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 Lunch & Learn webinar, Thursday, Jan. 15, 12-1 p.m. |
Prior authorization changes for 2026: What’s new and improved for your practice |
State laws governing prior authorization will change beginning in 2026, bringing new reforms to support patients and physician practices. This CME Lunch and Learn webinar will feature attorney John Conklin, who will lead you through a session to: |
- Understand upcoming state law changes related to prior authorization and key requirements taking effect in 2026.
- Identify how these changes will impact clinical, administrative, and financial operations within your practice
- Learn practical steps to take when insurers are not complying with or cooperating with the law
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This virtual event will be held Thursday, Jan. 15, 12-1 p.m. It is ideal for physicians, practice administrators, and billing or compliance staff who want to be prepared for the 2026 implementation. It will be recorded, so even if you can't make it at the time, we encourage you to register to receive the recording. |
ACCME Accreditation Statement: The Colorado Medical Society is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
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AMA Credit Designation Statement: The Colorado Medical Society designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. |
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Right code, right care: Stop health plan downcoding, protect complex care for patients |
As you may be aware, several health plans have implemented automatic downcoding programs that reduce physician reimbursement for services without prior review of medical records. Health plan automatic downcoding represents a clear violation of Colorado Division of Insurance Regulation 4-2-17 and a fundamental breach of the physician-payer relationship. These practices threaten physician practice viability, undermine patient access to care, and establish a "guilty until proven innocent" approach to claims adjudication that violates basic due process principles.
Colorado Medical Society has a duty to its members and to patients to vigorously oppose these illegal practices through all available means. As a first step, CMS has formally notified the Colorado Division of Insurance and sent letters to the health plans (Aetna, Anthem, Cigna and UnitedHealthcare) engaging in automatic downcoding.
As this issue continues to develop, CMS has and will post updates, resources, and next steps on the Colorado Medical Society members-only resource page. Login is required; username is the CMS member's email address or CMS member number. Password can be reset here. If you are a practice manager and need a login separate from your CMS-member physician, contact us at [email protected].
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Your legal rights cataloged in AMA National Managed Care Legal Database |
The American Medical Association and Colorado Medical Society have long advocated for physicians' rights with health plans, ensuring an appropriate balance between those who provide care and those who pay for it.
The AMA maintains a critical resource of state and federal statutes and regulations won over the years in the National Managed Care Legal Database, and recently has opened it to the public, now making it accessible without a login. This resource catalogs how statutes and regulations address issues that may occur between private payers and physicians, such as prior authorization, credentialing, network adequacy, out-of-network payment and contract termination, that can help you when interacting with insurers. The database also contains relevant AMA policy and a state laws map, categorizing 1,300 state and federal statutes and regulations under 52 topics in a way that is intended to help you navigate your rights with payers on a broad range of issues.
The Colorado Medical Society is also here to help you know your legal rights. Reach out to [email protected] if you have a pain point to share. |
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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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Thank you for returning your 2026 dues invoice! |
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Thank you for your partnership to renew membership for your practice's physicians for 2026—we truly appreciate your continued commitment to Colorado’s physician community. Your support strengthens our collective voice for advocacy, education, and connection. As we look ahead to an exciting and impactful year in 2026, we invite you to reach out to CMS anytime with your concern or to add a physician to your group bill. Together, we’re building a vibrant, engaged medical community ready to meet the challenges and opportunities of the year ahead. |
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CMS Community Marketplace |
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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