Major Colorado Changes Regarding ATP Selection Coming in 2028

On June 4, 2025, Governor Jared Polis signed House Bill 25-1300 “Workers’ Compensation Benefits Proof of Entitlement” into law. Workers’ compensation stakeholders should become familiar with this law, as it (1) dramatically changes the method of selecting an authorized treating physician; (2) changes the method of changing an authorized treating physician (“ATP”); and (3) clarifies the consequences of not using the Medical Treatment Guidelines.

Selecting an ATP

The law’s most significant change is to the provisions on the process of initially selecting an ATP contained in C.R.S. § 8-43-404(5)(a)(I). Currently, employers must provide an injured worker with a Designated Provider List within seven business days of having notice of a work injury. The required number of providers on the list varies based on the employer’s place of business. The injured worker then selects a physician from this Designated Provider List, who then serves as the ATP.

The new law eliminates the Designated Provider List process and replaces it with different procedures, depending on whether the injured worker is a Colorado resident.

If the injured worker is a Colorado resident: Within seven days of receiving notice of a work injury, an employer or insurer must notify the injured worker of their right to designate an ATP and where to find the directory of Level I and II accredited physicians. The injured worker is then free to designate any Level I or II accredited physician as their ATP, within prescribed distance limitations. This designation must occur on a specific Division form. Failure of the injured worker to designate an ATP within seven days of receiving notice of their right to designate and the location of the accredited provider directory permits the employer or insurer to designate a Level I or II accredited physician. However, an injured worker may still subsequently designate an ATP.

If the injured worker is not a Colorado resident: Within ten days of receiving notice of a work injury, an employer or insurer must select an ATP within 100 miles of the employee’s home address and notify the injured worker in writing. Failure to do so empowers the injured worker to designate an ATP within 100 miles of their home address by simply attending an appointment.

Changing an ATP

The law also changes the provision in C.R.S. § 8-43-404(5)(a)(II) allowing for the injured worker to make a one-time change of physician request.

Currently, an injured worker may request a one-time change of physician to another physician on the Designated Provider List within 90 days of the injury.

The new law allows an injured worker to request a one-time change of physician to any Level I or II accredited physician within 120 days of the injury.

Utilization Standards

This law amends C.R.S. § 8-42-101(3)(a)(I) to clarify that the failure to use the Division of Workers’ Compensation’s utilization standards to respond to a request for prior authorization permits the finding that the requested service is authorized, reasonable, and necessary.

This change underscores the necessity of using the Rule 17 Medical Treatment Guidelines, and not any other guidelines (e.g., Official Disability Guidelines (“ODG”) in Rule 16 records reviews.

Implementation

This law will take effect on January 1, 2028. Governor Polis has called for the creation of a working group of stakeholders, legislators, and agency staff to formulate recommendations for the law’s implementation. Specifically, this working group is to address the following issues:

1. Further clarifying the permissibility of in-house clinics that employ level 1 or 2 accredited physicians as an option available to injured workers.
2. Clarifying that nothing precludes an employer or insurer from selecting any number of level 1 or level 2 accredited physicians to provide as a list of recommendations.
3. The functionality of DOWC’s provider directory and clarifications around appropriate provider types to serve as a designated provider.
4. The accreditation process for providers, including DOWC tracking of licensure and malpractice status.
5. The applicability of the premium credit described in the Division of Insurance’s Amended Regulation 5-1-1 Section 5(E).
6. Clarification of any timelines, including around designation of and change of physician, or other legislative provisions to ensure workers receive prompt care; and
7. Identifying mechanisms to lower costs.

While it remains to be seen how the working group may shape the law’s implementation, the “Workers’ Compensation Benefits Proof of Entitlement” law will have a profound effect on medical treatment under the Colorado Workers’ Compensation Act.

See the signed version of this law with changes indicated at this URL: https://leg.colorado.gov/sites/default/files/2025a_1300_signed.pdf

Want to know more? Contact Cameron Azimi at cazimi@pollartmiller.com