Second Regular Session
Seventy-third General Assembly
STATE OF COLORADO
INTRODUCED
LLS NO. 22-0778.01 Brita Darling x2241
SENATE BILL 22-125
Senate Committees House Committees
State, Veterans, & Military Affairs
A BILL FOR AN ACT
C
ONCERNING ALLOWING CERTAIN PUBLIC HEALTH -CARE ENTITIES TO101
IMPROVE HEALTH-CARE EFFICIENCY THROUGH COOPERATION .102
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 authorizes county public hospitals and affiliates and health
service districts and affiliates authorized under certain statutory
provisions, all of which are in rural areas of the state, to engage in
activities that might be characterized as anticompetitive or that might
result in a monopoly or displace competition.
The activities that a county public hospital or health service district
SENATE SPONSORSHIP
Sonnenberg, Donovan
HOUSE SPONSORSHIP
Will,
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. may engage in include, among others, joint ventures, joint purchasing
agreements, and joint negotiations.
In exercising these powers, the county public hospital or health
service district or its affiliate is performing essential public functions on
behalf of the state and is immune from any liability under federal and
state antitrust laws.
Be it enacted by the General Assembly of the State of Colorado:1
SECTION 1. In Colorado Revised Statutes, add 25-3-304.5 as2
follows:3
25-3-304.5. Hospital collaboration - anticompetitive affiliations4
or actions. (1) A
PUBLIC HOSPITAL BOARD OF TRUSTEES MAY ENGAGE5
THE HOSPITAL, OR AN AFFILIATE OF THE HOSPITAL THAT IS EITHER UNDER6
THE SOLE CONTROL OF THE HOSPITAL OR UNDER THE COMMON CONTROL7
OF THE HOSPITAL AND OTHER COUNTY PUBLIC HOSPITALS , IN ACTIVITIES8
DESCRIBED IN SUBSECTION (2) OF THIS SECTION, EITHER ON ITS OWN OR IN9
COLLABORATION WITH OTHER PERSONS , THAT MIGHT BE CHARACTERIZED10
AS ANTICOMPETITIVE, THAT MIGHT RESULT IN THE ACQUISITION OR11
MAINTENANCE OF MONOPOLY POWER WITHIN THE MEANING OF STATE AND12
FEDERAL ANTITRUST LAWS, OR THAT MIGHT RESULT IN THE DISPLACEMENT13
OF COMPETITION IN THE PROVISION OF HOSPITAL , PHYSICIAN, OR OTHER14
HEALTH-CARE-RELATED SERVICES.15
(2) T
HE ACTIVITIES THAT A PUBLIC HOSPITAL BOARD OF TRUSTEES16
MAY ENGAGE IN PURSUANT TO SUBSECTION (1) OF THIS SECTION, EITHER17
INDEPENDENTLY OR IN COLLABORATION WITH OTHER PERSONS , INCLUDE,18
AT A MINIMUM:19
(a) J
OINT VENTURES;20
(b) J
OINT PURCHASING ARRANGEMENTS ;21
(c) J
OINT NEGOTIATIONS WITH PHYSICIANS , HOSPITALS, AND22
SB22-125-2- PAYERS, REGARDLESS OF WHETHER SUCH NEGOTIATIONS RESULT IN1
SEPARATE OR COMBINED AGREEMENTS ;2
(d) L
EASES; AND3
(e) A
GREEMENTS THAT INVOLVE DELIVERY SYSTEM NETWORK4
CREATION OR OPERATION.5
SECTION 2. In Colorado Revised Statutes, add 25-3-316 as6
follows:7
25-3-316. Legislative declaration - anticompetitive practices8
- state action - immunity - definition. (1) I
N SUPPORT OF AND IN9
FURTHERANCE OF THE POWERS GRANTED IN SECTION 25-3-304.5 AND THIS10
SECTION, THE GENERAL ASSEMBLY FINDS AND DECLARES THAT :11
(a) A
COUNTY PUBLIC HOSPITAL ESTABLISHED PURSUANT TO THIS12
PART 3 AND A HOSPITAL AFFILIATE PERFORM ESSENTIAL PUBLIC FUNCTIONS13
ON BEHALF OF THE STATE;14
(b) R
URAL COMMUNITIES AND THEIR HOSPITALS ARE GENERALLY15
CONSIDERED VULNERABLE DUE TO LOW PATIENT VOLUMES , HIGH16
MEDICARE AND MEDICAID PAYER MIX , GEOGRAPHIC ISOLATION ,17
WORKFORCE SHORTAGES , LIMITED ACCESS TO ESSENTIAL HEALTH -CARE18
SERVICES, AGING INFRASTRUCTURE, AND HIGHER INCIDENCE OF CHRONIC19
DISEASE;20
(c) I
NCREASED COLLABORATION WILL IMPROVE RURAL HOSPITALS '21
CHANCES OF SURVIVAL WHILE PRESERVING THE ETHIC OF INDEPENDENT ,22
LOCALLY CONTROLLED HEALTH CARE ;23
(d) T
HE EXERCISE OF POWERS CONFERRED ON COUNTY PUBLIC24
HOSPITALS AND THEIR HOSPITAL AFFILIATES UNDER THIS PART 3 MAY25
COMPEL OR RESULT IN EACH COUNTY PUBLIC HOSPITAL OR HOSPITAL26
AFFILIATE ENGAGING IN ACTIVITIES DESCRIBED IN SUBSECTION (2) OF THIS27
SB22-125
-3- SECTION, ITSELF OR IN COLLABORATION WITH OTHER PERSONS , THAT1
MIGHT BE CHARACTERIZED AS ANTICOMPETITIVE , THAT MIGHT RESULT IN2
THE ACQUISITION OR MAINTENANCE OF MONOPOLY POWER WITHIN THE3
MEANING OF STATE AND FEDERAL ANTITRUST LAWS , OR THAT MIGHT4
RESULT IN THE DISPLACEMENT OF COMPETITION IN THE PROVISION OF5
HOSPITAL, PHYSICIAN, OR OTHER HEALTH-CARE-RELATED SERVICES;6
(e) I
N CARRYING OUT ITS PUBLIC HEALTH MISSION THROUGH THE7
EXERCISE OF THE POWERS GRANTED BY THIS PART 3, INCLUDING, WITHOUT8
LIMITATION, THE COLLABORATIVE ACTIVITIES EXPRESSLY AUTHORIZED BY9
THIS PART 3, A COUNTY PUBLIC HOSPITAL OR HOSPITAL AFFILIATE AND THE10
OTHER PERSONS WITH WHICH IT COLLABORATES ARE IMMUNE FROM11
LIABILITY UNDER FEDERAL AND STATE ANTITRUST LAWS TO THE FULLEST12
EXTENT ALLOWED BY LAW ; AND13
(f) A
S AN EXPRESSION OF THE PUBLIC POLICY OF THE STATE WITH14
RESPECT TO THE DISPLACEMENT OF COMPETITION IN THE FIELD OF HEALTH15
CARE, EACH COUNTY PUBLIC HOSPITAL OR HOSPITAL AFFILIATE , WHEN16
EXERCISING ITS POWERS UNDER THIS PART 3, IS ACTING AS A POLITICAL17
SUBDIVISION OF THE STATE, AND AS SUCH, IS NOT SUBJECT TO ACTIVE18
SUPERVISION BY THE STATE IN ORDER TO ENJOY IMMUNITY FROM THE19
APPLICATION OF STATE AND FEDERAL ANTITRUST LAWS .20
(2) T
HE ACTIVITIES THAT A PUBLIC HOSPITAL BOARD OF TRUSTEES21
OR HOSPITAL AFFILIATE MAY ENGAGE IN PURSUANT TO SUBSECTION (1)(d)22
OF THIS SECTION, EITHER INDEPENDENTLY OR IN COLLABORATION WITH23
OTHER PERSONS, INCLUDE, AT A MINIMUM:24
(a) J
OINT VENTURES;25
(b) J
OINT PURCHASING ARRANGEMENTS ;26
(c) J
OINT NEGOTIATIONS WITH PHYSICIANS , HOSPITALS, AND27
SB22-125
-4- PAYERS, REGARDLESS OF WHETHER SUCH NEGOTIATIONS RESULT IN1
SEPARATE OR COMBINED AGREEMENTS ;2
(d) L
EASES; AND3
(e) A
GREEMENTS THAT INVOLVE DELIVERY SYSTEM NETWORK4
CREATION OR OPERATION.5
(3) A
S USED IN THIS SECTION, "HOSPITAL AFFILIATE" MEANS AN6
AFFILIATE OF THE COUNTY PUBLIC HOSPITAL THAT IS EITHER UNDER THE7
SOLE CONTROL OF THE COUNTY PUBLIC HOSPITAL OR UNDER THE COMMON8
CONTROL OF THE COUNTY PUBLIC HOSPITAL AND OTHER COUNTY PUBLIC9
HOSPITALS OR HEALTH SERVICE DISTRICTS , AS DEFINED IN SECTION10
32-1-103
(9).11
SECTION 3. In Colorado Revised Statutes, add 32-1-102.1 as12
follows:13
32-1-102.1. Legislative declaration - anticompetitive practices14
- state action - immunity. (1) I
N SUPPORT OF AND IN FURTHERANCE OF15
THE POWERS GRANTED IN SECTION 32-1-1003 (6) AND THIS SECTION, THE16
GENERAL ASSEMBLY FINDS AND DECLARES THAT :17
(a) T
HE ORGANIZATION OF HEALTH SERVICE DISTRICTS AND18
HEALTH SERVICE DISTRICT AFFILIATES PROVIDING THE SERVICES AND19
HAVING THE PURPOSES, POWERS, AND AUTHORITY GRANTED IN THIS20
ARTICLE 1 SERVE A PUBLIC USE AND PROMOTE THE HEALTH , SAFETY,21
PROSPERITY, SECURITY, AND GENERAL WELFARE OF THE INHABITANTS OF22
THE HEALTH SERVICE DISTRICTS AND OF THE PEOPLE OF THE STATE OF23
C
OLORADO;24
(b) R
URAL ACCESS TO HEALTH CARE IS VULNERABLE DUE TO LOW25
PATIENT VOLUMES, HIGH MEDICARE AND MEDICAID PAYER MIX ,26
GEOGRAPHIC ISOLATION, WORKFORCE SHORTAGES , LIMITED ACCESS TO27
SB22-125
-5- ESSENTIAL HEALTH-CARE SERVICES, AGING INFRASTRUCTURE, AND HIGHER1
INCIDENCE OF CHRONIC DISEASE;2
(c) I
NCREASED COLLABORATION WILL HELP MAINTAIN ACCESS TO3
HEALTH-CARE SERVICES AND PRESERVE THE ETHIC OF INDEPENDENT ,4
LOCALLY CONTROLLED HEALTH CARE .5
(d) T
HE EXERCISE OF POWERS CONFERRED ON HEALTH SERVICE6
DISTRICTS AND HEALTH SERVICE DISTRICT AFFILIATES BY THIS ARTICLE 17
MAY COMPEL EACH HEALTH SERVICE DISTRICT AND HEALTH SERVICE8
DISTRICT AFFILIATE TO ENGAGE IN ACTIVITIES DESCRIBED IN SUBSECTION9
(2)
OF THIS SECTION, ITSELF OR IN COLLABORATION WITH OTHER PERSONS ,10
THAT MIGHT BE CHARACTERIZED AS ANTICOMPETITIVE , THAT MIGHT11
RESULT IN THE ACQUISITION OR MAINTENANCE OF MONOPOLY POWER12
WITHIN THE MEANING OF STATE AND FEDERAL ANTITRUST LAWS , OR THAT13
MIGHT RESULT IN THE DISPLACEMENT OF COMPETITION IN THE PROVISION14
OF HOSPITAL, PHYSICIAN, OR OTHER HEALTH-CARE-RELATED SERVICES.15
(e) I
N CARRYING OUT ITS PUBLIC HEALTH MISSION THROUGH THE16
EXERCISE OF THE POWERS GRANTED BY THIS ARTICLE 1, INCLUDING,17
WITHOUT LIMITATION, THE COLLABORATIVE ACTIVITIES EXPRESSLY18
AUTHORIZED BY THIS ARTICLE 1, A HEALTH SERVICE DISTRICT OR HEALTH19
SERVICE DISTRICT AFFILIATE AND THE OTHER PERSONS WITH WHICH IT20
COLLABORATES ARE IMMUNE FROM LIABILITY UNDER FEDERAL AND STATE21
ANTITRUST LAWS TO THE FULLEST EXTENT ALLOWED BY LAW ; AND22
(f) A
S AN EXPRESSION OF THE PUBLIC POLICY OF THE STATE WITH23
RESPECT TO THE DISPLACEMENT OF COMPETITION IN THE FIELD OF HEALTH24
CARE, EACH HEALTH SERVICE DISTRICT AND HEALTH SERVICE DISTRICT25
AFFILIATE, WHEN EXERCISING ITS POWERS UNDER THIS ARTICLE 1, IS26
ACTING AS A POLITICAL SUBDIVISION OF THE STATE, AND AS SUCH, IS NOT27
SB22-125
-6- SUBJECT TO ACTIVE SUPERVISION BY THE STATE IN ORDER TO ENJOY1
IMMUNITY FROM THE APPLICATION OF STATE AND FEDERAL ANTITRUST2
LAWS.3
(2) T
HE ACTIVITIES THAT A HEALTH SERVICE DISTRICT OR HEALTH4
SERVICE DISTRICT AFFILIATE MAY ENGAGE IN PURSUANT TO SUBSECTION5
(1)(d)
OF THIS SECTION, EITHER INDEPENDENTLY OR IN COLLABORATION6
WITH OTHER PERSONS, INCLUDE, AT A MINIMUM:7
(a) J
OINT VENTURES;8
(b) J
OINT PURCHASING ARRANGEMENTS ;9
(c) J
OINT NEGOTIATIONS WITH PHYSICIANS , HOSPITALS, AND10
PAYERS, REGARDLESS OF WHETHER SUCH NEGOTIATIONS RESULT IN11
SEPARATE OR COMBINED AGREEMENTS ;12
(d) L
EASES; AND13
(e) A
GREEMENTS THAT INVOLVE DELIVERY SYSTEM NETWORK14
CREATION OR OPERATION.15
SECTION 4. In Colorado Revised Statutes, 32-1-103, add (9.1)16
as follows:17
32-1-103. Definitions. As used in this article 1, unless the context18
otherwise requires:19
(9.1) "H
EALTH SERVICE DISTRICT AFFILIATE" MEANS AN AFFILIATE20
OF A HEALTH SERVICE DISTRICT THAT IS EITHER UNDER THE SOLE CONTROL21
OF A HEALTH SERVICE DISTRICT OR UNDER THE COMMON CONTROL OF A22
HEALTH SERVICE DISTRICT AND OTHER HEALTH SERVICE DISTRICTS OR23
COUNTY PUBLIC HOSPITALS.24
SECTION 5. In Colorado Revised Statutes, 32-1-1003, add (6)25
as follows:26
32-1-1003. Health service districts - additional powers -27
SB22-125
-7- anticompetitive practices. (6) (a) T HE BOARD OF A HEALTH SERVICE1
DISTRICT THAT IS CREATED IN ACCORDANCE WITH THIS PART 10 OR AN2
AFFILIATE OF A HEALTH SERVICE DISTRICT HAS THE POWER TO ENGAGE THE3
HEALTH SERVICE DISTRICT OR HEALTH SERVICE DISTRICT AFFILIATE IN4
ACTIVITIES DESCRIBED IN SUBSECTION (6)(b) OF THIS SECTION, EITHER ON5
ITS OWN OR IN COLLABORATION WITH OTHER PERSONS , THAT MIGHT BE6
CHARACTERIZED AS ANTICOMPETITIVE , THAT MIGHT RESULT IN THE7
ACQUISITION OR MAINTENANCE OF MONOPOLY POWER WITHIN THE8
MEANING OF STATE AND FEDERAL ANTITRUST LAWS , OR THAT MIGHT9
RESULT IN THE DISPLACEMENT OF COMPETITION IN THE PROVISION OF10
HOSPITAL, PHYSICIAN, OR OTHER HEALTH-CARE-RELATED SERVICES.11
(b) T
HE ACTIVITIES THAT THE BOARD OF A HEALTH SERVICE12
DISTRICT OR HEALTH SERVICE DISTRICT AFFILIATE MAY ENGAGE IN13
PURSUANT TO SUBSECTION (6)(a) OF THIS SECTION , EITHER14
INDEPENDENTLY OR IN COLLABORATION WITH OTHER PERSONS , INCLUDE,15
AT A MINIMUM:16
(I) J
OINT VENTURES;17
(II) J
OINT PURCHASING ARRANGEMENTS ;18
(III) J
OINT NEGOTIATIONS WITH PHYSICIANS , HOSPITALS, AND19
PAYERS, REGARDLESS OF WHETHER SUCH NEGOTIATIONS RESULT IN20
SEPARATE OR COMBINED AGREEMENTS ;21
(IV) L
EASES; AND22
(V) A
GREEMENTS THAT INVOLVE DELIVERY SYSTEM NETWORK23
CREATION OR OPERATION.24
SECTION 6. Safety clause. The general assembly hereby finds,25
determines, and declares that this act is necessary for the immediate26
preservation of the public peace, health, or safety.27
SB22-125
-8-