Colorado 2023 Regular Session

Colorado House Bill HB1226 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
	1	+	First Regular Session
	2	+	Seventy-fourth General Assembly
	3	+	STATE OF COLORADO
	4	+	REREVISED
	5	+	This Version Includes All Amendments
	6	+	Adopted in the Second House
	7	+	LLS NO. 23-0720.01 Shelby Ross x4510
1	8		HOUSE BILL 23-1226
2		-	BY REPRESENTATIVE(S) Soper and deGruy Kennedy, Amabile,
3		-	Boesenecker, Brown, Dickson, Froelich, Gonzales-Gutierrez, Hamrick,
4		-	Jodeh, Kipp, Lieder, Lindsay, Lindstedt, McCormick, McLachlan, Ricks,
5		-	Sirota, Titone, Weissman, Willford, McCluskie;
6		-	also SENATOR(S) Roberts and Will, Bridges, Buckner, Cutter, Exum,
7		-	Fields, Hansen, Jaquez Lewis, Moreno, Priola, Fenberg.
	9	+	House Committees Senate Committees
	10	+	Health & Insurance Health & Human Services
	11	+	Appropriations Appropriations
	12	+	A BILL FOR AN ACT
8	13		C
9		-	ONCERNING TRANSPARENCY REQUIREMENTS FOR HOSPITALS , AND, IN
10		-	CONNECTION THEREWITH
11		-	, CREATING MORE TIMELY SUBMISSIONS OF
12		-	DATA
13		-	; PROVIDING INSIGHTS INTO TRANSFERS OF CASH AND PROFITS
14		-	AND RESERVES
15		-	, INCLUDING THOSE LEAVING COLORADO; REPORTING
16		-	ON ALL INFORMATION RECEIVED
17		-	; REPORTING INFORMATION BY EACH
18		-	HOSPITAL IN ADDITION TO HEALTH SYSTEMS
19		-	; DISCLOSING EXECUTIVE
20		-	COMPENSATION
21		-	, INCLUDING COMPENSATED INCENTIVES ; REPORTING
22		-	MERGERS AND ACQUISITIONS OF HOSPITALS AND PHYSICIANS
23		-	;
24		-	REPORTING INVESTMENTS IN CAPITAL EQUIPMENT AND
25		-	CONSTRUCTION
26		-	; AND MAKING AN APPROPRIATION .
27		-
28		-	Be it enacted by the General Assembly of the State of Colorado:
29		-	SECTION 1. In Colorado Revised Statutes, 25.5-4-402.8, amend
30		-	(2)(a), (2)(b) introductory portion, (2)(b)(II)(A), (2)(b)(III)(J),
31		-	NOTE: This bill has been prepared for the signatures of the appropriate legislative
32		-	officers and the Governor. To determine whether the Governor has signed the bill
33		-	or taken other action on it, please consult the legislative status sheet, the legislative
34		-	history, or the Session Laws.
35		-	________
36		-	Capital letters or bold & italic numbers indicate new material added to existing law; dashes
37		-	through words or numbers indicate deletions from existing law and such material is not part of
38		-	the act. (2)(b)(III)(M), (2)(c) introductory portion, (2)(e), (3) introductory portion,
39		-	(4)(a) introductory portion, (4)(a)(I), and (4)(b); repeal (2)(d); and add
40		-	(2)(b)(II)(D), (2)(b)(II)(E), (2)(b)(II)(F), (2)(b)(II)(G), (2)(b)(III)(O),
41		-	(2)(b)(III)(P), (2)(b)(III)(Q), (2)(b)(IV), (2)(b.5), (2)(g), and (4.5) as
42		-	follows:
43		-	25.5-4-402.8. Hospital transparency report - definitions.
44		-	(2) (a) The state department shall annually prepare a written hospital
45		-	expenditure
46		-	TRANSPARENCY report detailing uncompensated hospital costs,
47		-	INCLUDING UNCOMPENSATED CARE COSTS , and the different categories of
48		-	expenditures, by major payer group, made by hospitals in the state. The state
49		-	department shall
50		-	COORDINATE THE ANALYSIS, REVIEW, AND RELEASE OF THE
51		-	HOSPITAL TRANSPARENCY REPORT AND THE REPORTS REQUIRED PURSUANT
52		-	TO SECTION
53		-	25.5-1-703 (3) AND 25.5-4-402.4 (7)(e), INCLUDING THE
54		-	OPPORTUNITY TO REVIEW AND
55		-	consult with
56		-	ON THE REPORTS MADE BY the
57		-	Colorado healthcare affordability and sustainability enterprise board,
58		-	created pursuant to section 25.5-4-402.4 (7) and referred to in this section
59		-	as the "enterprise board". in developing the hospital expenditure report.
60		-	The
61		-	state department may share any information
62		-	AND ANALYTICS OF
63		-	INFORMATION THAT
64		-	it receives from hospitals with the enterprise board. The
65		-	state department may include information it receives from hospitals in
66		-	accordance with subsection (2)(b) of this section and that is not otherwise
67		-	publicly available in the expenditure
68		-	TRANSPARENCY report and share such
69		-	information with the enterprise board; except that information the state
70		-	department receives from hospitals in accordance with subsection
71		-	SUBSECTIONS (2)(b)(II)(D), (2)(b)(III)(N), (2)(b)(III)(O), (2)(b.5)(I), AND
72		-	(2)(b.5)(II) of this section is confidential, proprietary, contains trade secrets, and is not a public record pursuant to part 2 of article 72 of title 24. The state department shall not include in the expenditure
73		-	TRANSPARENCY report,
74		-	share with the enterprise board, or otherwise publish or distribute
75		-	information derived from reports pursuant to subsection
76		-	SUBSECTIONS
77		-	(2)(b)(II)(D), (2)(b)(III)(N), (2)(b)(III)(O), (2)(b.5)(I), AND (2)(b.5)(II) of
78		-	this section, although the state department may share this information if
79		-	such information has been de-identified and aggregated in a manner to
80		-	prevent identification of the transaction price of any individual acquisition
81		-	or affiliation. A hospital shall not be in violation of this section if the
82		-	hospital makes a good faith effort to comply with the reporting
83		-	requirements of this section.
84		-	(b) Except as provided in subsection (2)(c) of this section, each
85		-	PAGE 2-HOUSE BILL 23-1226 hospital licensed pursuant to part 1 of article 3 of title 25, or certified
86		-	pursuant to section 25-1.5-103 (1)(a)(II), shall make information available
87		-	to the state department for purposes of preparing the annual hospital
88		-	expenditure
89		-	TRANSPARENCY report. The state board shall establish the
90		-	format of the information provided by each hospital on an annual basis. The
91		-	first submission by each hospital must include the information described in
92		-	subsections (2)(b)(I) and (2)(b)(II) of this section for fiscal years 2011-12
93		-	through 2018-19 and the information described in subsection (2)(b)(III) of
94		-	this section for those fiscal years if such information is available. For each
95		-	subsequent submission, Each hospital shall provide the following
96		-	information to the state department:
97		-	(II) (A) An Annual audited financial statement STATEMENTS,
98		-	prepared in accordance with generally accepted accounting principles. Each
99		-	hospital shall submit the statement
100		-	STATEMENTS within one hundred twenty
101		-	days after the end of its fiscal year unless the state department grants an
102		-	extension in writing in advance of that date.
103		-	(D) A
104		-	N ANNUAL SUMMARY OF THE HOSPITAL 'S TRANSFERS OF CASH,
105		-	EQUITY, INVESTMENTS, OR OTHER ASSETS TO AND FROM RELATED PARTIES ,
106		-	INCLUDING BUT NOT LIMITED TO THE HOSPITAL 'S PARENT ORGANIZATION.
107		-	T
108		-	HE SUMMARY MUST INCLUDE THE PURPOSE OF THE TRANSFERS AND
109		-	WHETHER THE TRANSFERS WERE MADE WITHIN OR OUTSIDE OF
110		-	COLORADO.
111		-	A
112		-	HOSPITAL MAY AGGREGATE THE TRANSFERS FOR EACH ENTITY RECEIVING
113		-	OR MAKING THE TRANSFER
114		-	.
115		-	(E) A
116		-	HOSPITAL-SPECIFIC STATEMENT OF CASH FLOW WITHIN A TIME
117		-	FRAME SPECIFIED ANNUALLY BY THE STATE DEPARTMENT
118		-	, BUT NOT LESS
119		-	THAN ONE HUNDRED TWENTY DAYS AFTER THE HOSPITAL
120		-	'S FISCAL YEAR
121		-	END
122		-	.
	14	+	ONCERNING TRANSPARENCY REQUIREMENTS FOR HOSPITALS , AND, IN101
	15	+	CONNECTION THEREWITH , CREATING MORE TIMELY102
	16	+	SUBMISSIONS OF DATA; PROVIDING INSIGHTS INTO TRANSFERS103
	17	+	OF CASH AND PROFITS AND RESERVES , INCLUDING THOSE104
	18	+	LEAVING COLORADO; REPORTING ON ALL INFORMATION105
	19	+	RECEIVED; REPORTING INFORMATION BY EACH HOSPITAL IN106
	20	+	ADDITION TO HEALTH SYSTEMS ; DISCLOSING EXECUTIVE107
	21	+	COMPENSATION, INCLUDING COMPENSATED INCENTIVES ;108
	22	+	REPORTING MERGERS AND ACQUI SITIONS OF HOSPITALS AND109
	23	+	PHYSICIANS;
	24	+	REPORTING INVESTMENTS IN CAPITAL110
	25	+	EQUIPMENT AND CONSTRUCTION ; AND MAKING AN111
	26	+	APPROPRIATION.112
	27	+	SENATE
	28	+	3rd Reading Unamended
	29	+	May 5, 2023
	30	+	SENATE
	31	+	2nd Reading Unamended
	32	+	May 4, 2023
	33	+	HOUSE
	34	+	3rd Reading Unamended
	35	+	April 24, 2023
	36	+	HOUSE
	37	+	Amended 2nd Reading
	38	+	April 21, 2023
	39	+	HOUSE SPONSORSHIP
	40	+	Soper and deGruy Kennedy, Amabile, Boesenecker, Brown, Dickson, Froelich,
	41	+	Gonzales-Gutierrez, Hamrick, Jodeh, Kipp, Lieder, Lindsay, Lindstedt, McCluskie,
	42	+	McCormick, McLachlan, Ricks, Sirota, Titone, Weissman, Willford
	43	+	SENATE SPONSORSHIP
	44	+	Roberts and Will, Bridges, Buckner, Cutter, Exum, Fenberg, Fields, Hansen, Jaquez
	45	+	Lewis, Moreno, Priola
	46	+	Shading denotes HOUSE amendment. Double underlining denotes SENATE amendment.
	47	+	Capital letters or bold & italic numbers indicate new material to be added to existing law.
	48	+	Dashes through the words or numbers indicate deletions from existing law. Bill Summary
	49	+	(Note: This summary applies to this bill as introduced and does
	50	+	not reflect any amendments that may be subsequently adopted. If this bill
	51	+	passes third reading in the house of introduction, a bill summary that
	52	+	applies to the reengrossed version of this bill will be available at
	53	+	http://leg.colorado.gov
	54	+	.)
	55	+	Current law requires the department of health care policy and
	56	+	financing (state department) to annually prepare a written hospital
	57	+	expenditure report. The bill changes the name of the report to the hospital
	58	+	transparency report (transparency report).
	59	+	The bill adds specified information that each hospital shall report
	60	+	to the state department for the transparency report.
	61	+	No later than July 1, 2024, the bill requires each hospital to
	62	+	provide specified information to the state department for previous fiscal
	63	+	years.
	64	+	The bill authorizes the state department to impose certain
	65	+	enforcement mechanisms against a hospital that does not provide all of
	66	+	the information required to be reported to the state department.
	67	+	Beginning July 1, 2024, the bill requires any patient bill to include
	68	+	a clear, plain language description of the services the patient is being
	69	+	billed for and a statement that the patient has a right to receive a detailed
	70	+	explanation of the services charged and who to contact to receive such
	71	+	information.
	72	+	Be it enacted by the General Assembly of the State of Colorado:1
	73	+	SECTION 1. In Colorado Revised Statutes, 25.5-4-402.8, amend2
	74	+	(2)(a), (2)(b) introductory portion, (2)(b)(II)(A), (2)(b)(III)(J),3
	75	+	(2)(b)(III)(M), (2)(c) introductory portion, (2)(e), (3) introductory portion,4
	76	+	(4)(a) introductory portion
	77	+	(4)(a)(I),, and (4)(b); repeal (2)(d); and add5
	78	+	(2)(b)(II)(D), (2)(b)(II)(E), (2)(b)(II)(F), (2)(b)(III)(O), (2)(b)(III)(P),6
	79	+	(2)(b)(III)(Q), (2)(b)(IV), (2)(b.5), (2)(g), and (4.5) as follows:7
	80	+	25.5-4-402.8. Hospital transparency report - definitions.8
	81	+	(2) (a) The state department shall annually prepare a written hospital9
	82	+	expenditure TRANSPARENCY report detailing uncompensated hospital10
	83	+	costs,
	84	+	INCLUDING UNCOMPENSATED
	85	+	CARE COSTS, and the different11
	86	+	1226-2- categories of expenditures, by major payer group, made by hospitals in1
	87	+	the state. The state department shall
	88	+	COORDINATE THE ANALYSIS, REVIEW,2
	89	+	AND RELEASE OF THE HOSPITAL TRANSPARENCY REPORT AND THE REPORTS3
	90	+	REQUIRED PURSUANT TO SECTION 25.5-1-703 (3) AND 25.5-4-402.4 (7)(e),4
	91	+	INCLUDING THE OPPORTUNITY TO REVIEW AND consult with
	92	+	ON THE5
	93	+	REPORTS MADE BY the Colorado healthcare affordability and sustainability6
	94	+	enterprise board, created pursuant to section 25.5-4-402.4 (7) and referred7
	95	+	to in this section as the "enterprise board". in developing the hospital8
	96	+	expenditure report. The state department may share any information AND9
	97	+	ANALYTICS OF INFORMATION THAT it receives from hospitals with the10
	98	+	enterprise board. The state department may include information it11
	99	+	receives from hospitals in accordance with subsection (2)(b) of this12
	100	+	section and that is not otherwise publicly available in the expenditure13
	101	+	TRANSPARENCY report and share such information with the enterprise14
	102	+	board; except that information the state department receives from15
	103	+	hospitals in accordance with subsection SUBSECTIONS (2)(b)(II)(D),16
	104	+	(2)(b)(III)(N), (2)(b)(III)(O), (2)(b.5)(I), AND (2)(b.5)(II) of this section17
	105	+	is confidential, proprietary, contains trade secrets, and is not a public18
	106	+	record pursuant to part 2 of article 72 of title 24. The state department19
	107	+	shall not include in the expenditure TRANSPARENCY report, share with the20
	108	+	enterprise board, or otherwise publish or distribute information derived21
	109	+	from reports pursuant to subsection SUBSECTIONS (2)(b)(II)(D),22
	110	+	(2)(b)(III)(N), (2)(b)(III)(O), (2)(b.5)(I), AND (2)(b.5)(II) of this section,23
	111	+	although the state department may share this information if such24
	112	+	information has been de-identified and aggregated in a manner to prevent25
	113	+	identification of the transaction price of any individual acquisition or26
	114	+	affiliation. A hospital shall not be in violation of this section if the27
	115	+	1226
	116	+	-3- hospital makes a good faith effort to comply with the reporting1
	117	+	requirements of this section.2
	118	+	(b) Except as provided in subsection (2)(c) of this section, each3
	119	+	hospital licensed pursuant to part 1 of article 3 of title 25, or certified4
	120	+	pursuant to section 25-1.5-103 (1)(a)(II), shall make information available5
	121	+	to the state department for purposes of preparing the annual hospital6
	122	+	expenditure TRANSPARENCY report. The state board shall establish the7
	123	+	format of the information provided by each hospital on an annual basis.8
	124	+	The first submission by each hospital must include the information9
	125	+	described in subsections (2)(b)(I) and (2)(b)(II) of this section for fiscal10
	126	+	years 2011-12 through 2018-19 and the information described in11
	127	+	subsection (2)(b)(III) of this section for those fiscal years if such12
	128	+	information is available. For each subsequent submission, Each hospital13
	129	+	shall provide the following information to the state department:14
	130	+	(II) (A) An Annual audited financial statement STATEMENTS,15
	131	+	prepared in accordance with generally accepted accounting principles.16
	132	+	Each hospital shall submit the statement STATEMENTS within one hundred17
	133	+	twenty days after the end of its fiscal year unless the state department18
	134	+	grants an extension in writing in advance of that date.19
	135	+	(D) AN ANNUAL SUMMARY OF THE HOSPITAL 'S TRANSFERS OF20
	136	+	CASH, EQUITY, INVESTMENTS, OR OTHER ASSETS TO AND FROM RELATED21
	137	+	PARTIES, INCLUDING BUT NOT LIMITED TO THE HOSPITAL 'S PARENT22
	138	+	ORGANIZATION. THE SUMMARY MUST INCLUDE THE PURPOSE OF THE23
	139	+	TRANSFERS AND WHETHER THE TRANSFERS WERE MADE WITHIN OR24
	140	+	OUTSIDE OF COLORADO. A HOSPITAL MAY AGGREGATE THE TRANSFERS25
	141	+	FOR EACH ENTITY RECEIVING OR MAKING THE TRANSFER .26
	142	+	(E) A HOSPITAL-SPECIFIC STATEMENT OF CASH FLOW WITHIN A27
	143	+	1226
	144	+	-4- TIME FRAME SPECIFIED ANNUALLY BY THE STATE DEPARTMENT, BUT NOT1
	145	+	LESS THAN ONE HUNDRED TWENTY DAYS AFTER THE HOSPITAL'S FISCAL2
	146	+	YEAR END.3
123	147		(F) C
124		-	HANGES TO NO MORE ~~THAN~~ TWENTY -FIVE CATEGORIES OF
125		-	SPECIFIC MAJOR SERVICE LINES
126		-	~~, AS REQUESTED BY THE STATE~~ DEPARTMENT .
	148	+	HANGES TO NO MORE T HAN TWENTY -FIVE CATEGORIES OF4
	149	+	SPECIFIC MAJOR SERVICE LINES , AS REQUESTED BY THE STATE5
	150	+	DEPARTMENT.6
127	151		(G) A
128		-	NARRATIVE REPORT OF MAJOR PLANNED AND COMPLETED
129		-	PROJECTS AND CAPITAL INVESTMENTS GREATER THAN TWENTY
130		-	-FIVE MILLION
131		-	DOLLARS
132		-	; EXCEPT THAT THE INFORMATION THE STATE DEPARTMENT
133		-	RECEIVES FROM HOSPITALS REGARDING PLANNED ACTIVITIES IS
134		-	CONFIDENTIAL
135		-	, PROPRIETARY, CONTAINS TRADE SECRETS, AND IS NOT A
136		-	PUBLIC RECORD PURSUANT TO PART
137		-	2 OF ARTICLE 72 OF TITLE 24.
138		-	PAGE 3-HOUSE BILL 23-1226 (III) A report that contains the following information:
139		-	(J) Other operating revenue, operating margin, nonoperating gains
	152	+	NARRATIVE REPORT OF MAJOR PLANNED AND COMPLETED7
	153	+	PROJECTS AND CAPITAL INVESTMENTS GREATER THAN TWENTY -FIVE8
	154	+	MILLION DOLLARS; EXCEPT THAT THE INFORMATION THE STATE9
	155	+	DEPARTMENT RECEIVES FROM HOSPITALS REGARDING PLANNED ACTIVITIES10
	156	+	IS CONFIDENTIAL, PROPRIETARY, CONTAINS TRADE SECRETS, AND IS NOT11
	157	+	A PUBLIC RECORD PURSUANT TO PART 2 OF ARTICLE 72 OF TITLE 24.12
	158	+	(III) A report that contains the following information:13
	159	+	(J) Other operating revenue, operating margin, nonoperating gains14
140	160		and losses,
141		-	GROSS REVENUE, NET PROFIT, and total margin;
142		-	(M) A roll forward of property, plant, and equipment accounts by
143		-	asset type from the beginning to the end of the reporting period by asset
144		-	category, including, but not limited to, purchases, other acquisitions, sales,
145		-	disposals, and other changes; and
146		-	(O) INFORMATION ON CURRENT AFFILIATIONS AND A REPORT OF
147		-	PHYSICIAN PRACTICE ACQUISITIONS
148		-	;
	161	+	GROSS REVENUE, NET PROFIT, and total margin;15
	162	+	(M) A roll forward of property, plant, and equipment accounts by16
	163	+	asset type from the beginning to the end of the reporting period by asset17
	164	+	category, including, but not limited to, purchases, other acquisitions,18
	165	+	sales, disposals, and other changes; and
	166	+	19
	167	+	(O) I
	168	+	NFORMATION ON CURRENT AFFILIATIONS AND A REPORT OF20
	169	+	PHYSICIAN PRACTICE ACQUISITIONS;21
149	170		(P) S
150		-	ALARY AND TOTAL COMPENSATION DATA OF THE TOP FIVE
151		-	HIGHEST PAID ADMINISTRATIVE POSITIONS OF EACH NONPROFIT HOSPITAL
152		-	,
153		-	INCLUDING THE TITLE , A BRIEF DESCRIPTION OF DUTIES , BASE
154		-	COMPENSATION
155		-	, INCENTIVE OR BONUS COMPENSATION , AND OTHER
156		-	COMPENSATION
157		-	. THE COMPENSATION REPORTED MUST INDICATE WHAT
158		-	PERFORMANCE MEASURES WERE INCLUDED IN THE CHIEF EXECUTIVE
159		-	OFFICER
160		-	'S PERFORMANCE EVALUATION GENERATED BY THE HOSPITAL 'S
161		-	GOVERNING BOARD
162		-	, INCLUDING, AT A MINIMUM , QUALITY OF CARE
163		-	OUTCOMES PERFORMANCE
164		-	; PATIENT SATISFACTION PERFORMANCE ;
165		-	COMMUNITY BENEFIT PERFORMANCE ; CONSUMER AND EMPLOYER
166		-	AFFORDABILITY PERFORMANCE
167		-	; MARKET SHARE PERFORMANCE ; PROFITS OR
168		-	MARGINS
169		-	; REVENUE GROWTH; CHANGE IN DAYS CASH ON HAND OR CASH
170		-	RESERVES
171		-	; AND WORKFORCE . THE STATE DEPARTMENT MAY INCLUDE
172		-	INFORMATION IT RECEIVES FROM PUBLIC HOSPITALS PURSUANT TO THIS
173		-	SUBSECTION
174		-	(2)(b)(III)(P) THAT IS NOT OTHERWISE PUBLICLY AVAILABLE IN
175		-	THE HOSPITAL TRANSPARENCY REPORT
176		-	; EXCEPT THAT INFORMATION THE
177		-	STATE DEPARTMENT RECEIVES FROM A NONPROFIT HOSPITAL IS NOT A PUBLIC
178		-	RECORD PURSUANT TO PART
179		-	2 OF ARTICLE 72 OF TITLE 24. THE STATE
180		-	DEPARTMENT MAY ONLY REPORT INFORMATION RECEIVED PURSUANT TO
181		-	THIS SUBSECTION
182		-	(2)(b)(III)(P) IN AN AGGREGATED FORMAT THAT DOES NOT
183		-	NAME INDIVIDUAL HOSPITALS OR ADMINISTRATORS
184		-	.
	171	+	ALARY AND TOTAL COMPENSATION DATA OF THE TOP FIVE22
	172	+	HIGHEST PAID ADMINISTRATIVE POSITIONS OF EACH NONPROFIT HOSPITAL ,23
	173	+	INCLUDING THE TITLE , A BRIEF DESCRIPTION OF DUTIES , BASE24
	174	+	COMPENSATION, INCENTIVE OR BONUS COMPENSATION , AND OTHER25
	175	+	COMPENSATION.
	176	+	THE COMPENSATION REPORTED MUST INDICATE WHAT26
	177	+	PERFORMANCE MEASURES WERE INCLUDED IN THE CHIEF EXECUTIVE27
	178	+	1226
	179	+	-5- OFFICER'S PERFORMANCE EVALUATION GENERATED BY THE HOSPITAL'S1
	180	+	GOVERNING BOARD, INCLUDING, AT A MINIMUM, QUALITY OF CARE2
	181	+	OUTCOMES PERFORMANCE; PATIENT SATISFACTION PERFORMANCE;3
	182	+	COMMUNITY BENEFIT PERFORMANCE; CONSUMER AND EMPLOYER4
	183	+	AFFORDABILITY PERFORMANCE; MARKET SHARE PERFORMANCE; PROFITS5
	184	+	OR MARGINS; REVENUE GROWTH; CHANGE IN DAYS CASH ON HAND OR6
	185	+	CASH RESERVES; AND WORKFORCE. THE STATE DEPARTMENT MAY7
	186	+	INCLUDE INFORMATION IT RECEIVES FROM PUBLIC HOSPITALS PURSUANT8
	187	+	TO THIS SUBSECTION (2)(b)(III)(P) THAT IS NOT OTHERWISE PUBLICLY9
	188	+	AVAILABLE IN THE HOSPITAL TRANSPARENCY REPORT ; EXCEPT THAT10
	189	+	INFORMATION THE STATE DEPARTMENT RECEIVES FROM A NONPROFIT11
	190	+	HOSPITAL IS NOT A PUBLIC RECORD PURSUANT TO PART 2 OF ARTICLE 72 OF12
	191	+	TITLE 24. THE STATE DEPARTMENT MAY ONLY REPORT INFORMATION13
	192	+	RECEIVED PURSUANT TO THIS SUBSECTION (2)(b)(III)(P) IN AN14
	193	+	AGGREGATED FORMAT THAT DOES NOT NAME INDIVIDUAL HOSPITALS OR15
	194	+	ADMINISTRATORS.16
185	195		(Q) I
186		-	N A FORM AND MANNER SPECIFIED BY THE STATE DEPARTMENT ,
187		-	DETAILS OF SIGNIFICANT OTHER REVENUE THAT WOULD OTHERWISE BE
188		-	REPORTED IN THE MEDICARE COST REPORT
189		-	.
190		-	(IV) (A) A
191		-	QUARTERLY FINANCIAL REPORT THAT INCLUDES AN
192		-	PAGE 4-HOUSE BILL 23-1226 INCOME STATEMENT AND BALANCE SHEET . IF A HOSPITAL IS OWNED OR
193		-	AFFILIATED WITH A HEALTH SYSTEM THAT IS COMPRISED OF THREE OR MORE
194		-	HOSPITALS OR THAT HAS MORE THAN ONE BILLION DOLLARS IN RESERVES
195		-	,
196		-	THE HEALTH SYSTEM MAY SUBMIT A CONSOLIDATED QUARTERLY FINANCIAL
197		-	REPORT
198		-	.
199		-	(B) A
200		-	NY QUARTERLY FINANCIAL REPORT MADE PUBLICLY AVAILABLE
201		-	MUST CLEARLY STATE THAT THE QUARTERLY FINANCIAL REPORT IS
202		-	UNAUDITED
203		-	, IF APPLICABLE. THE STATE DEPARTMENT SHALL PROVIDE ANY
204		-	ANALYSIS
205		-	, REPORT, OR PRESENTATION BASED ON THE QUARTERLY FINANCIAL
206		-	REPORT TO EACH HOSPITAL AT LEAS T FIFTEEN DAYS PRIOR TO THE PUBLIC
207		-	RELEASE OF THE ANALYSIS
208		-	, REPORT, OR PRESENTATION.
	196	+	N A FORM AND MANNER SPECIFIED BY THE STATE17
	197	+	DEPARTMENT, DETAILS OF SIGNIFICANT OTHER REVENUE THAT WOULD18
	198	+	OTHERWISE BE REPORTED IN THE MEDICARE COST REPORT .19 (IV) (A) A QUARTERLY FINANCIAL REPORT THAT INCLUDES AN20
	199	+	INCOME STATEMENT AND BALANCE SHEET. IF A HOSPITAL IS OWNED OR21
	200	+	AFFILIATED WITH A HEALTH SYSTEM THAT IS COMPRISED OF THREE OR22
	201	+	MORE HOSPITALS OR THAT HAS MORE THAN ONE BILLION DOLLARS IN23
	202	+	RESERVES, THE HEALTH SYSTEM MAY SUBMIT A CONSOLIDATED24
	203	+	QUARTERLY FINANCIAL REPORT .25
	204	+	(B) ANY QUARTERLY FINANCIAL REPORT MADE PUBLICLY26
	205	+	AVAILABLE MUST CLEARLY STATE THAT THE QUARTERLY FINANCIAL27
	206	+	1226
	207	+	-6- REPORT IS UNAUDITED, IF APPLICABLE. THE STATE DEPARTMENT SHALL1
	208	+	PROVIDE ANY ANALYSIS, REPORT, OR PRESENTATION BASED ON THE2
	209	+	QUARTERLY FINANCIAL REPORT TO EACH HOSPITAL AT LEAST FIFTEEN3
	210	+	DAYS PRIOR TO THE PUBLIC RELEASE OF THE ANALYSIS, REPORT, OR4
	211	+	PRESENTATION.5
209	212		(b.5) N
210		-	O LATER THAN JULY 1, 2024, EACH HOSPITAL SHALL PROVIDE
211		-	THE FOLLOWING INFORMATION TO THE STATE DEPARTMENT
212		-	:
213		-	(I) F
214		-	OR EACH FISCAL YEAR 2014-15 THROUGH 2019-20, A SUMMARY
215		-	OF THE HOSPITAL
216		-	'S TRANSFERS OF CASH, EQUITY, INVESTMENTS, OR OTHER
217		-	ASSETS TO AND FROM RELATED PARTIES
218		-	, INCLUDING BUT NOT LIMITED TO
219		-	THE HOSPITAL
220		-	'S PARENT ORGANIZATION. THE SUMMARY MUST INCLUDE THE
221		-	PURPOSE OF THE TRANSFERS AND WHETHER THE TRANSFERS WERE MADE
222		-	WITHIN OR OUTSIDE OF
223		-	COLORADO. A HOSPITAL MAY AGGREGATE THE
224		-	TRANSFERS FOR EACH ENTITY RECEIVING OR MAKING THE TRANSFER
225		-	.
	213	+	O LATER THAN JULY 1, 2024, EACH HOSPITAL SHALL6
	214	+	PROVIDE THE FOLLOWING INFORMATION TO THE STATE DEPARTMENT :7 (I) FOR EACH FISCAL YEAR 2014-15 THROUGH 2019-20, A8
	215	+	SUMMARY OF THE HOSPITAL'S TRANSFERS OF CASH, EQUITY, INVESTMENTS,9
	216	+	OR OTHER ASSETS TO AND FROM RELATED PARTIES, INCLUDING BUT NOT10
	217	+	LIMITED TO THE HOSPITAL'S PARENT ORGANIZATION. THE SUMMARY MUST11
	218	+	INCLUDE THE PURPOSE OF THE TRANSFERS AND WHETHER THE TRANSFERS12
	219	+	WERE MADE WITHIN OR OUTSIDE OF COLORADO. A HOSPITAL MAY13
	220	+	AGGREGATE THE TRANSFERS FOR EACH ENTITY RECEIVING OR MAKING THE14
	221	+	TRANSFER.15
226	222		(II) F
227		-	OR EACH FISCAL YEAR FROM 2014-15 THROUGH 2019-20,
228		-	INFORMATION ON AFFILIATIONS AND A REPORT OF PHYSICIAN PRACTICE
229		-	ACQUISITIONS
230		-	; AND
231		-	(III) FOR EACH FISCAL YEAR FROM 2019-20 THROUGH 2022-23, IN A
232		-	FORM AND MANNER SPECIFIED BY THE STATE DEPARTMENT
233		-	, DETAILS OF
234		-	SIGNIFICANT OTHER REVENUE THAT WOULD OTHERWISE BE REPORTED IN THE
235		-	MEDICARE COST REPORT
236		-	.
	223	+	OR EACH FISCAL YEAR FROM 2014-15 THROUGH 2019-20,16
	224	+	INFORMATION ON AFFILIATIONS AND A REPORT OF PHYSICIAN PRACTICE17
	225	+	ACQUISITIONS; AND18
	226	+	(III) F
	227	+	OR EACH FISCAL YEAR FROM 2019-20 THROUGH 2022-23, IN19
	228	+	A FORM AND MANNER SPECIFIED BY THE STATE DEPARTMENT , DETAILS OF20
	229	+	SIGNIFICANT OTHER REVENUE THAT WOULD OTHERWISE BE REPORTED IN21
	230	+	THE MEDICARE COST REPORT.22
237	231		(c) The state department may exempt from the
238		-	CERTAIN reporting
239		-	requirements described in subsection SUBSECTIONS (2)(b) AND (2)(b.5) of
240		-	this section certain types of hospitals, including but not limited to:
241		-	(d) Prior to developing the first annual hospital expenditure report,
242		-	the state department shall consult with the enterprise board regarding the
243		-	development of the report. The state department shall strive for consistency
244		-	PAGE 5-HOUSE BILL 23-1226 in reporting the components in each annual report with those in the report
245		-	of the enterprise board required pursuant to section 25.5-4-402.4 (7)(e).
246		-	(e) Prior to issuing the hospital expenditure TRANSPARENCY report,
247		-	the state department shall provide any hospital referenced in the hospital
248		-	expenditure
249		-	TRANSPARENCY report a copy of the report. Each hospital shall
250		-	MUST have a minimum of fifteen days to review the hospital expenditure
251		-	TRANSPARENCY report and any underlying data and submit corrections or
252		-	clarifications to the state department.
	232	+	CERTAIN reporting23
	233	+	requirements described in subsection SUBSECTIONS (2)(b) AND (2)(b.5) of24
	234	+	this section certain types of hospitals, including but not limited to:25
	235	+	(d) Prior to developing the first annual hospital expenditure report,26
	236	+	the state department shall consult with the enterprise board regarding the27
	237	+	1226
	238	+	-7- development of the report. The state department shall strive for1
	239	+	consistency in reporting the components in each annual report with those2
	240	+	in the report of the enterprise board required pursuant to section3
	241	+	25.5-4-402.4 (7)(e).4
	242	+	(e) Prior to issuing the hospital expenditure TRANSPARENCY5
	243	+	report, the state department shall provide any hospital referenced in the6
	244	+	hospital expenditure TRANSPARENCY report a copy of the report. Each7
	245	+	hospital shall MUST have a minimum of fifteen days to review the hospital8
	246	+	expenditure TRANSPARENCY report and any underlying data and submit9
	247	+	corrections or clarifications to the state department.10
253	248		(g) (I) I
254		-	F A HOSPITAL DOES NOT PROVIDE ALL OF THE INFORMATION
255		-	REQUIRED PURSUANT TO SUBSECTION
256		-	(2)(b) OF THIS SECTION, THE STATE
257		-	DEPARTMENT SHALL INFORM THE HOSPITAL OF ITS NONCOMPLIANCE WITHIN
258		-	SIXTY DAYS AND IDENTIFY THE INFORMATION THAT NEEDS TO BE PROVIDED
259		-	.
260		-	I
261		-	F A HOSPITAL DOES NOT COMPLY, THE STATE DEPARTMENT SHALL ISSUE A
262		-	CORRECTIVE ACTION PLAN WITH A TIMELINE OF SIXTY DAYS REQUIRED FOR
263		-	COMPLIANCE
264		-	. IF A HOSPITAL CONTINUES TO NOT COMPLY , THE STATE
265		-	DEPARTMENT MAY CREATE A MANDATORY PAY
266		-	-FOR-REPORTING
267		-	COMPLIANCE MEASURE WITHIN THE HOSPITAL TRANSFORMATION PROGRAM
268		-	THAT IS TIED TO THE HEALTHCARE AFFORDABILITY AND SUSTAINABILITY FEE
269		-	SUPPLEMENTAL PAYMENT AND IS BASED ON COMPLIANCE WITH SUBSECTION
270		-	(2)(b) OF THIS SECTION.
	249	+	F A HOSPITAL DOES NOT PROVIDE ALL OF THE INFORMATION11
	250	+	REQUIRED PURSUANT TO SUBSECTION (2)(b) OF THIS SECTION, THE STATE12
	251	+	DEPARTMENT SHALL INFORM THE HOSPITAL OF ITS NONCOMPLIANCE13
	252	+	WITHIN SIXTY DAYS AND IDENTIFY THE INFORMATION THAT NEEDS TO BE14
	253	+	PROVIDED. IF A HOSPITAL DOES NOT COMPLY , THE STATE DEPARTMENT15
	254	+	SHALL ISSUE A CORRECTIVE ACTION PLAN WITH A TIMELINE OF SIXTY DAYS16
	255	+	REQUIRED FOR COMPLIANCE. IF A HOSPITAL CONTINUES TO NOT COMPLY ,17
	256	+	THE STATE DEPARTMENT MAY CREATE A MANDATORY18
	257	+	PAY-FOR-REPORTING COMPLIANCE MEASURE WITHIN THE HOSPITAL19
	258	+	TRANSFORMATION PROGRAM THAT IS TIED TO THE HEALTHCARE20
	259	+	AFFORDABILITY AND SUSTAINABILITY FEE SUPPLEMENTAL PAYMENT AND21
	260	+	IS BASED ON COMPLIANCE WITH SUBSECTION (2)(b) OF THIS SECTION.22
271	261		(II) I
272		-	F THE STATE DEPARTMENT DETERMINES A HOSPITAL 'S
273		-	NONCOMPLIANCE WITH THIS SECTION IS KNOWING OR WILLFUL OR THERE IS
274		-	A REPEATED PATTERN OF NONCOMPLIANCE
275		-	, THE STATE DEPARTMENT SHALL
276		-	CONSIDER THE SIZE OF THE HOSPITAL AND THE SERIOUSNESS OF THE
277		-	VIOLATION IN SETTING A FINE AMOUNT WHICH
278		-	, FOR HOSPITALS OWNED OR
279		-	AFFILIATED WITH A HOSPITAL SYSTEM COMPRISED OF THREE OR MORE
280		-	HOSPITALS
281		-	, MUST NOT EXCEED TWENTY THOUSAND DOLLARS PER VIOLATION
282		-	PER WEEK UNTIL THE HOSPITAL TAKES CORRECTIVE AND
283		-	, FOR ALL OTHER
284		-	HOSPITALS
285		-	, MUST NOT EXCEED FIVE THOUSAND DOLLARS PER WEEK UNTIL
286		-	THE HOSPITAL TAKES CORRECTIVE ACTION
287		-	.
288		-	(3) The hospital expenditure
289		-	TRANSPARENCY report must include,
290		-	but not be limited to:
291		-	(4) (a) On or before January 15, 2020, and on or before January 15
292		-	each year thereafter, the state department shall submit the annual hospital
293		-	expenditure
294		-	TRANSPARENCY report to:
295		-	PAGE 6-HOUSE BILL 23-1226 (I) The public health care and human services committee of the
296		-	house of representatives HEALTH AND INSURANCE COMMITTEE AND THE
297		-	HOUSE OF REPRESENTATIVES PUBLIC AND BEHAVIORAL HEALTH AND HUMAN
298		-	SERVICES COMMITTEE
299		-	, or any successor committee;
300		-	(b) The state department may request that the enterprise board
301		-	combine the hospital expenditure
302		-	TRANSPARENCY report described in this
303		-	section with the report of the enterprise board specified in section
304		-	25.5-4-402.4 (7)(e), so long as the specific requirements of this section are
305		-	fulfilled, and so long as the enterprise board agrees to the request. The state
306		-	department shall post the annual report on its website by January 15 of each
307		-	year.
308		-	(4.5) T
309		-	HE STATE DEPARTMENT SHALL REPORT ON THE ANNUAL
310		-	HOSPITAL TRANSPARENCY REPORT DURING THE STATE DEPARTMENT
311		-	'S
312		-	"SMART ACT" HEARING.
313		-	SECTION 2. In Colorado Revised Statutes, add 25.5-4-429 as
314		-	follows:
315		-	25.5-4-429. Hospital and provider billing requirements -
316		-	description of service provided - rules. (1) B
317		-	EGINNING JULY 1, 2024, ANY
318		-	PATIENT BILL FOR SERVICES RENDERED MUST FOLLOW INDUSTRY STANDARD
319		-	BILLING PRACTICES
320		-	, INCLUDING, AT A MINIMUM, THE DATE OF SERVICE, THE
321		-	PATIENT
322		-	'S NAME, THE PROVIDER'S NAME, A DESCRIPTION OF THE SERVICES
323		-	PROVIDED
324		-	, AND THE CHARGES FOR EACH SERVICE .
325		-	SECTION 3. Appropriation. (1) For the 2023-24 state fiscal year,
326		-	$75,167 is appropriated to the department of health care policy and
327		-	financing for use by the executive director's office. This appropriation is
328		-	from the healthcare affordability and sustainability fee cash fund created in
329		-	Section 25.5-4-402.4 (5)(a), C.R.S. To implement this act, the office may
330		-	use this appropriation as follows:
331		-	(a) $67,349 for personal services, which amount is based on an
332		-	assumption that the office will require an additional 1.7 FTE; and
333		-	(b) $7,818 for operating expenses.
334		-	(2) For the 2023-24 state fiscal year, the general assembly
335		-	PAGE 7-HOUSE BILL 23-1226 anticipates that the department of health care policy and financing will
336		-	receive $75,165 in federal funds to implement this act, which amount is
337		-	subject to the "(I)" notation as defined in the annual general appropriation
338		-	act for the same fiscal year. The appropriation in subsection (1) of this
339		-	section is based on the assumption that the department will receive this
340		-	amount of federal funds to be used as follows:
341		-	(a) $67,348 for personal services; and
342		-	(b) $7,817 for operating expenses.
343		-	SECTION 4. Act subject to petition - effective date. This act
344		-	takes effect at 12:01 a.m. on the day following the expiration of the
345		-	ninety-day period after final adjournment of the general assembly; except
346		-	that, if a referendum petition is filed pursuant to section 1 (3) of article V
347		-	of the state constitution against this act or an item, section, or part of this act
348		-	within such period, then the act, item, section, or part will not take effect
349		-	unless approved by the people at the general election to be held in
350		-	PAGE 8-HOUSE BILL 23-1226 November 2024 and, in such case, will take effect on the date of the official
351		-	declaration of the vote thereon by the governor.
352		-	____________________________ ____________________________
353		-	Julie McCluskie Steve Fenberg
354		-	SPEAKER OF THE HOUSE PRESIDENT OF
355		-	OF REPRESENTATIVES THE SENATE
356		-	____________________________ ____________________________
357		-	Robin Jones Cindi L. Markwell
358		-	CHIEF CLERK OF THE HOUSE SECRETARY OF
359		-	OF REPRESENTATIVES THE SENATE
360		-	APPROVED________________________________________
361		-	(Date and Time)
362		-	_________________________________________
363		-	Jared S. Polis
364		-	GOVERNOR OF THE STATE OF COLORADO
365		-	PAGE 9-HOUSE BILL 23-1226
	262	+	F THE STATE DEPARTMENT DETERMINES A HOSPITAL 'S23
	263	+	NONCOMPLIANCE WITH THIS SECTION IS KNOWING OR WILLFUL OR THERE24
	264	+	IS A REPEATED PATTERN OF NONCOMPLIANCE , THE STATE DEPARTMENT25
	265	+	SHALL CONSIDER THE SIZE OF THE HOSPITAL AND THE SERIOUSNESS OF THE26
	266	+	VIOLATION IN SETTING A FINE AMOUNT
	267	+	WHICH, FOR HOSPITALS OWNED OR27
	268	+	1226
	269	+	-8- AFFILIATED WITH A HOSPITAL SYSTEM COMPRISED OF THREE OR MORE1
	270	+	HOSPITALS, MUST NOT EXCEED TWENTY THOUS AND DOLLARS PER2
	271	+	VIOLATION PER WEEK UNTIL THE HOSPITAL TAKES CORRECTIVE AND, FOR3
	272	+	ALL OTHER HOSPITALS, MUST NOT EXCEED FIVE THOUSAND DOLLARS PER4
	273	+	WEEK UNTIL THE HOSPITAL TAKES CORRECTIVE ACTION .5
	274	+	(3) The hospital expenditure TRANSPARENCY report must include,6
	275	+	but not be limited to:7
	276	+	(4) (a) On or before January 15, 2020, and on or before January8
	277	+	15 each year thereafter, the state department shall submit the annual9
	278	+	hospital expenditure TRANSPARENCY report to:10
	279	+	(I) The public health care and human services committee of the11
	280	+	house of representatives HEALTH AND INSURANCE COMMITTEE AND THE12
	281	+	HOUSE OF REPRESENTATIVES PUBLIC AND BEHAVIORAL HEALTH AND13
	282	+	HUMAN SERVICES COMMITTEE , or any successor committee;14
	283	+	(b) The state department may request that the enterprise board15
	284	+	combine the hospital expenditure TRANSPARENCY report described in this16
	285	+	section with the report of the enterprise board specified in section17
	286	+	25.5-4-402.4 (7)(e), so long as the specific requirements of this section18
	287	+	are fulfilled, and so long as the enterprise board agrees to the request. The19
	288	+	state department shall post the annual report on its website by January 1520
	289	+	of each year.21
	290	+	(4.5) THE STATE DEPARTMENT SHALL REPORT ON THE ANNUAL22
	291	+	HOSPITAL TRANSPARENCY REPORT DURING THE STATE DEPARTMENT'S23
	292	+	"SMART ACT" HEARING.24
	293	+	SECTION 2. In Colorado Revised Statutes, add 25.5-4-427 as25
	294	+	follows:26
	295	+	25.5-4-427. Hospital and provider billing requirements -27
	296	+	1226
	297	+	-9- description of service provided - rules. (1) B EGINNING JULY 1, 2024,1
	298	+	ANY PATIENT BILL FOR SERVICES RENDERED MUST FOLLOW INDUSTRY2
	299	+	STANDARD BILLING PRACTICES, INCLUDING, AT A MINIMUM, THE DATE OF3
	300	+	SERVICE, THE PATIENT'S NAME, THE PROVIDER'S NAME, A DESCRIPTION OF4
	301	+	THE SERVICES PROVIDED, AND THE CHARGES FOR EACH SERVICE .5
	302	+	SECTION 3. Appropriation. (1) For the 2023-24 state fiscal6
	303	+	year, $75,167 is appropriated to the department of health care policy and7
	304	+	financing for use by the executive director's office. This appropriation is8
	305	+	from the healthcare affordability and sustainability fee cash fund created9
	306	+	in Section 25.5-4-402.4 (5)(a), C.R.S. To implement this act, the office10
	307	+	may use this appropriation as follows:11
	308	+	(a) $67,349 for personal services, which amount is based on an12
	309	+	assumption that the office will require an additional 1.7 FTE; and13
	310	+	(b) $7,818 for operating expenses.14
	311	+	(2) For the 2023-24 state fiscal year, the general assembly15
	312	+	anticipates that the department of health care policy and financing will16
	313	+	receive $75,165 in federal funds to implement this act, which amount is17
	314	+	subject to the "(I)" notation as defined in the annual general appropriation18
	315	+	act for the same fiscal year. The appropriation in subsection (1) of this19
	316	+	section is based on the assumption that the department will receive this20
	317	+	amount of federal funds to be used as follows:21
	318	+	(a) $67,348 for personal services; and22
	319	+	(b) $7,817 for operating expenses.23
	320	+	SECTION 4. Act subject to petition - effective date. This act24
	321	+	takes effect at 12:01 a.m. on the day following the expiration of the25
	322	+	ninety-day period after final adjournment of the general assembly; except26
	323	+	that, if a referendum petition is filed pursuant to section 1 (3) of article V27
	324	+	1226
	325	+	-10- of the state constitution against this act or an item, section, or part of this1
	326	+	act within such period, then the act, item, section, or part will not take2
	327	+	effect unless approved by the people at the general election to be held in3
	328	+	November 2024 and, in such case, will take effect on the date of the4
	329	+	official declaration of the vote thereon by the governor.5
	330	+	1226
	331	+	-11-