government Website