HOUSE BILL 22-1285
BY REPRESENTATIVE(S) Neville and Esgar, Daugherty, Amabile,
Bernett, Bird, Boesenecker, Carver, Duran, Herod, Jodeh, Kennedy, Kipp,
Lindsay, Lontine, McCluskie, McCormick, Michaelson Jenet, Ortiz, Pico,
Roberts, Sirota, Snyder, Titone, Valdez A., Van Winkle, Weissman,
Garnett, Baisley, Exum, Geitner, Luck, Pelton, Sandridge, Valdez D.,
Van Beber, Williams, Young;
also SENATOR(S) Moreno and Cooke, Bridges, Buckner, Coram,
Danielson, Donovan, Fields, Ginal, Gonzales, Hinrichsen, Holbert,
Jaquez Lewis, Kolker, Lee, Pettersen, Priola, Rankin, Rodriguez, Scott,
Sonnenberg, Story, Winter, Woodward, Zenzinger, Fenberg.
C
ONCERNING A PROHIBITION AGAINST A HOSPITAL TAKING CERTAIN DEBT
COLLECTION ACTIONS AGAINST A PATIENT IF THE HOSPITAL IS NOT IN
COMPLIANCE WITH HOSPITAL PRICE TRANSPARENCY LAWS
.
Be it enacted by the General Assembly of the State of Colorado:
SECTION 1. In Colorado Revised Statutes, add part 8 to article 3
of title 25 as follows:
PART 8
CONSUMER PROTECTION RELATING TO
NOTE: This bill has been prepared for the signatures of the appropriate legislative
officers and the Governor. To determine whether the Governor has signed the bill
or taken other action on it, please consult the legislative status sheet, the legislative
history, or the Session Laws.
________
Capital letters or bold & italic numbers indicate new material added to existing law; dashes
through words or numbers indicate deletions from existing law and such material is not part of
the act. HOSPITAL PRICE TRANSPARENCY
25-3-801. Legislative declaration. (1) T
HE GENERAL ASSEMBLY
FINDS AND DECLARES THAT
:
(a) S
ECTION 1001 OF THE "PATIENT PROTECTION AND AFFORDABLE
CARE ACT OF 2010", PUB.L. 111-148, AS AMENDED BY SECTION 10101 OF
THE
"HEALTH CARE AND EDUCATION RECONCILIATION ACT OF 2010",
P
UB.L. 111-152, AMENDED TITLE XXVII OF THE "PUBLIC HEALTH SERVICE
ACT", PUB.L. 78-410, IN PART, BY ADDING A NEW SECTION 2718(e),
REQUIRING, IN PART, THAT EACH HOSPITAL OPERATING WITHIN THE UNITED
STATES ESTABLISH, UPDATE, AND MAKE PUBLIC A LIST OF THE HOSPITAL'S
STANDARD CHARGES FOR THE ITEMS AND SERVICES THAT THE HOSPITAL
PROVIDES
;
(b) E
FFECTIVE JANUARY 1, 2021, THE FEDERAL CENTERS FOR
MEDICARE AND MEDICAID SERVICES PUBLISHED THE FINAL RULE TO
IMPLEMENT THE LAW
, CODIFIED AT 45 CFR 180;
(c) I
N ITS SUMMARY OF THE FINAL RULE , CMS STATES THAT
INFORMATION ON HOSPITAL STANDARD CHARGES IS NECESSARY FOR THE
PUBLIC TO
"MAKE MORE INFORMED DECISIONS ABOUT THEIR CARE " AND
THAT THE
"IMPACT OF THESE FINAL POLICIES WILL HELP TO INCREASE
MARKET COMPETITION
, AND ULTIMATELY DRIVE DOWN THE COST OF HEALTH
CARE SERVICES
, MAKING THEM MORE AFFORDABLE FOR ALL PATIENTS ";
(d) O
N JULY 9, 2021, PRESIDENT BIDEN, BUILDING UPON EFFORTS OF
PAST PRESIDENTS
, ISSUED THE "EXECUTIVE ORDER ON PROMOTING
COMPETITION IN THE AMERICAN ECONOMY", DIRECTING THE SECRETARY OF
THE
UNITED STATES DEPARTMENT OF HEALTH AND HUMAN SERVICES TO
SUPPORT NEW AND EXISTING PRICE TRANSPARENCY INITIATIVES FOR
HOSPITALS
;
(e) H
EALTH-CARE PRICE TRANSPARENCY IS IN THE BEST INTEREST OF
ALL
COLORADANS, INCLUDING:
(I) T
HE STATE GOVERNMENT , WHICH PURCHASES HEALTH -CARE
SERVICES FOR ALMOST A QUARTER OF ALL
COLORADANS;
(II) C
OLORADO BUSINESSES, WHICH FUND EMPLOYEE MEDICAL
PAGE 2-HOUSE BILL 22-1285 EXPENSES; AND
(III) COLORADO RESIDENTS, WHO ULTIMATELY BEAR THE BRUNT OF
HIGH HEALTH
-CARE COSTS IN THE FORM OF HIGHER TAXES , LOWER WAGES,
AND RESIDENTS' OWN OUT-OF-POCKET SPENDING;
(f) M
OREOVER, HEALTH-CARE PRICES IN COLORADO ARE AMONG THE
HIGHEST IN THE NATION
;
(g) H
OWEVER, NOT ALL COLORADO HOSPITALS ARE IN COMPLIANCE
WITH ALL OF THE DISCLOSURE REQUIREMENTS UNDER FEDERAL LAW AND
OTHER STATE LAWS GOVERNING HEALTH
-CARE PRICE TRANSPARENCY; AND
(h) THIS LACK OF COMPLIANCE WITH HEALTH -CARE PRICE
TRANSPARENCY LAWS BY
COLORADO HOSPITALS DECREASES THE
LIKELIHOOD THAT
COLORADO CONSUMERS WILL BE FULLY AWARE OF
AFFORDABLE HEALTH
-CARE OPTIONS BEFORE PURCHASING ITEMS AND
SERVICES FROM HOSPITALS
, PLACING HEALTH-CARE CONSUMERS AT
GREATER RISK OF COLLECTION ACTIONS AND OTHER ADVERSE ACTIONS
RELATING TO UNPAID MEDICAL BILLS
.
(2) T
HEREFORE, THE GENERAL ASSEMBLY FINDS AND DECLARES THAT
IT IS IMPERATIVE TO PROTECT
COLORADO HEALTH-CARE CONSUMERS FROM
COLLECTION ACTIONS AND OTHER ADVERSE ACTIONS TAKEN BY
COLORADO
HOSPITALS DURING THE TIME WHEN THE HOSPITAL WAS NOT IN MATERIAL
COMPLIANCE WITH HOSPITAL PRICE TRANSPARENCY LAWS INTENDED TO
PROTECT HEALTH
-CARE CONSUMERS.
25-3-802. Definitions. A
S USED IN THIS SECTION, UNLESS THE
CONTEXT OTHERWISE REQUIRES
:
(1) "C
OLLECTION ACTION" MEANS ANY OF THE FOLLOWING ACTIONS
TAKEN WITH RESPECT TO A DEBT FOR ITEMS AND SERVICES THAT WERE
PURCHASED FROM OR PROVIDED TO A PATIENT BY A HOSPITAL ON A DATE
DURING WHICH THE HOSPITAL WAS NOT IN MATERIAL COMPLIANCE WITH
HOSPITAL PRICE TRANSPARENCY LAWS
:
(a) A
TTEMPTING TO COLLECT A DEBT FROM A PATIENT OR PATIENT
GUARANTOR BY REFERRING THE DEBT
, DIRECTLY OR INDIRECTLY, TO A DEBT
COLLECTOR
, A COLLECTION AGENCY, OR OTHER THIRD PARTY RETAINED BY
PAGE 3-HOUSE BILL 22-1285 OR ON BEHALF OF THE HOSPITAL;
(b) S
UING THE PATIENT OR PATIENT GUARANTOR , OR ENFORCING AN
ARBITRATION OR MEDIATION CLAUSE IN ANY HOSPITAL DOCUMENTS
INCLUDING CONTRACTS
, AGREEMENTS, STATEMENTS, OR BILLS; OR
(c) DIRECTLY OR INDIRECTLY CAUSING A REPORT TO BE MADE TO A
CONSUMER REPORTING AGENCY
.
(2) (a) "C
OLLECTION AGENCY" MEANS ANY:
(I) P
ERSON WHO ENGAGES IN A BUSINESS THE PRINCIPAL PURPOSE OF
WHICH IS THE COLLECTION OF DEBTS
; OR
(II) PERSON WHO:
(A) R
EGULARLY COLLECTS OR ATTEMPTS TO COLLECT , DIRECTLY OR
INDIRECTLY
, DEBTS OWED OR DUE OR ASSERTED TO BE OWED OR DUE TO
ANOTHER
;
(B) T
AKES ASSIGNMENT OF DEBTS FOR COLLECTION PURPOSES ;
(C) D
IRECTLY OR INDIRECTLY SOLICITS FOR COLLECTION DEBTS
OWED OR DUE OR ASSERTED TO BE OWED OR DUE TO ANOTHER
; OR
(D) COLLECTS DEBT FOR THE DEPARTMENT OF PERSONNEL .
(b) "C
OLLECTION AGENCY" DOES NOT INCLUDE:
(I) A
NY OFFICER OR EMPLOYEE OF A CREDITOR WHILE , IN THE NAME
OF THE CREDITOR
, COLLECTING DEBTS FOR SUCH CREDITOR ;
(II) A
NY PERSON WHILE ACTING AS A COLLECTION AGENCY FOR
ANOTHER PERSON
, BOTH OF WHOM ARE RELATED BY COMMON OWNERSHIP
OR AFFILIATED BY CORPORATE CONTROL
, IF THE PERSON ACTING AS A
COLLECTION AGENCY DOES SO ONLY FOR CREDITORS TO WHOM IT IS SO
RELATED OR AFFILIATED AND IF THE PRINCIPAL BUSINESS OF THE PERSON IS
NOT THE COLLECTION OF DEBTS
;
(III) A
NY OFFICER OR EMPLOYEE OF THE UNITED STATES OR ANY
PAGE 4-HOUSE BILL 22-1285 STATE TO THE EXTENT THAT COLLECTING OR ATTEMPTING TO COLLECT ANY
DEBT IS IN THE PERFORMANCE OF THE OFFICER
'S OR EMPLOYEE'S OFFICIAL
DUTIES
;
(IV) A
NY PERSON WHILE SERVING OR ATTEMPTING TO SERVE LEGAL
PROCESS ON ANY OTHER PERSON IN CONNECTION WITH THE JUDICIAL
ENFORCEMENT OF ANY DEBT
;
(V) A
NY DEBT-MANAGEMENT SERVICES PROVIDER OPERATING IN
COMPLIANCE WITH OR EXEMPT FROM THE
"UNIFORM DEBT-MANAGEMENT
SERVICES ACT", PART 2 OF ARTICLE 19 OF TITLE 5;
(VI) A
NY PERSON COLLECTING OR ATTEMPTING TO COLLECT ANY
DEBT OWED OR DUE OR ASSERTED TO BE OWED OR DUE ANOTHER TO THE
EXTENT THAT
:
(A) T
HE ACTIVITY IS INCIDENTAL TO A BONA FIDE FIDUCIARY
OBLIGATION OR A BONA FIDE ESCROW ARRANGEMENT
;
(B) T
HE ACTIVITY CONCERNS A DEBT THAT WAS EXTENDED BY THE
PERSON
;
(C) T
HE ACTIVITY CONCERNS A DEBT THAT WAS NOT IN DEFAULT AT
THE TIME IT WAS OBTAINED BY THE PERSON
; OR
(D) THE ACTIVITY CONCERNS A DEBT OBTAINED BY THE PERSON AS
A SECURED PARTY IN A COMMERCIAL CREDIT TRANSACTION INVOLVING THE
CREDITOR
;
(VII) A
NY PERSON WHOSE PRINCIPAL BUSINESS IS THE MAKING OF
LOANS OR THE SERVICING OF DEBT NOT IN DEFAULT AND WHO ACTS AS A
LOAN CORRESPONDENT
, SELLER AND SERVICER FOR THE OWNER, OR HOLDER
OF A DEBT THAT IS SECURED BY A DEED OF TRUST ON REAL PROPERTY
WHETHER OR NOT THE DEBT IS ALSO SECURED BY AN INTEREST IN PERSONAL
PROPERTY
;
(VIII) A
LIMITED GAMING OR RACING LICENSEE ACTING PURSUANT
TO ARTICLE
33 OF TITLE 44.
(c) N
OTWITHSTANDING THE PROVISIONS OF SUBSECTION (2)(b) OF
PAGE 5-HOUSE BILL 22-1285 THIS SECTION, "COLLECTION AGENCY" INCLUDES ANY PERSON WHO, IN THE
PROCESS OF COLLECTING THE PERSON
'S OWN DEBTS, USES ANOTHER NAME
THAT WOULD INDICATE THAT A THIRD PERSON IS COLLECTING OR
ATTEMPTING TO COLLECT SUCH DEBTS
.
(3) (a) "C
ONSUMER REPORTING AGENCY " MEANS ANY PERSON THAT,
FOR MONETARY FEES, DUES, OR ON A COOPERATIVE NONPROFIT BASIS ,
REGULARLY ENGAGES , IN WHOLE OR IN PART , IN THE PRACTICE OF
ASSEMBLING OR EVALUATING CONSUMER CREDIT INFORMATION OR OTHER
INFORMATION ON CONSUMERS FOR THE PURPOSE OF FURNISHING CONSUMER
REPORTS TO THIRD PARTIES
. "CONSUMER REPORTING AGENCY " INCLUDES
ANY PERSON DEFINED IN
15 U.S.C. SEC. 1681a (f) OR SECTION 5-18-103 (4).
(b) "C
ONSUMER REPORTING AGENCY " DOES NOT INCLUDE ANY
BUSINESS ENTITY THAT PROVIDES CHECK VERIFICATION OR CHECK
GUARANTEE SERVICES ONLY
.
(4) (a) "D
EBT" MEANS ANY OBLIGATION OR ALLEGED OBLIGATION OF
A CONSUMER TO PAY MONEY ARISING OUT OF A TRANSACTION
, WHETHER OR
NOT THE OBLIGATION HAS BEEN REDUCED TO JUDGMENT
.
(b) "D
EBT" DOES NOT INCLUDE A DEBT FOR BUSINESS, INVESTMENT,
COMMERCIAL, OR AGRICULTURAL PURPOSES OR A DEBT INCURRED BY A
BUSINESS
.
(5) "D
EBT COLLECTOR" MEANS ANY PERSON EMPLOYED OR E NGAGED
BY A COLLECTION AGENCY TO PERFORM THE COLLECTION OF DEBTS OWED OR
DUE OR ASSERTED TO BE OWED OR DUE TO ANOTHER
.
(6) "F
EDERAL CENTERS FOR MEDICARE AND MEDICAID SERVICES " OR
"CMS" MEANS THE CENTER FOR MEDICARE AND MEDICAID SERVICES IN THE
UNITED STATES DEPARTMENT OF HEALTH AND HUMAN SERVICES .
(7) "H
OSPITAL" MEANS, CONSISTENT WITH 45 CFR 180.20, A
HOSPITAL
:
(a) L
ICENSED OR CERTIFIED BY THE DEPARTMENT PURSUANT TO
SECTION
25-1.5-103 (1)(a); OR
(b) APPROVED BY THE DEPARTMENT AS MEETING THE STANDARDS
PAGE 6-HOUSE BILL 22-1285 ESTABLISHED FOR LICENSING A HOSPITAL.
(8) "H
OSPITAL PRICE TRANSPARENCY LAWS" MEANS SECTION 2718(e)
OF THE "PUBLIC HEALTH SERVICE (PHS) ACT", PUB.L. 78-410, AS
AMENDED
, AND RULES ADOPTED BY THE UNITED STATES DEPARTMENT OF
HEALTH AND HUMAN SERVICES IMPLEMENTING SECTION
2718(e).
(9) "I
TEMS AND SERVICES" OR "ITEMS OR SERVICES" MEANS "ITEMS
AND SERVICES
" AS DEFINED IN 45 CFR 180.20.
25-3-803. Failure to comply with hospital price transparency
laws - prohibiting collection of debt - penalty. (1) (a) E
XCEPT AS
PROVIDED IN SUBSECTION
(1)(b) OF THIS SECTION, ON AND AFTER THE
EFFECTIVE DATE OF THIS SECTION
, A HOSPITAL THAT IS NOT IN MATERIAL
COMPLIANCE WITH HOSPITAL PRICE TRANSPARENCY LAWS ON THE DATE
THAT ITEMS OR SERVICES ARE PURCHASED FROM OR PROVIDED TO A PATIENT
BY THE HOSPITAL SHALL NOT INITIATE OR PURSUE A COLLECTION ACTION
AGAINST THE PATIENT OR PATIENT GUARANTOR FOR A DEBT OWED FOR THE
ITEMS OR SERVICES
.
(b) T
HIS PART 8 APPLIES, ON AND AFTER FEBRUARY 15, 2023, TO
CRITICAL ACCESS HOSPITALS LICENSED AND CERTIFIED BY THE DEPARTMENT
PURSUANT TO
42 CFR 485 SUBPART F.
(2) I
F A PATIENT BELIEVES THAT A HOSPITAL WAS NOT IN MATERIAL
COMPLIANCE WITH HOSPITAL PRICE TRANSPARENCY LAWS ON A DATE ON OR
AFTER THE EFFECTIVE DATE OF THIS SECTION THAT ITEMS OR SERVICES WERE
PURCHASED BY OR PROVIDED TO THE PATIENT
, AND THE HOSPITAL TAKES A
COLLECTION ACTION AGAINST THE PATIENT OR PATIENT GUARANTOR
, THE
PATIENT OR PATIENT GUARANTOR MAY FILE SUIT TO D ETERMINE IF THE
HOSPITAL WAS MATERIALLY OUT OF COMPLIANCE WITH THE HOSPITAL PRICE
TRANSPARENCY LAWS AND RULES AND REGULATIONS ON THE DATE OF
SERVICE
, AND THE NONCOMPLIANCE IS RELATED TO THE ITEMS OR SERVICES .
T
HE HOSPITAL SHALL NOT TAKE A COLLECTION ACTION AGAINST THE
PATIENT OR PATIENT GUARANTOR WHILE THE LAWSUIT IS PENDING
.
(3) A
HOSPITAL THAT HAS BEEN FOUND BY A JUDGE OR JURY ,
CONSIDERING COMPLIANCE STANDARDS ISSUED BY THE FEDERAL CENTERS
FOR MEDICARE AND MEDICAID SERVICES
, TO BE MATERIALLY OUT OF
COMPLIANCE WITH HOSPITAL PRICE TRANSPARENCY LAWS AND RULES AND
PAGE 7-HOUSE BILL 22-1285 REGULATIONS:
(a) S
HALL REFUND THE PAYER ANY AMOUNT OF THE DEBT THE PAYER
HAS PAID AND SHALL PAY A PENALTY TO THE PATIENT OR PATIENT
GUARANTOR IN AN AMOUNT EQUAL TO THE TOTAL AMOUNT OF THE DEBT
;
(b) S
HALL DISMISS OR CAUSE TO BE DISMISSED ANY COURT ACTION
WITH PREJUDICE AND PAY ANY ATTORNEY FEES AND COSTS INCURRED BY
THE PATIENT OR PATIENT GUARANTOR RELATING TO THE ACTION
; AND
(c) REMOVE OR CAUSE TO BE REMOVED FROM THE PATIENT 'S OR
PATIENT GUARANTOR
'S CREDIT REPORT ANY REPORT MADE TO A CONSUMER
REPORTING AGENCY RELATING TO THE DEBT
.
(4) N
OTHING IN THIS PART 8:
(a) P
ROHIBITS A HOSPITAL FROM BILLING A PATIENT , PATIENT
GUARANTOR
, OR THIRD-PARTY PAYER, INCLUDING HEALTH INSURER, FOR
ITEMS OR SERVICES PROVIDED TO THE PATIENT
; OR
(b) REQUIRES A HOSPITAL TO REFUND ANY PAYMENT MADE TO THE
HOSPITAL FOR ITEMS OR SERVICES PROVIDED TO THE PATIENT
, SO LONG AS
NO COLLECTION ACTION IS TAKEN IN VIOLATION OF THIS PART
8.
SECTION 2. Act subject to petition - effective date. This act
takes effect at 12:01 a.m. on the day following the expiration of the
ninety-day period after final adjournment of the general assembly; except
that, if a referendum petition is filed pursuant to section 1 (3) of article V
of the state constitution against this act or an item, section, or part of this act
within such period, then the act, item, section, or part will not take effect
unless approved by the people at the general election to be held in
PAGE 8-HOUSE BILL 22-1285 November 2022 and, in such case, will take effect on the date of the official
declaration of the vote thereon by the governor.
____________________________ ____________________________
Alec Garnett Steve Fenberg
SPEAKER OF THE HOUSE PRESIDENT OF
OF REPRESENTATIVES THE SENATE
____________________________ ____________________________
Robin Jones Cindi L. Markwell
CHIEF CLERK OF THE HOUSE SECRETARY OF
OF REPRESENTATIVES THE SENATE
APPROVED________________________________________
(Date and Time)
_________________________________________
Jared S. Polis
GOVERNOR OF THE STATE OF COLORADO
PAGE 9-HOUSE BILL 22-1285