Another Sold Out

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Denver Zoo Lights!

Thank you to all our members who brought their families to our 4th annual Member + Family Appreciation Night at Denver Zoo Lights on Dec. 14th. Once again, we sold out of our 300+ tickets within days of offering them. Members enjoyed great food, drink, and a quick hello from Santa before heading out to enjoy the lights.

We look forward to hosting again in 2026! Thanks again to our title sponsor, Merrill Lynch, and our Gold level sponsor, Touchstone Medical Imaging. Great sponsors help us make this event possible year after year. Thank you!

January is Human Trafficking Prevention Month, a designated observance designed to educate the public about human trafficking and the role they can play in preventing and responding to human trafficking.

CMS and NCMS is offering an on-demand CME called Gasping for Air in which Dr. Narina Grove discusses with local law enforcement and a victim advocacy group "A Courageous Rose" the signs of human trafficking, review real life case studies, and hear a courageous survivor's story firsthand so you can advocate for your patients. Earn 1 CME Credit Here with your registration and participation.

What’s new and improved for your practice

CMS Lunch & Learn Webinar

Thursday, January 15, 12-1 p.m.

State laws governing prior authorization will begin in 2026, bringing new changes to support patients and physician practices. This CME Lunch and Learn webinar will help you and your practice: 

• 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 their practice 
• Learn practical steps to take when insurers are not complying with or cooperating with the law

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 ahead of the 2026 implementation. It will be recorded, so even if you can't make it at the time, register to receive the recording. Register Here

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. 

AMA Credit Designation Statement: The Colorado Medical Society designates this live activity for a maximum of 1.0AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

On behalf of the ADEMS Board of Directors, thank you for renewing your membership for 2026—we truly appreciate your continued commitment to Colorado’s physician community. Your support strengthens our collective voice for advocacy, education, and connection, and we look forward to serving you in 2026.

If perhaps you still need to renew your 2026 dues or update your contact information, please click here or contact the CMS membership department at 720-859-1001 or membership@cms.org. If you have additional questions or concerns you would like to discuss further, ADEMS can assist you! Please email Andrea Chase at ADEMSstaff@gmail.com for prompt assistance. Thank you!

As you may be aware, several large 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 the viability of physician practices, undermine patient access to care, and establish a "guilty until proven innocent" approach to claims adjudication that violates basic due process principles.

Physicians increasingly report issues with 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, improperly rely on claim data rather than medical records, and lack transparency in how downcoding decisions are made. Such approaches discourage appropriate billing and increase friction between physicians and payers.

The Colorado Medical Society (CMS) has mounted a vigorous opposition to 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 that are currently engaging in automatic downcoding.

As this issue continues to develop, updates, resources, and next steps will continue to be posted on the CMS members-only resource page. A member login is required; username is the CMS member's email address or CMS member number. The password can be reset here. If you are a practice manager and need a login separate from your CMS-member physician, contact us at membership@cms.org.  You may also relay any current experiences you are seeing to this same email address.