The Colorado Medical Society is proud to deliver exclusive news to the inbox of CMS members, practice managers and strategic partners. Update your subscription preferences by contacting [email protected] |
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CMS is taking action to help practices recover lost revenue from MultiPlan |
The Colorado Medical Society has joined a national lawsuit alleging that MultiPlan enabled insurers to systematically depress out-of-network payments. This multilateral price-fixing scheme has directly affected practice revenue and, for has forced many medical practices to shut their doors, cease offering certain services, or seek other employment arrangements, leaving patients with fewer and fewer medical practice options.
CMS is working to help practices pursue the money you may be owed. We are negotiating favorable legal-representation terms so practices can seek damages and compensation from MultiPlan and major insurers, including UnitedHealthcare, Cigna, Aetna, Anthem and BlueCross BlueShield. Holding MultiPlan accountable is essential to recovering lost revenue, stopping ongoing underpayments, protecting practices from future reimbursement abuses, and promoting regulatory action. More information will be available soon on how to determine whether your practice was affected and how to connect with legal support. |
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CMS wants to partner with your practice on new campaign to rebuild trust |
The Colorado Medical Society wants to work with you to rebuild trust between the public and physicians. This fall, CMS launched Your Care is at our Core – a communications and advocacy strategy in partnership with the American Medical Association. By sharing stories of great patient care, we aim to strengthen the bond between patients and their physicians – the foundation of health care – and illustrate the importance of a strong physician/patient connection.
There are two immediate opportunities: |
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Provide your practice logo for CMS to co-brand our Your Care is at our Core marketing materials, like the image shown above with CMS/Northern Colorado Medical Society branding.
- Let us know if a physician from your practice, or one of your practice's patients, is willing to share a story of great patient care by written or video testimonial. These will be used in CMS publications.
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Prior authorization reform takes effect January 2026: What practices need to know |
Beginning Jan. 1, 2026, Colorado’s prior authorization reform law — HB24-1149 — takes effect. This new law, achieved through dedicated Colorado Medical Society advocacy, streamlines approvals, improves transparency, and reduces administrative burdens that delay patient care. Key changes include: |
- Prior authorization approvals will be extended to one year (three years for most chronic medications).
- Health plans must post all prior authorization requirements and outcomes data publicly.
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Exemption programs will reduce or remove prior authorization for high-performing providers.
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We will share more information in the coming weeks so your practice knows your legal rights. |
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CMS helping you navigate effects of the federal legislation on Colorado health care |
The federal HR-1 legislation – alongside the ACA Marketplace Integrity Rule passed earlier this year – is reshaping health care across the country. For Colorado physicians and practices, these sweeping federal changes are already rippling through our state budget, coverage systems, and clinical practice environment. The effects will build over the next several years, and CMS has recommendations on actions practices can take now to be ready to adapt and engage.
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CMS taking action for you on inappropriate downcoding: Resources coming soon |
The Colorado Medical Society, American Medical Association and other state medical societies across the country are raising concerns about insurer policies that automatically downcode higher-level E/M claims without reviewing medical records. Physicians increasingly report issues with Aetna, Cigna and other insurers using automated tools to downcode claims without clear justification. These policies reduce payment, threaten practice sustainability, and disproportionately affect physicians caring for patients with complex needs. Appeals can cost practices $40–$75 per claim, adding significant administrative burden.
The AMA has warned that policies like Cigna’s E/M “coding accuracy” review conflict with CPT guidelines, rely improperly on claim data rather than medical records, and lack transparency around how downcoding decisions are made. Such approaches discourage appropriate billing and increase friction between physicians and payers.
CMS demands insurers halt inappropriate downcoding and promote more transparent, targeted, and education-based approaches. We are developing resources for practices experiencing inappropriate downcoding. If you are seeing patterns of downcoding in your practice, respond to this email or reach out to [email protected] to share your experience. |
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CMS joins national call for Anthem to withdraw new “nonparticipating provider” policy |
The Colorado Medical Society has signed onto a national physician coalition letter urging Anthem Blue Cross and Blue Shield to rescind a newly announced policy that would penalize hospitals for using out-of-network physicians. The policy is slated for rollout in 11 states—including Colorado—beginning Jan. 1, 2026. Under Anthem’s plan, hospitals would face a 10% reimbursement cut—and potentially even removal from Anthem’s network—if they use nonparticipating physicians. CMS joins other physician organizations warning that this approach sidesteps the No Surprises Act, disrupts long-standing contracting norms, and could increase pressure on or lead to the closure of independent physicians.
The letter, spearheaded by the American Medical Association (AMA), highlights significant concerns for independent practices that depend on hospital access to care for their patients. Rather than strengthening networks through fair contracting and administrative improvements, the policy could instead force practices into unfavorable contracts or limit which physicians hospitals can use—ultimately risking delays in care, higher costs, and reduced access, especially in rural communities. CMS joined this letter because safeguarding independent practices and ensuring stability across all practice models remains a core priority. We will continue monitoring Anthem’s actions closely and keep members and their practices informed of developments. |
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Exclusive benefit for your practice: Start a small group long-term care + life insurance plan |
Seventy percent of individuals 65 and older will need long-term care. The best time to prepare financially for your own long-term care is now. Why? Because your health insurance does not cover long-term care nor does Medicare.
The Colorado Medical Society, in partnership with Copic Financial and BuddyIns is pleased to present an offer to individuals and group practices: long-term care with a life insurance benefit. If you are an employer, this benefit is one to add to a great package to increase employee recruitment and retention. Contact Copic Financial's Jeff Feakes at [email protected] or 720-858-6285 for more information on setting up a small group.
Enrollment is available on a rolling monthly basis. Purchase coverage during an enrollment period with guaranteed approval and affordable premiums. This is a policy that you can keep for the rest of your life and use anywhere in the U.S.
Read more about the offering in this article: "Consider the future: Why you need to start your long-term care plan." |
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Thank you for returning your 2026 dues invoice! |
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Dues invoices for Colorado Medical Society members for practices that have opted into group billing have been sent by email, and staff is following up by phone. All invoices are due Dec. 31, 2025 for the membership period ending Dec. 31, 2026. Pay early to ensure your physicians have no disruption in benefits through the end of 2025 -- especially if you are Copic insured and benefit from the significant discount in medical liability insurance!
If you have updates to your contact information or billing contact, please contact our membership department at 720-859-1001 or [email protected]. It is strict CMS policy that your personal information is never sold or shared.
Our Member Engagement team seeks to visit practices to connect with you. If you're open to a CMS staff person stopping by to say hello and drop off swag and treats, please respond to this email, reach out to [email protected] or call (720) 859-1001.
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Mary Jo Heins is a former medical practice manager. As an independent Medicare insurance agent, she now helps people with all facets of Medicare – objectively and fee free. |
- Enrollment in Medicare Parts A & B
- Supplement v Medicare Advantage
- Rx plans – mapping medication regiments to the best formulary
- Dental/Vision plans
- Patient education sessions at your practice
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Medicare Insurance Help – Be Medicare CONFIDENT |
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CMS Community Marketplace |
Volunteer physicians needed to care for Colorado’s uninsured Corvida Health Clinic (formerly Clinica Colorado) in Adams County is seeking volunteer physicians to help provide primary care to uninsured and underserved patients, many of whom are Spanish-speaking. The clinic offers flexible onboarding and scheduling to make volunteering accessible for active and retired physicians alike. Retired physicians may also qualify for Copic’s volunteer liability coverage.
If you’re interested in giving back to your community, Corvida Health Clinic—and other safety-net clinics through the Colorado Safety Net Collaborative—would welcome your support. Contact Vanessa Vergara, FNP-BC, Corvida Health Clinic medical director at 720-443-8461 or [email protected]. Visit their website to learn more about their work at www.clinicacolorado.org.
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Do you have a position open at your practice? Space to sub-let? Selling your practice? Place a marketplace classified ad with CMS! Members receive the first month free. Contact [email protected] for more information! |
Is your practice on social media? Follow us or reply to this email with your handles so we can follow you back, share content and tag you in posts to promote your practice! |
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