Second Regular Session
Seventy-third General Assembly
STATE OF COLORADO
INTRODUCED
LLS NO. 22-0589.01 Brita Darling x2241
HOUSE BILL 22-1285
House Committees Senate Committees
Health & Insurance
A BILL FOR AN ACT
C
ONCERNING A PROHIBITION AGAINS T A HOSPITAL TAKING CERTAIN101
DEBT COLLECTION ACTIONS AGAINST A PATIENT IF THE102
HOSPITAL IS NOT IN COMPLI ANCE WITH HOSPITAL PRICE103
TRANSPARENCY LAWS .104
Bill Summary
(Note: This summary applies to this bill as introduced and does
not reflect any amendments that may be subsequently adopted. If this bill
passes third reading in the house of introduction, a bill summary that
applies to the reengrossed version of this bill will be available at
http://leg.colorado.gov
.)
The bill prohibits a hospital or other person or entity collecting on
behalf of the hospital from initiating or pursuing collection actions
against a patient or patient guarantor for debt incurred by the patient on
HOUSE SPONSORSHIP
Neville and Esgar, Daugherty
SENATE SPONSORSHIP
Moreno and Cooke,
Shading denotes HOUSE amendment. Double underlining denotes SENATE amendment.
Capital letters or bold & italic numbers indicate new material to be added to existing statute.
Dashes through the words indicate deletions from existing statute. the date or dates of service when the hospital was not in compliance with
federal hospital price transparency laws.
Nothing in the bill:
! Prohibits a hospital from billing a patient or health insurer
for items or services provided to the patient; or
! Requires a hospital to refund a payment made to the
hospital for items or services provided to a patient.
A hospital that initiates or pursues a prohibited collection action
is subject to a penalty equal to the amount of the debt and must refund
any amount paid on the debt and pay attorney fees and costs.
The bill makes attempting to collect the debt an unfair practice
under the "Colorado Fair Debt Collections Act".
The bill authorizes the department of public health and
environment, in considering a hospital's license renewal application, to
consider whether the hospital is or has been in compliance with federal
hospital price transparency laws.
Be it enacted by the General Assembly of the State of Colorado:1
SECTION 1. In Colorado Revised Statutes, add part 8 to article2
3 of title 25 as follows:3
PART 84
CONSUMER PROTECTION RELATING TO5
HOSPITAL PRICE TRANSPARENCY6
25-3-801. Legislative declaration. (1) T
HE GENERAL ASSEMBLY7
FINDS AND DECLARES THAT:8
(a) S
ECTION 1001 OF THE "PATIENT PROTECTION AND9
A
FFORDABLE CARE ACT OF 2010", PUB.L. 111-148, AS AMENDED BY10
SECTION 10101 OF THE "HEALTH CARE AND EDUCATION RECONCILIATION11
A
CT OF 2010", PUB.L. 111-152, AMENDED TITLE XXVII OF THE "PUBLIC12
H
EALTH SERVICE ACT", PUB.L. 78-410, IN PART, BY ADDING A NEW13
SECTION 2718(e), REQUIRING, IN PART, THAT EACH HOSPITAL OPERATING14
WITHIN THE UNITED STATES ESTABLISH, UPDATE, AND MAKE PUBLIC A LIST15
OF THE HOSPITAL'S STANDARD CHARGES FOR THE ITEMS AND SERVICES16
HB22-1285-2- THAT THE HOSPITAL PROVIDES;1
(b) E
FFECTIVE JANUARY 1, 2021, THE FEDERAL CENTERS FOR2
MEDICARE AND MEDICAID SERVICES PUBLISHED THE FINAL RULE TO3
IMPLEMENT THE LAW, CODIFIED AT 45 CFR 180;4
(c) I
N ITS SUMMARY OF THE FINAL RULE , CMS STATES THAT5
INFORMATION ON HOSPITAL STANDARD CHARGES IS NECESSARY FOR THE6
PUBLIC TO "MAKE MORE INFORMED DECISIONS ABOUT THEIR CARE " AND7
THAT THE "IMPACT OF THESE FINAL POLICIES WILL HELP TO INCREASE8
MARKET COMPETITION, AND ULTIMATELY DRIVE DOWN THE COST OF9
HEALTH CARE SERVICES, MAKING THEM MORE AFFORDABLE FOR ALL10
PATIENTS";11
(d) O
N JULY 9, 2021, PRESIDENT BIDEN, BUILDING UPON EFFORTS12
OF PAST PRESIDENTS, ISSUED THE "EXECUTIVE ORDER ON PROMOTING13
C
OMPETITION IN THE AMERICAN ECONOMY", DIRECTING THE SECRETARY14
OF THE UNITED STATES DEPARTMENT OF HEALTH AND HUMAN SERVICES15
TO SUPPORT NEW AND EXISTING PRICE TRANSPARENCY INITIATIVES FOR16
HOSPITALS;17
(e) H
EALTH-CARE PRICE TRANSPARENCY IS IN THE BEST INTEREST18
OF ALL COLORADANS, INCLUDING:19
(I) T
HE STATE GOVERNMENT , WHICH PURCHASES HEALTH -CARE20
SERVICES FOR ALMOST A QUARTER OF ALL COLORADANS;21
(II) C
OLORADO BUSINESSES, WHICH FUND EMPLOYEE MEDICAL22
EXPENSES; AND23
(III) C
OLORADO RESIDENTS, WHO ULTIMATELY BEAR THE BRUNT24
OF HIGH HEALTH-CARE COSTS IN THE FORM OF HIGHER TAXES , LOWER25
WAGES, AND RESIDENTS' OWN OUT-OF-POCKET SPENDING;26
(f) M
OREOVER, HEALTH-CARE PRICES IN COLORADO ARE AMONG27
HB22-1285
-3- THE HIGHEST IN THE NATION;1
(g) H
OWEVER, NOT ALL COLORADO HOSPITALS ARE IN2
COMPLIANCE WITH ALL OF THE DISCLOSURE REQUIREMENTS UNDER3
FEDERAL LAW AND OTHER STATE LAWS GOVERNING HEALTH -CARE PRICE4
TRANSPARENCY; AND5
(h) T
HIS LACK OF COMPLIANCE WITH HEALTH -CARE PRICE6
TRANSPARENCY LAWS BY COLORADO HOSPITALS DECREASES THE7
LIKELIHOOD THAT COLORADO CONSUMERS WILL BE FULLY AWARE OF8
AFFORDABLE HEALTH-CARE OPTIONS BEFORE PURCHASING ITEMS AND9
SERVICES FROM HOSPITALS , PLACING HEALTH-CARE CONSUMERS AT10
GREATER RISK OF COLLECTION ACTIONS AND OTHER ADVERSE ACTIONS11
RELATING TO UNPAID MEDICAL BILLS.12
(2) T
HEREFORE, THE GENERAL ASSEMBLY FINDS AND DECLARES13
THAT IT IS IMPERATIVE TO PROTECT COLORADO HEALTH-CARE CONSUMERS14
FROM COLLECTION ACTIONS AND OTHER ADVERSE ACTIONS TAKEN BY15
C
OLORADO HOSPITALS DURING THE TIME WHEN THE HOSPITAL WAS NOT IN16
COMPLIANCE WITH HOSPITAL PRICE TRANSPARENCY LAWS INTENDED TO17
PROTECT HEALTH-CARE CONSUMERS.18
25-3-802. Definitions. A
S USED IN THIS SECTION, UNLESS THE19
CONTEXT OTHERWISE REQUIRES :20
(1) "C
OLLECTION ACTION" MEANS ANY OF THE FOLLOWING21
ACTIONS TAKEN WITH RESPECT TO A DEBT FOR ITEMS AND SERVICES THAT22
WERE PURCHASED FROM OR PROVIDED TO A PATIENT BY A HOSPITAL ON A23
DATE DURING WHICH THE HOSPITAL WAS NOT IN COMPLIANCE WITH24
HOSPITAL PRICE TRANSPARENCY LAWS :25
(a) A
TTEMPTING TO COLLECT A DEBT FROM A PATIENT OR PATIENT26
GUARANTOR, WHETHER BY THE HOSPITAL , AN INDEPENDENT BILLING27
HB22-1285
-4- OFFICE, A DEBT COLLECTOR AS DEFINED IN SECTION 5-16-103 (9), A1
COLLECTION AGENCY AS DEFINED IN SECTION 5-16-103 (3), OR OTHER2
THIRD PARTY RETAINED BY OR ON BEHALF OF THE HOSPITAL ;3
(b) S
UING THE PATIENT OR PATIENT GUARANTOR , OR ENFORCING4
AN ARBITRATION OR MEDIATION CLAUSE IN ANY HOSPITAL DOCUMENTS5
INCLUDING CONTRACTS, AGREEMENTS, STATEMENTS, OR BILLS; OR6
(c) D
IRECTLY OR INDIRECTLY CAUSING A REPORT TO BE MADE TO7
A CONSUMER REPORTING AGENCY , AS DEFINED IN SECTION 5-16-103 (6).8
(2) "D
EBT" HAS THE SAME MEANING AS SET FORTH IN SECTION9
5-16-103.10
(3) "F
EDERAL CENTERS FOR MEDICARE AND MEDICAID SERVICES "11
OR "CMS" MEANS THE CENTER FOR MEDICARE AND MEDICAID SERVICES12
IN THE UNITED STATES DEPARTMENT OF HEALTH AND HUMAN SERVICES .13
(4) "H
OSPITAL" MEANS, CONSISTENT WITH 45 CFR 180.20, A14
HOSPITAL:15
(a) L
ICENSED OR CERTIFIED BY THE DEPARTMENT PURSUANT TO16
SECTION 25-1.5-103 (1)(a); OR17
(b) A
PPROVED BY THE DEPARTMENT AS MEETING THE STANDARDS18
ESTABLISHED FOR LICENSING A HOSPITAL.19
(4) "H
OSPITAL PRICE TRANSPARENCY LAWS " MEANS SECTION20
2718(e)
OF THE "PUBLIC HEALTH SERVICE (PHS) ACT", PUB.L. 78-410, AS21
AMENDED, AND RULES ADOPTED BY THE UNITED STATES DEPARTMENT OF22
HEALTH AND HUMAN SERVICES IMPLEMENTING SECTION 2718 (e).23
(5) "I
TEMS AND SERVICES" OR "ITEMS OR SERVICES" MEANS "ITEMS24
AND SERVICES" AS DEFINED IN 45 CFR 180.20.25
25-3-803. Failure to comply with hospital price transparency26
laws - prohibiting collection of debt - penalty. (1) O
N AND AFTER THE27
HB22-1285
-5- EFFECTIVE DATE OF THIS SECTION , A HOSPITAL THAT IS NOT IN1
COMPLIANCE WITH HOSPITAL PRICE TRANSPARENCY LAWS ON THE DATE2
THAT ITEMS OR SERVICES ARE PURCHASED FROM OR PROVIDED TO A3
PATIENT BY THE HOSPITAL SHALL NOT INITIATE OR PURSUE A COLLECTION4
ACTION AGAINST THE PATIENT OR PATIENT GUARANTOR FOR A DEBT OWED5
FOR THE ITEMS OR SERVICES.6
(2) A
HOSPITAL THAT INITIATES OR PURSUES A COLLECTION7
ACTION FOR A DEBT AGAINST A PATIENT OR PATIENT GUARANTOR IN8
VIOLATION OF THIS SECTION:9
(a) S
HALL REFUND THE PAYER ANY AMOUNT OF THE DEBT THE10
PAYER HAS PAID AND SHALL PAY A PENALTY TO THE PATIENT OR PATIENT11
GUARANTOR IN AN AMOUNT EQUAL TO THE TOTAL AMOUNT OF THE DEBT ;12
(b) S
HALL DISMISS OR CAUSE TO BE DISMISSED ANY COURT ACTION13
WITH PREJUDICE AND PAY ANY ATTORNEY FEES AND COSTS INCURRED BY14
THE PATIENT OR PATIENT GUARANTOR RELATING TO THE ACTION ; AND15
(c) R
EMOVE OR CAUSE TO BE REMOVED FROM THE PATIENT 'S OR16
PATIENT GUARANTOR 'S CREDIT REPORT ANY REPORT MADE TO A17
CONSUMER REPORTING AGENCY RELATING TO THE DEBT .18
(3) N
OTHING IN THIS PART 8:19
(a) P
ROHIBITS A HOSPITAL FROM BILLING A PATIENT , PATIENT20
GUARANTOR, OR THIRD-PARTY PAYER, INCLUDING HEALTH INSURER, FOR21
ITEMS OR SERVICES PROVIDED TO THE PATIENT ; OR22
(b) R
EQUIRES A HOSPITAL TO REFUND ANY PAYMENT MADE TO THE23
HOSPITAL FOR ITEMS OR SERVICES PROVIDED TO THE PATIENT , SO LONG AS24
NO COLLECTION ACTION IS TAKEN IN VIOLATION OF THIS PART 8.25
SECTION 2. In Colorado Revised Statutes, 5-16-108, add (1)(m)26
as follows:27
HB22-1285
-6- 5-16-108. Unfair practices. (1) A debt collector or collection1
agency shall not use unfair or unconscionable means to collect or attempt2
to collect any debt, including, but not limited to, the following conduct:3
(m) A
TTEMPTING TO COLLECT A DEBT IN VIOLATION OF PART 8 OF4
ARTICLE 3 OF TITLE 25.5
SECTION 3. In Colorado Revised Statutes, 25-3-102, add (4) as6
follows:7
25-3-102. License - application - issuance - certificate of8
compliance required - rules. (4) N
OTWITHSTANDING ANY PROVISION OF9
LAW TO THE CONTRARY, IN CONSIDERING AN APPLICATION FOR RENEWAL10
OF A HOSPITAL'S LICENSE OR CERTIFICATION, THE DEPARTMENT MAY11
CONSIDER WHETHER THE HOSPITAL IS OR HAS BEEN IN COMPLIANCE WITH12
HOSPITAL PRICE TRANSPARENCY LAWS , AS DEFINED IN SECTION 25-3-802.13
SECTION 4. Act subject to petition - effective date. This act14
takes effect at 12:01 a.m. on the day following the expiration of the15
ninety-day period after final adjournment of the general assembly; except16
that, if a referendum petition is filed pursuant to section 1 (3) of article V17
of the state constitution against this act or an item, section, or part of this18
act within such period, then the act, item, section, or part will not take19
effect unless approved by the people at the general election to be held in20
November 2022 and, in such case, will take effect on the date of the21
official declaration of the vote thereon by the governor.22
HB22-1285
-7-