Page 1 April 11, 2023 SB 23-252 Legislative Council Staff Nonpartisan Services for Colorado’s Legislature Fiscal Note Drafting Number: Prime Sponsors: LLS 23-0554 Sen. Van Winkle; Gonzales Rep. Daugherty; Hartsook Date: Bill Status: Fiscal Analyst: April 11, 2023 Senate Health & Human Services Kristine McLaughlin | 303-866-4776 kristine.mclaughlin@coleg.gov Bill Topic: MEDICAL PRICE TRANSPARENCY Summary of Fiscal Impact: ☒ State Revenue ☒ State Expenditure ☐ State Transfer ☐ TABOR Refund ☒ Local Government ☐ Statutory Public Entity The bill places price disclosure requirements on hospitals. Failure to comply is a deceptive trade practice and subjects the hospital to corrective action. The bill minimally impacts state and local revenue and expenditures on an ongoing basis. Appropriation Summary: No appropriation is required. Fiscal Note Status: The fiscal note reflects the introduced bill. Summary of Legislation The bill requires hospitals to disclose standard charges for services. The Department of Health Care Policy and Financing (HCPF) must design the disclosure template, monitor hospitals for compliance, and take corrective action. Failure to comply is a deceptive trade practice. The bill also moves existing hospital transparency reporting requirements from the Department of Public Health and Environment (CDPHE) to HCPF. State Revenue The bill may increase state revenue from civil penalties and court filing fees by a minimal amount. Civil penalties. Under the Colorado Consumer Protection Act, a person committing a deceptive trade practice may be subject to a civil penalty of up to $20,000 for each violation. Additional penalties may be imposed for subsequent violations of a court order or injunction. This revenue is classified as a damage award and not subject to TABOR. Given the uncertainty about the number of cases that may be pursued by the Attorney General and district attorneys, as well as the wide range in potential penalty amounts, the fiscal note cannot estimate the potential impact of these civil penalties. Filing fees. The bill may increase revenue to the Judicial Department from an increase in civil case filings. Revenue from filing fees is subject to TABOR. Page 2 April 11, 2023 SB 23-252 State Expenditures The bill impacts workload in the Department of Health Care Policy and Financing, the Department of Law (DOL), the Judicial Department, and the CDPHE by a minimal amount. Department of Health Care Policy and Financing. Workload in HCPF will minimally increase to assume responsibilities previously under CDPHE, design the disclosure template, monitor hospitals for compliance, and take corrective action. This work is absorbable within current resources. Department of Law. Workload in the DOL will minimally increase to the extent that deceptive trade practice complaints are filed. The DOL will review complaints under the bill and prioritize investigations as necessary within the overall number of deceptive trade practice complaints and available resources. Judicial Department. The trial courts in the Judicial Department may have an increase in cases filed under the Colorado Consumer Protection Act from the addition of a new deceptive trade practice. It is assumed that impacted entities will abide by the law and that any violation of the legislation will result in minimal number of new cases. In addition, requirements for documents filed in legal proceedings related to medical debt may slightly streamline court workload. The fiscal note assumes that workload changes can be accomplished within existing resources and that no change in appropriations is required. Department of Public Health and Environment. Workload in CDPHE will minimally decrease as some of the department’s responsibilities transfer to HCPF. CDPHE did not receive an appropriation for these responsibilities, so no change in appropriations is required. Local Government Similar to the state, to the extent district attorneys receive deceptive trade practice complaints related to the new deceptive trade practice under the bill, workload will increase to investigate complaints and seek relief when appropriate. I t is assumed most such cases will be handled at the state level by the Attorney General. Effective Date The bill takes effect 90 days following adjournment of the General Assembly sine die, assuming no referendum petition is filed. State and Local Government Contacts Health Care Policy and Financing Higher Education Human Services Information Technology Law Public Health and Environment Regulatory Agencies The revenue and expenditure impacts in this fiscal note represent changes from current law under the bill for each fiscal year. For additional information about fiscal notes, please visit: leg.colorado.gov/fiscalnotes.