Reimbursement Rate: The Colorado Department of Health Care Policy and Financing will reimburse acute care hospitals and ambulatory surgery facilities 75% of the cost for acquiring a vagus nerve stimulator device.
Additional Surgical Reimbursement: This reimbursement is in addition to and does not replace payments for the surgical procedure required to implant the device.
Eligibility: The reimbursement applies to facilities providing vagus nerve stimulation therapy to patients diagnosed with drug-resistant epilepsy.
This legislation aims to enhance access to vagus nerve stimulation therapy for patients whose epilepsy does not respond to medication.
Summary
Beginning July 1, 2025, the bill requires the department of health
care policy and financing to reimburse acute care hospitals and ambulatory surgery facilities that provide vagus nerve stimulation therapy to members diagnosed with drug-resistant epilepsy at a rate that is equal to 75% of the cost for acquiring the vagus nerve stimulator device, which reimbursement is in addition to and does not supplant the reimbursement for any necessary surgical procedure associated with implanting the device.
