HOUSE BILL 23-1226
BY REPRESENTATIVE(S) Soper and deGruy Kennedy, Amabile,
Boesenecker, Brown, Dickson, Froelich, Gonzales-Gutierrez, Hamrick,
Jodeh, Kipp, Lieder, Lindsay, Lindstedt, McCormick, McLachlan, Ricks,
Sirota, Titone, Weissman, Willford, McCluskie;
also SENATOR(S) Roberts and Will, Bridges, Buckner, Cutter, Exum,
Fields, Hansen, Jaquez Lewis, Moreno, Priola, Fenberg.
C
ONCERNING TRANSPARENCY REQUIREMENTS FOR HOSPITALS , AND, IN
CONNECTION THEREWITH
, CREATING MORE TIMELY SUBMISSIONS OF
DATA
; PROVIDING INSIGHTS INTO TRANSFERS OF CASH AND PROFITS
AND RESERVES
, INCLUDING THOSE LEAVING COLORADO; REPORTING
ON ALL INFORMATION RECEIVED
; REPORTING INFORMATION BY EACH
HOSPITAL IN ADDITION TO HEALTH SYSTEMS
; DISCLOSING EXECUTIVE
COMPENSATION
, INCLUDING COMPENSATED INCENTIVES ; REPORTING
MERGERS AND ACQUISITIONS OF HOSPITALS AND PHYSICIANS
;
REPORTING INVESTMENTS IN CAPITAL EQUIPMENT AND
CONSTRUCTION
; AND MAKING AN APPROPRIATION .
Be it enacted by the General Assembly of the State of Colorado:
SECTION 1. In Colorado Revised Statutes, 25.5-4-402.8, amend
(2)(a), (2)(b) introductory portion, (2)(b)(II)(A), (2)(b)(III)(J),
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. (2)(b)(III)(M), (2)(c) introductory portion, (2)(e), (3) introductory portion,
(4)(a) introductory portion, (4)(a)(I), and (4)(b); repeal (2)(d); and add
(2)(b)(II)(D), (2)(b)(II)(E), (2)(b)(II)(F), (2)(b)(II)(G), (2)(b)(III)(O),
(2)(b)(III)(P), (2)(b)(III)(Q), (2)(b)(IV), (2)(b.5), (2)(g), and (4.5) as
follows:
25.5-4-402.8. Hospital transparency report - definitions.
(2) (a) The state department shall annually prepare a written hospital
expenditure
TRANSPARENCY report detailing uncompensated hospital costs,
INCLUDING UNCOMPENSATED CARE COSTS , and the different categories of
expenditures, by major payer group, made by hospitals in the state. The state
department shall
COORDINATE THE ANALYSIS, REVIEW, AND RELEASE OF THE
HOSPITAL TRANSPARENCY REPORT AND THE REPORTS REQUIRED PURSUANT
TO SECTION
25.5-1-703 (3) AND 25.5-4-402.4 (7)(e), INCLUDING THE
OPPORTUNITY TO REVIEW AND
consult with
ON THE REPORTS MADE BY the
Colorado healthcare affordability and sustainability enterprise board,
created pursuant to section 25.5-4-402.4 (7) and referred to in this section
as the "enterprise board". in developing the hospital expenditure report.
The
state department may share any information
AND ANALYTICS OF
INFORMATION THAT
it receives from hospitals with the enterprise board. The
state department may include information it receives from hospitals in
accordance with subsection (2)(b) of this section and that is not otherwise
publicly available in the expenditure
TRANSPARENCY report and share such
information with the enterprise board; except that information the state
department receives from hospitals in accordance with subsection
SUBSECTIONS (2)(b)(II)(D), (2)(b)(III)(N), (2)(b)(III)(O), (2)(b.5)(I), AND
(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
TRANSPARENCY report,
share with the enterprise board, or otherwise publish or distribute
information derived from reports pursuant to subsection
SUBSECTIONS
(2)(b)(II)(D), (2)(b)(III)(N), (2)(b)(III)(O), (2)(b.5)(I), AND (2)(b.5)(II) of
this section, although the state department may share this information if
such information has been de-identified and aggregated in a manner to
prevent identification of the transaction price of any individual acquisition
or affiliation. A hospital shall not be in violation of this section if the
hospital makes a good faith effort to comply with the reporting
requirements of this section.
(b) Except as provided in subsection (2)(c) of this section, each
PAGE 2-HOUSE BILL 23-1226 hospital licensed pursuant to part 1 of article 3 of title 25, or certified
pursuant to section 25-1.5-103 (1)(a)(II), shall make information available
to the state department for purposes of preparing the annual hospital
expenditure
TRANSPARENCY report. The state board shall establish the
format of the information provided by each hospital on an annual basis. The
first submission by each hospital must include the information described in
subsections (2)(b)(I) and (2)(b)(II) of this section for fiscal years 2011-12
through 2018-19 and the information described in subsection (2)(b)(III) of
this section for those fiscal years if such information is available. For each
subsequent submission, Each hospital shall provide the following
information to the state department:
(II) (A) An Annual audited financial statement STATEMENTS,
prepared in accordance with generally accepted accounting principles. Each
hospital shall submit the statement
STATEMENTS within one hundred twenty
days after the end of its fiscal year unless the state department grants an
extension in writing in advance of that date.
(D) A
N ANNUAL SUMMARY OF THE HOSPITAL 'S TRANSFERS OF CASH,
EQUITY, INVESTMENTS, OR OTHER ASSETS TO AND FROM RELATED PARTIES ,
INCLUDING BUT NOT LIMITED TO THE HOSPITAL 'S PARENT ORGANIZATION.
T
HE SUMMARY MUST INCLUDE THE PURPOSE OF THE TRANSFERS AND
WHETHER THE TRANSFERS WERE MADE WITHIN OR OUTSIDE OF
COLORADO.
A
HOSPITAL MAY AGGREGATE THE TRANSFERS FOR EACH ENTITY RECEIVING
OR MAKING THE TRANSFER
.
(E) A
HOSPITAL-SPECIFIC STATEMENT OF CASH FLOW WITHIN A TIME
FRAME SPECIFIED ANNUALLY BY THE STATE DEPARTMENT
, BUT NOT LESS
THAN ONE HUNDRED TWENTY DAYS AFTER THE HOSPITAL
'S FISCAL YEAR
END
.
(F) C
HANGES TO NO MORE THAN TWENTY -FIVE CATEGORIES OF
SPECIFIC MAJOR SERVICE LINES
, AS REQUESTED BY THE STATE DEPARTMENT .
(G) A
NARRATIVE REPORT OF MAJOR PLANNED AND COMPLETED
PROJECTS AND CAPITAL INVESTMENTS GREATER THAN TWENTY
-FIVE MILLION
DOLLARS
; EXCEPT THAT THE INFORMATION THE STATE DEPARTMENT
RECEIVES FROM HOSPITALS REGARDING PLANNED ACTIVITIES IS
CONFIDENTIAL
, PROPRIETARY, CONTAINS TRADE SECRETS, AND IS NOT A
PUBLIC RECORD PURSUANT TO PART
2 OF ARTICLE 72 OF TITLE 24.
PAGE 3-HOUSE BILL 23-1226 (III) A report that contains the following information:
(J) Other operating revenue, operating margin, nonoperating gains
and losses,
GROSS REVENUE, NET PROFIT, and total margin;
(M) A roll forward of property, plant, and equipment accounts by
asset type from the beginning to the end of the reporting period by asset
category, including, but not limited to, purchases, other acquisitions, sales,
disposals, and other changes; and
(O) INFORMATION ON CURRENT AFFILIATIONS AND A REPORT OF
PHYSICIAN PRACTICE ACQUISITIONS
;
(P) S
ALARY AND TOTAL COMPENSATION DATA OF THE TOP FIVE
HIGHEST PAID ADMINISTRATIVE POSITIONS OF EACH NONPROFIT HOSPITAL
,
INCLUDING THE TITLE , A BRIEF DESCRIPTION OF DUTIES , BASE
COMPENSATION
, INCENTIVE OR BONUS COMPENSATION , AND OTHER
COMPENSATION
. THE COMPENSATION REPORTED MUST INDICATE WHAT
PERFORMANCE MEASURES WERE INCLUDED IN THE CHIEF EXECUTIVE
OFFICER
'S PERFORMANCE EVALUATION GENERATED BY THE HOSPITAL 'S
GOVERNING BOARD
, INCLUDING, AT A MINIMUM , QUALITY OF CARE
OUTCOMES PERFORMANCE
; PATIENT SATISFACTION PERFORMANCE ;
COMMUNITY BENEFIT PERFORMANCE ; CONSUMER AND EMPLOYER
AFFORDABILITY PERFORMANCE
; MARKET SHARE PERFORMANCE ; PROFITS OR
MARGINS
; REVENUE GROWTH; CHANGE IN DAYS CASH ON HAND OR CASH
RESERVES
; AND WORKFORCE . THE STATE DEPARTMENT MAY INCLUDE
INFORMATION IT RECEIVES FROM PUBLIC HOSPITALS PURSUANT TO THIS
SUBSECTION
(2)(b)(III)(P) THAT IS NOT OTHERWISE PUBLICLY AVAILABLE IN
THE HOSPITAL TRANSPARENCY REPORT
; EXCEPT THAT INFORMATION THE
STATE DEPARTMENT RECEIVES FROM A NONPROFIT HOSPITAL IS NOT A PUBLIC
RECORD PURSUANT TO PART
2 OF ARTICLE 72 OF TITLE 24. THE STATE
DEPARTMENT MAY ONLY REPORT INFORMATION RECEIVED PURSUANT TO
THIS SUBSECTION
(2)(b)(III)(P) IN AN AGGREGATED FORMAT THAT DOES NOT
NAME INDIVIDUAL HOSPITALS OR ADMINISTRATORS
.
(Q) I
N A FORM AND MANNER SPECIFIED BY THE STATE DEPARTMENT ,
DETAILS OF SIGNIFICANT OTHER REVENUE THAT WOULD OTHERWISE BE
REPORTED IN THE MEDICARE COST REPORT
.
(IV) (A) A
QUARTERLY FINANCIAL REPORT THAT INCLUDES AN
PAGE 4-HOUSE BILL 23-1226 INCOME STATEMENT AND BALANCE SHEET . IF A HOSPITAL IS OWNED OR
AFFILIATED WITH A HEALTH SYSTEM THAT IS COMPRISED OF THREE OR MORE
HOSPITALS OR THAT HAS MORE THAN ONE BILLION DOLLARS IN RESERVES
,
THE HEALTH SYSTEM MAY SUBMIT A CONSOLIDATED QUARTERLY FINANCIAL
REPORT
.
(B) A
NY QUARTERLY FINANCIAL REPORT MADE PUBLICLY AVAILABLE
MUST CLEARLY STATE THAT THE QUARTERLY FINANCIAL REPORT IS
UNAUDITED
, IF APPLICABLE. THE STATE DEPARTMENT SHALL PROVIDE ANY
ANALYSIS
, REPORT, OR PRESENTATION BASED ON THE QUARTERLY FINANCIAL
REPORT TO EACH HOSPITAL AT LEAS T FIFTEEN DAYS PRIOR TO THE PUBLIC
RELEASE OF THE ANALYSIS
, REPORT, OR PRESENTATION.
(b.5) N
O LATER THAN JULY 1, 2024, EACH HOSPITAL SHALL PROVIDE
THE FOLLOWING INFORMATION TO THE STATE DEPARTMENT
:
(I) F
OR EACH FISCAL YEAR 2014-15 THROUGH 2019-20, A SUMMARY
OF THE HOSPITAL
'S TRANSFERS OF CASH, EQUITY, INVESTMENTS, OR OTHER
ASSETS TO AND FROM RELATED PARTIES
, INCLUDING BUT NOT LIMITED TO
THE HOSPITAL
'S PARENT ORGANIZATION. THE SUMMARY MUST INCLUDE THE
PURPOSE OF THE TRANSFERS AND WHETHER THE TRANSFERS WERE MADE
WITHIN OR OUTSIDE OF
COLORADO. A HOSPITAL MAY AGGREGATE THE
TRANSFERS FOR EACH ENTITY RECEIVING OR MAKING THE TRANSFER
.
(II) F
OR EACH FISCAL YEAR FROM 2014-15 THROUGH 2019-20,
INFORMATION ON AFFILIATIONS AND A REPORT OF PHYSICIAN PRACTICE
ACQUISITIONS
; AND
(III) FOR EACH FISCAL YEAR FROM 2019-20 THROUGH 2022-23, IN A
FORM AND MANNER SPECIFIED BY THE STATE DEPARTMENT
, DETAILS OF
SIGNIFICANT OTHER REVENUE THAT WOULD OTHERWISE BE REPORTED IN THE
MEDICARE COST REPORT
.
(c) The state department may exempt from the
CERTAIN reporting
requirements described in subsection SUBSECTIONS (2)(b) AND (2)(b.5) of
this section certain types of hospitals, including but not limited to:
(d) Prior to developing the first annual hospital expenditure report,
the state department shall consult with the enterprise board regarding the
development of the report. The state department shall strive for consistency
PAGE 5-HOUSE BILL 23-1226 in reporting the components in each annual report with those in the report
of the enterprise board required pursuant to section 25.5-4-402.4 (7)(e).
(e) Prior to issuing the hospital expenditure TRANSPARENCY report,
the state department shall provide any hospital referenced in the hospital
expenditure
TRANSPARENCY report a copy of the report. Each hospital shall
MUST have a minimum of fifteen days to review the hospital expenditure
TRANSPARENCY report and any underlying data and submit corrections or
clarifications to the state department.
(g) (I) I
F A HOSPITAL DOES NOT PROVIDE ALL OF THE INFORMATION
REQUIRED PURSUANT TO SUBSECTION
(2)(b) OF THIS SECTION, THE STATE
DEPARTMENT SHALL INFORM THE HOSPITAL OF ITS NONCOMPLIANCE WITHIN
SIXTY DAYS AND IDENTIFY THE INFORMATION THAT NEEDS TO BE PROVIDED
.
I
F A HOSPITAL DOES NOT COMPLY, THE STATE DEPARTMENT SHALL ISSUE A
CORRECTIVE ACTION PLAN WITH A TIMELINE OF SIXTY DAYS REQUIRED FOR
COMPLIANCE
. IF A HOSPITAL CONTINUES TO NOT COMPLY , THE STATE
DEPARTMENT MAY CREATE A MANDATORY PAY
-FOR-REPORTING
COMPLIANCE MEASURE WITHIN THE HOSPITAL TRANSFORMATION PROGRAM
THAT IS TIED TO THE HEALTHCARE AFFORDABILITY AND SUSTAINABILITY FEE
SUPPLEMENTAL PAYMENT AND IS BASED ON COMPLIANCE WITH SUBSECTION
(2)(b) OF THIS SECTION.
(II) I
F THE STATE DEPARTMENT DETERMINES A HOSPITAL 'S
NONCOMPLIANCE WITH THIS SECTION IS KNOWING OR WILLFUL OR THERE IS
A REPEATED PATTERN OF NONCOMPLIANCE
, THE STATE DEPARTMENT SHALL
CONSIDER THE SIZE OF THE HOSPITAL AND THE SERIOUSNESS OF THE
VIOLATION IN SETTING A FINE AMOUNT WHICH
, FOR HOSPITALS OWNED OR
AFFILIATED WITH A HOSPITAL SYSTEM COMPRISED OF THREE OR MORE
HOSPITALS
, MUST NOT EXCEED TWENTY THOUSAND DOLLARS PER VIOLATION
PER WEEK UNTIL THE HOSPITAL TAKES CORRECTIVE AND
, FOR ALL OTHER
HOSPITALS
, MUST NOT EXCEED FIVE THOUSAND DOLLARS PER WEEK UNTIL
THE HOSPITAL TAKES CORRECTIVE ACTION
.
(3) The hospital expenditure
TRANSPARENCY report must include,
but not be limited to:
(4) (a) On or before January 15, 2020, and on or before January 15
each year thereafter, the state department shall submit the annual hospital
expenditure
TRANSPARENCY report to:
PAGE 6-HOUSE BILL 23-1226 (I) The public health care and human services committee of the
house of representatives HEALTH AND INSURANCE COMMITTEE AND THE
HOUSE OF REPRESENTATIVES PUBLIC AND BEHAVIORAL HEALTH AND HUMAN
SERVICES COMMITTEE
, or any successor committee;
(b) The state department may request that the enterprise board
combine the hospital expenditure
TRANSPARENCY report described in this
section with the report of the enterprise board specified in section
25.5-4-402.4 (7)(e), so long as the specific requirements of this section are
fulfilled, and so long as the enterprise board agrees to the request. The state
department shall post the annual report on its website by January 15 of each
year.
(4.5) T
HE STATE DEPARTMENT SHALL REPORT ON THE ANNUAL
HOSPITAL TRANSPARENCY REPORT DURING THE STATE DEPARTMENT
'S
"SMART ACT" HEARING.
SECTION 2. In Colorado Revised Statutes, add 25.5-4-429 as
follows:
25.5-4-429. Hospital and provider billing requirements -
description of service provided - rules. (1) B
EGINNING JULY 1, 2024, ANY
PATIENT BILL FOR SERVICES RENDERED MUST FOLLOW INDUSTRY STANDARD
BILLING PRACTICES
, INCLUDING, AT A MINIMUM, THE DATE OF SERVICE, THE
PATIENT
'S NAME, THE PROVIDER'S NAME, A DESCRIPTION OF THE SERVICES
PROVIDED
, AND THE CHARGES FOR EACH SERVICE .
SECTION 3. Appropriation. (1) For the 2023-24 state fiscal year,
$75,167 is appropriated to the department of health care policy and
financing for use by the executive director's office. This appropriation is
from the healthcare affordability and sustainability fee cash fund created in
Section 25.5-4-402.4 (5)(a), C.R.S. To implement this act, the office may
use this appropriation as follows:
(a) $67,349 for personal services, which amount is based on an
assumption that the office will require an additional 1.7 FTE; and
(b) $7,818 for operating expenses.
(2) For the 2023-24 state fiscal year, the general assembly
PAGE 7-HOUSE BILL 23-1226 anticipates that the department of health care policy and financing will
receive $75,165 in federal funds to implement this act, which amount is
subject to the "(I)" notation as defined in the annual general appropriation
act for the same fiscal year. The appropriation in subsection (1) of this
section is based on the assumption that the department will receive this
amount of federal funds to be used as follows:
(a) $67,348 for personal services; and
(b) $7,817 for operating expenses.
SECTION 4. 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 23-1226 November 2024 and, in such case, will take effect on the date of the official
declaration of the vote thereon by the governor.
____________________________ ____________________________
Julie McCluskie 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 23-1226