Colorado 2023 Regular Session

Colorado Senate Bill SB252 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	+	REVISED
	5	+	This Version Includes All Amendments Adopted
	6	+	on Second Reading in the Second House
	7	+	LLS NO. 23-0554.04 Kristen Forrestal x4217
1	8		SENATE BILL 23-252
2		-	BY SENATOR(S) Van Winkle and Gonzales, Buckner, Coleman, Cutter,
3		-	Danielson, Exum, Fields, Hansen, Jaquez Lewis, Marchman, Moreno,
4		-	Priola, Rodriguez;
5		-	also REPRESENTATIVE(S) Daugherty and Hartsook, Amabile, Bacon,
6		-	Boesenecker, Bradley, Brown, Dickson, English, Froelich, Garcia,
7		-	Gonzales-Gutierrez, Hamrick, Herod, Jodeh, Joseph, Kipp, Lieder, Lindsay,
8		-	Lindstedt, Lukens, Lynch, Mabrey, Marshall, Martinez, Mauro,
9		-	McCormick, McLachlan, Michaelson Jenet, Ortiz, Ricks, Sharbini, Sirota,
10		-	Snyder, Soper, Titone, Valdez, Weissman, Woodrow, McCluskie.
	9	+	Senate Committees House Committees
	10	+	Health & Human Services Public & Behavioral Health & Human Services
	11	+	A BILL FOR AN ACT
11	12		C
12		-	ONCERNING HOSPITAL MEDICAL PRICE TRANSPARENCY .
13		-
14		-	Be it enacted by the General Assembly of the State of Colorado:
15		-	SECTION 1. In Colorado Revised Statutes, 6-1-105, add (1)(bbbb)
16		-	as follows:
17		-	6-1-105. Unfair or deceptive trade practices. (1) A person
18		-	engages in a deceptive trade practice when, in the course of the person's
19		-	business, vocation, or occupation, the person:
20		-	(bbbb) V
21		-	IOLATES SECTION 25.5-1-904.
22		-	NOTE: This bill has been prepared for the signatures of the appropriate legislative
23		-	officers and the Governor. To determine whether the Governor has signed the bill
24		-	or taken other action on it, please consult the legislative status sheet, the legislative
25		-	history, or the Session Laws.
26		-	________
27		-	Capital letters or bold & italic numbers indicate new material added to existing law; dashes
28		-	through words or numbers indicate deletions from existing law and such material is not part of
29		-	the act. SECTION 2. Repeal of provisions being relocated in this act. In
30		-	Colorado Revised Statutes, repeal part 8 of article 3 of title 25.
31		-	SECTION 3. In Colorado Revised Statutes, add with amended
32		-	and relocated provisions part 9 to article 1 of title 25.5 as follows:
33		-	PART 9
34		-	HOSPITAL PRICE TRANSPARENCY
35		-	25.5-1-901. [Formerly 25-3-801] Legislative declaration. (1) The
36		-	general assembly finds and declares that:
37		-	(a) Section 1001 of the "Patient Protection and Affordable Care
38		-	Act", of 2010", Pub.L. 111-148, as amended by section 10101 of the
39		-	"Health Care and Education Reconciliation Act of 2010", Pub.L. 111-152,
40		-	amended Title XXVII of the "Public Health Service Act", Pub.L. 78-410,
41		-	in part, by adding a new section 2718 (e), requiring, in part, that each
42		-	hospital operating within the United States establish, update, and make
43		-	public a list of the hospital's standard charges for the items and services that
44		-	the hospital provides;
45		-	(b) Effective January 1, 2021, the federal centers for medicare and
46		-	medicaid services published the final rule to implement the law, codified at
47		-	45 CFR 180;
48		-	(c) In its summary of the final rule, CMS states that information on
49		-	hospital standard charges is necessary for the public to "make more
50		-	informed decisions about their care" and that the "impact of these final
51		-	policies will help to increase market competition, and ultimately drive down
52		-	the cost of health care services, making them more affordable for all
53		-	patients";
54		-	(d) On July 9, 2021, President Biden, building upon efforts of past
55		-	presidents, issued the "Executive Order on Promoting Competition in the
56		-	American Economy", directing the secretary of the United States
57		-	department of health and human services to support new and existing price
58		-	transparency initiatives for hospitals;
59		-	(e) Health-care price transparency is in the best interest of all
60		-	PAGE 2-SENATE BILL 23-252 Coloradans, including:
61		-	(I) The state government, which purchases health-care services for
62		-	almost a quarter ONE-FOURTH of all Coloradans;
63		-	(II) Colorado businesses, which fund employee medical expenses;
64		-	and
65		-	(III) Colorado residents, who ultimately bear the brunt of high
66		-	health-care costs in the form of higher taxes, lower wages, and residents'
67		-	own out-of-pocket spending;
68		-	(f) Moreover, health-care prices in Colorado are among the highest
69		-	in the nation;
70		-	(g) However, not all Colorado hospitals are in compliance with all
71		-	of the disclosure requirements under federal law and other state laws
72		-	governing health-care price transparency; and
73		-	(h) This lack of compliance with health-care price transparency laws
74		-	by Colorado hospitals decreases the likelihood that Colorado consumers
75		-	will be fully aware of affordable health-care options before purchasing
76		-	items and services from hospitals, placing health-care consumers at greater
77		-	risk of collection actions and other adverse actions relating to unpaid
78		-	medical bills.
79		-	(2) Therefore, the general assembly finds and declares that it is
80		-	imperative to protect Colorado health-care consumers from collection
81		-	actions and other adverse actions taken by Colorado hospitals during the
82		-	time when the hospital was not in material compliance with hospital price
83		-	transparency laws intended to protect health-care consumers.
84		-	25.5-1-902. [Formerly 25-3-802] Definitions. As used in this
85		-	section
86		-	PART 9, unless the context otherwise requires:
87		-	(1) "Collection action" means any of the following actions taken
88		-	with respect to a debt for items and services that were purchased from or
89		-	provided to a patient by a hospital on a date during which the hospital was
90		-	not in material compliance with hospital price transparency laws:
91		-	PAGE 3-SENATE BILL 23-252 (a) Attempting to collect a debt from a patient or patient guarantor
92		-	by referring the debt, directly or indirectly, to a debt collector, a collection
93		-	agency, or other third party retained by or on behalf of the hospital;
94		-	(b) Suing the patient or patient guarantor or enforcing an arbitration
95		-	or mediation clause in any hospital documents, including contracts,
96		-	agreements, statements, or bills; or
97		-	(c) Directly or indirectly causing a report to be made to a consumer
98		-	reporting agency.
99		-	(2) (a) "Collection agency" means any:
100		-	(I) Person who engages in a business, the principal purpose of which
101		-	is the collection of debts; or
102		-	(II) Person who:
103		-	(A) Regularly collects or attempts to collect, directly or indirectly,
104		-	debts owed or due or asserted to be owed or due to another;
105		-	(B) Takes assignment of debts for collection purposes;
106		-	(C) Directly or indirectly solicits for collection debts owed or due
107		-	or asserted to be owed or due to another; or
108		-	(D) Collects debt for the department of personnel.
109		-	(b) "Collection agency" does not include:
110		-	(I) Any officer or employee of a creditor while, in the name of the
111		-	creditor, collecting debts for such creditor;
112		-	(II) Any person while acting as a collection agency for another
113		-	person, both of whom are related by common ownership or affiliated by
114		-	corporate control, if the person acting as a collection agency does so only
115		-	for creditors to whom it is so related or affiliated and if the principal
116		-	business of the person is not the collection of debts;
117		-	(III) Any officer or employee of the United States or any state to the
118		-	PAGE 4-SENATE BILL 23-252 extent that collecting or attempting to collect any debt is in the performance
119		-	of the officer's or employee's official duties;
120		-	(IV) Any person while serving or attempting to serve legal process
121		-	on any other person in connection with the judicial enforcement of any debt;
122		-	(V) Any debt-management services provider operating in
123		-	compliance with or exempt from the "Uniform Debt-Management Services
124		-	Act", part 2 of article 19 of title 5;
125		-	(VI) Any person collecting or attempting to collect any debt owed
126		-	or due or asserted to be owed or due another to the extent that:
127		-	(A) The activity is incidental to a bona fide fiduciary obligation or
128		-	a bona fide escrow arrangement;
129		-	(B) The activity concerns a debt that was extended by the person;
130		-	(C) The activity concerns a debt that was not in default at the time
131		-	it was obtained by the person; or
132		-	(D) The activity concerns a debt obtained by the person as a secured
133		-	party in a commercial credit transaction involving the creditor;
134		-	(VII) Any person whose principal business is the making of loans
135		-	or the servicing of debt not in default and who acts as a loan correspondent,
136		-	seller and servicer for the owner, or holder of a debt that is secured by a
137		-	deed of trust on real property, whether or not the debt is also secured by an
138		-	interest in personal property;
139		-	(VIII) A limited gaming or racing licensee acting pursuant to article
140		-	33 of title 44.
141		-	(c) Notwithstanding the provisions of subsection (2)(b) of this
142		-	section, "collection agency" includes any person who, in the process of
143		-	collecting the person's own debts, uses another name that would indicate
144		-	that a third person is collecting or attempting to collect such debts.
145		-	(3) (a) "Consumer reporting agency" means any person that, for
146		-	monetary fees or dues or on a cooperative nonprofit basis, regularly
147		-	PAGE 5-SENATE BILL 23-252 engages, in whole or in part, in the practice of assembling or evaluating
148		-	consumer credit information or other information on consumers for the
149		-	purpose of furnishing consumer reports to third parties. "Consumer
150		-	reporting agency" includes any person defined in 15 U.S.C. sec. 1681a (f)
151		-	or section 5-18-103 (4).
152		-	(b) "Consumer reporting agency" does not include any business
153		-	entity that provides check verification or check guarantee services only.
154		-	(4) (a) "Debt" means any obligation or alleged obligation of a
155		-	consumer to pay money arising out of a transaction, whether or not the
156		-	obligation has been reduced to judgment.
157		-	(b) "Debt" does not include a debt for business, investment,
158		-	commercial, or agricultural purposes or a debt incurred by a business.
159		-	(5) "Debt collector" means any person employed or engaged by a
160		-	collection agency to perform the collection of debts owed or due or asserted
161		-	to be owed or due to another.
162		-	(6) "Federal centers for medicare and medicaid services" or "CMS"
163		-	means the centers for medicare and medicaid services in the United States
164		-	department of health and human services.
165		-	(7) "Hospital" means, consistent with 45 CFR 180.20, a hospital:
	13	+	ONCERNING HOSPITAL MEDICAL PRICE TRANSPARENCY .101
	14	+	Bill Summary
	15	+	(Note: This summary applies to this bill as introduced and does
	16	+	not reflect any amendments that may be subsequently adopted. If this bill
	17	+	passes third reading in the house of introduction, a bill summary that
	18	+	applies to the reengrossed version of this bill will be available at
	19	+	http://leg.colorado.gov
	20	+	.)
	21	+	The bill requires hospitals to make public a list of all standard
	22	+	charges for all hospital items and services provided to patients. The
	23	+	standard charges include the gross billed charge, the payer-specific
	24	+	negotiated charge, the minimum and maximum negotiated charges, and
	25	+	the discounted cash price. The bill also requires each hospital to maintain
	26	+	and make public a list of at least 300 shoppable services provided by the
	27	+	hospital or, if the hospital does not provide 300 shoppable services, all of
	28	+	the hospital's shoppable services. Each hospital is required to report its
	29	+	HOUSE
	30	+	2nd Reading Unamended
	31	+	May 6, 2023
	32	+	SENATE
	33	+	Amended 3rd Reading
	34	+	May 6, 2023
	35	+	SENATE
	36	+	Amended 2nd Reading
	37	+	April 18, 2023
	38	+	SENATE SPONSORSHIP
	39	+	Van Winkle and Gonzales,
	40	+	HOUSE SPONSORSHIP
	41	+	Daugherty and Hartsook,
	42	+	Shading denotes HOUSE amendment. Double underlining denotes SENATE amendment.
	43	+	Capital letters or bold & italic numbers indicate new material to be added to existing law.
	44	+	Dashes through the words or numbers indicate deletions from existing law. updated lists to the department of health care policy and financing (state
	45	+	department).
	46	+	The bill requires the state department to monitor hospital
	47	+	compliance with the price transparency requirements. If the state
	48	+	department determines that a hospital is not in compliance, the state
	49	+	department is required to issue a written notice to the hospital and require
	50	+	the hospital to submit a corrective action plan.
	51	+	The bill repeals sections of statute regarding hospital price
	52	+	transparency and debt collection that are currently under the
	53	+	administration and authority of the department of public health and
	54	+	environment and relocates these sections so that hospital price
	55	+	transparency and debt collection are under the state department.
	56	+	The bill makes a violation of the hospital transparency
	57	+	requirements outlined in the bill a deceptive trade practice under the
	58	+	"Colorado Consumer Protection Act".
	59	+	Be it enacted by the General Assembly of the State of Colorado:1
	60	+	SECTION 1. In Colorado Revised Statutes, 6-1-105, add2
	61	+	(1)(uuu) as follows:3
	62	+	6-1-105. Unfair or deceptive trade practices. (1) A person4
	63	+	engages in a deceptive trade practice when, in the course of the person's5
	64	+	business, vocation, or occupation, the person:6
	65	+	(uuu) V
	66	+	IOLATES SECTION 25.5-1-904.7
	67	+	SECTION 2. Repeal of provisions being relocated in this act.8
	68	+	In Colorado Revised Statutes, repeal part 8 of article 3 of title 25.9
	69	+	SECTION 3. In Colorado Revised Statutes, add with amended10
	70	+	and relocated provisions part 9 to article 1 of title 25.5 as follows:11
	71	+	PART 912
	72	+	HOSPITAL PRICE TRANSPARENCY13
	73	+	25.5-1-901. [Formerly 25-3-801] Legislative declaration.14
	74	+	(1) The general assembly finds and declares that:15
	75	+	(a) Section 1001 of the "Patient Protection and Affordable Care16
	76	+	Act", of 2010",
	77	+	Pub.L. 111-148, as amended by section 10101 of the17
	78	+	252-2- "Health Care and Education Reconciliation Act of 2010", Pub.L.1
	79	+	111-152, amended Title XXVII of the "Public Health Service Act",2
	80	+	Pub.L. 78-410, in part, by adding a new section 2718 (e), requiring, in3
	81	+	part, that each hospital operating within the United States establish,4
	82	+	update, and make public a list of the hospital's standard charges for the5
	83	+	items and services that the hospital provides;6
	84	+	(b) Effective January 1, 2021, the federal centers for medicare and7
	85	+	medicaid services published the final rule to implement the law, codified8
	86	+	at 45 CFR 180;9
	87	+	(c) In its summary of the final rule, CMS states that information10
	88	+	on hospital standard charges is necessary for the public to "make more11
	89	+	informed decisions about their care" and that the "impact of these final12
	90	+	policies will help to increase market competition, and ultimately drive13
	91	+	down the cost of health care services, making them more affordable for14
	92	+	all patients";15
	93	+	(d) On July 9, 2021, President Biden, building upon efforts of past16
	94	+	presidents, issued the "Executive Order on Promoting Competition in the17
	95	+	American Economy", directing the secretary of the United States18
	96	+	department of health and human services to support new and existing19
	97	+	price transparency initiatives for hospitals;20
	98	+	(e) Health-care price transparency is in the best interest of all21
	99	+	Coloradans, including:22
	100	+	(I) The state government, which purchases health-care services for23
	101	+	almost a quarter ONE-FOURTH of all Coloradans;24
	102	+	(II) Colorado businesses, which fund employee medical expenses;25
	103	+	and26
	104	+	(III) Colorado residents, who ultimately bear the brunt of high27
	105	+	252
	106	+	-3- health-care costs in the form of higher taxes, lower wages, and residents'1
	107	+	own out-of-pocket spending;2
	108	+	(f) Moreover, health-care prices in Colorado are among the3
	109	+	highest in the nation;4
	110	+	(g) However, not all Colorado hospitals are in compliance with all5
	111	+	of the disclosure requirements under federal law and other state laws6
	112	+	governing health-care price transparency; and7
	113	+	(h) This lack of compliance with health-care price transparency8
	114	+	laws by Colorado hospitals decreases the likelihood that Colorado9
	115	+	consumers will be fully aware of affordable health-care options before10
	116	+	purchasing items and services from hospitals, placing health-care11
	117	+	consumers at greater risk of collection actions and other adverse actions12
	118	+	relating to unpaid medical bills.13
	119	+	(2) Therefore, the general assembly finds and declares that it is14
	120	+	imperative to protect Colorado health-care consumers from collection15
	121	+	actions and other adverse actions taken by Colorado hospitals during the16
	122	+	time when the hospital was not in material compliance with hospital price17
	123	+	transparency laws intended to protect health-care consumers.18
	124	+	25.5-1-902. [Formerly 25-3-802] Definitions. As used in this19
	125	+	section PART 9, unless the context otherwise requires:20
	126	+	21
	127	+	(1) "Collection action" means any of the following actions taken22
	128	+	with respect to a debt for items and services that were purchased from or23
	129	+	provided to a patient by a hospital on a date during which the hospital was24
	130	+	not in material compliance with hospital price transparency laws:25
	131	+	(a) Attempting to collect a debt from a patient or patient guarantor26
	132	+	by referring the debt, directly or indirectly, to a debt collector, a collection27
	133	+	252
	134	+	-4- agency, or other third party retained by or on behalf of the hospital;1
	135	+	(b) Suing the patient or patient guarantor or enforcing an2
	136	+	arbitration or mediation clause in any hospital documents, including3
	137	+	contracts, agreements, statements, or bills; or4
	138	+	(c) Directly or indirectly causing a report to be made to a5
	139	+	consumer reporting agency.6
	140	+	(2) (a) "Collection agency" means any:7
	141	+	(I) Person who engages in a business, the principal purpose of8
	142	+	which is the collection of debts; or9
	143	+	(II) Person who:10
	144	+	(A) Regularly collects or attempts to collect, directly or indirectly,11
	145	+	debts owed or due or asserted to be owed or due to another;12
	146	+	(B) Takes assignment of debts for collection purposes;13
	147	+	(C) Directly or indirectly solicits for collection debts owed or due14
	148	+	or asserted to be owed or due to another; or15
	149	+	(D) Collects debt for the department of personnel.16
	150	+	(b) "Collection agency" does not include:17
	151	+	(I) Any officer or employee of a creditor while, in the name of the18
	152	+	creditor, collecting debts for such creditor;19
	153	+	(II) Any person while acting as a collection agency for another20
	154	+	person, both of whom are related by common ownership or affiliated by21
	155	+	corporate control, if the person acting as a collection agency does so only22
	156	+	for creditors to whom it is so related or affiliated and if the principal23
	157	+	business of the person is not the collection of debts;24
	158	+	(III) Any officer or employee of the United States or any state to25
	159	+	the extent that collecting or attempting to collect any debt is in the26
	160	+	performance of the officer's or employee's official duties;27
	161	+	252
	162	+	-5- (IV) Any person while serving or attempting to serve legal process1
	163	+	on any other person in connection with the judicial enforcement of any2
	164	+	debt;3
	165	+	(V) Any debt-management services provider operating in4
	166	+	compliance with or exempt from the "Uniform Debt-Management5
	167	+	Services Act", part 2 of article 19 of title 5;6
	168	+	(VI) Any person collecting or attempting to collect any debt owed7
	169	+	or due or asserted to be owed or due another to the extent that:8
	170	+	(A) The activity is incidental to a bona fide fiduciary obligation9
	171	+	or a bona fide escrow arrangement;10
	172	+	(B) The activity concerns a debt that was extended by the person;11
	173	+	(C) The activity concerns a debt that was not in default at the time12
	174	+	it was obtained by the person; or13
	175	+	(D) The activity concerns a debt obtained by the person as a14
	176	+	secured party in a commercial credit transaction involving the creditor;15
	177	+	(VII) Any person whose principal business is the making of loans16
	178	+	or the servicing of debt not in default and who acts as a loan17
	179	+	correspondent, seller and servicer for the owner, or holder of a debt that18
	180	+	is secured by a deed of trust on real property, whether or not the debt is19
	181	+	also secured by an interest in personal property;20
	182	+	(VIII) A limited gaming or racing licensee acting pursuant to21
	183	+	article 33 of title 44.22
	184	+	(c) Notwithstanding the provisions of subsection (2)(b) (5)(b) of23
	185	+	this section, "collection agency" includes any person who, in the process24
	186	+	of collecting the person's own debts, uses another name that would25
	187	+	indicate that a third person is collecting or attempting to collect such26
	188	+	debts.27
	189	+	252
	190	+	-6- (3) (a) "Consumer reporting agency" means any person that, for1
	191	+	monetary fees or dues or on a cooperative nonprofit basis, regularly2
	192	+	engages, in whole or in part, in the practice of assembling or evaluating3
	193	+	consumer credit information or other information on consumers for the4
	194	+	purpose of furnishing consumer reports to third parties. "Consumer5
	195	+	reporting agency" includes any person defined in 15 U.S.C. sec. 1681a (f)6
	196	+	or section 5-18-103 (4).7
	197	+	(b) "Consumer reporting agency" does not include any business8
	198	+	entity that provides check verification or check guarantee services only.9
	199	+	10
	200	+	(4) (a) "Debt" means any obligation or alleged obligation of a11
	201	+	consumer to pay money arising out of a transaction, whether or not the12
	202	+	obligation has been reduced to judgment.13
	203	+	(b) "Debt" does not include a debt for business, investment,14
	204	+	commercial, or agricultural purposes or a debt incurred by a business.15
	205	+	(5) "Debt collector" means any person employed or engaged by16
	206	+	a collection agency to perform the collection of debts owed or due or17
	207	+	asserted to be owed or due to another.18
	208	+	19
	209	+	(6) "Federal centers for medicare and medicaid services" or20
	210	+	"CMS" means the centers for medicare and medicaid services in the21
	211	+	United States department of health and human services.22
	212	+	23
	213	+	(7) "Hospital" means, consistent with 45 CFR 180.20, a hospital:24
166	214		(a) Licensed or certified by the department
167		-	OF PUBLIC HEALTH AND
168		-	ENVIRONMENT
169		-	pursuant to section 25-1.5-103 (1)(a); or
	215	+	OF PUBLIC HEALTH AND25
	216	+	ENVIRONMENT pursuant to section 25-1.5-103 (1)(a); or26
170	217		(b) Approved by the department
171		-	OF PUBLIC HEALTH AND
172		-	ENVIRONMENT
173		-	as meeting the standards established for licensing a hospital.
174		-	(8) "Hospital price transparency laws" means section 2718 (e) of the
175		-	"Public Health Service (PHS)
176		-	Act", Pub.L. 78-410, as amended, and rules
177		-	adopted by the United States department of health and human services
178		-	implementing section 2718 (e).
179		-	(9) "Items and services" or "items or services" means "items and
180		-	services" as defined in 45 CFR 180.20.
181		-	PAGE 6-SENATE BILL 23-252 25.5-1-903. [Formerly 25-3-803] Failure to comply with hospital
182		-	price transparency laws - prohibiting collection of debt - penalty.
183		-	(1) (a) Except as provided in subsection (1)(b) of this section, on and after
184		-	August 10, 2022, A hospital that is not in material compliance with hospital
185		-	price transparency laws on the date that items or services are purchased
186		-	from or provided to a patient by the hospital shall not initiate or pursue a
187		-	collection action against the patient or patient guarantor for a debt owed for
188		-	the items or services.
189		-	(b) This part 8 applies, on and after February 15, 2023, to critical
190		-	access hospitals licensed and certified by the department pursuant to 42
191		-	CFR 485 subpart F.
192		-	(2) If a patient believes that a hospital was not in material
193		-	compliance with hospital price transparency laws on a THE date on or after
194		-	August 10, 2022, that items or services were purchased by or provided to
195		-	the patient, and the hospital takes a collection action against the patient or
196		-	patient guarantor, the patient or patient guarantor may file suit to determine
197		-	if:
198		-	(a) The hospital was materially out of compliance with the
199		-	hospital
200		-	price transparency laws, and rules, and OR regulations on the date of service
201		-	THE ITEMS OR SERVICES WERE PROVIDED ; and if
202		-	(b) The noncompliance is related to the items or services. The
203		-	hospital shall not take a collection action against the patient or patient
204		-	guarantor while the lawsuit is pending.
205		-	(3) A hospital that has been found by
206		-	IF a judge or jury, considering
207		-	compliance standards issued by the federal centers for medicare and
208		-	medicaid services,
209		-	FINDS A HOSPITAL to be materially out of compliance
210		-	with hospital price transparency laws, and rules, and OR regulations, THE
211		-	HOSPITAL SHALL
212		-	:
	218	+	OF PUBLIC HEALTH AND27
	219	+	252
	220	+	-7- ENVIRONMENT as meeting the standards established for licensing a1
	221	+	hospital.2
	222	+	3
	223	+	(8) "Hospital price transparency laws" means section 2718 (e) of4
	224	+	the "Public Health Service (PHS) Act", Pub.L. 78-410, as amended, and5
	225	+	rules adopted by the United States department of health and human6
	226	+	services implementing section 2718 (e).7
	227	+	(9) "Items and services" or "items or services" means "items and8
	228	+	services" as defined in 45 CFR 180.20.9
	229	+	10
	230	+	25.5-1-903. [Formerly 25-3-803] Failure to comply with11
	231	+	hospital price transparency laws - prohibiting collection of debt -12
	232	+	penalty. (1) (a) Except as provided in subsection (1)(b) of this section,13
	233	+	on and after August 10, 2022, A hospital that is not in material14
	234	+	compliance with hospital price transparency laws on the date that items15
	235	+	or services are purchased from or provided to a patient by the hospital16
	236	+	shall not initiate or pursue a collection action against the patient or patient17
	237	+	guarantor for a debt owed for the items or services.18
	238	+	(b) This part 8 applies, on and after February 15, 2023, to critical19
	239	+	access hospitals licensed and certified by the department pursuant to 4220
	240	+	CFR 485 subpart F.21
	241	+	(2) If a patient believes that a hospital was not in material22
	242	+	compliance with hospital price transparency laws on a THE date on or23
	243	+	after August 10, 2022, that items or services were purchased by or24
	244	+	provided to the patient, and the hospital takes a collection action against25
	245	+	the patient or patient guarantor, the patient or patient guarantor may file26
	246	+	suit to determine if:27
	247	+	252
	248	+	-8- (a) The hospital was materially out of compliance with the1
	249	+	hospital price transparency laws, and rules, and OR regulations on the date2
	250	+	of service THE ITEMS OR SERVICES WERE PROVIDED ; and if3
	251	+	(b) The noncompliance is related to the items or services. The4
	252	+	hospital shall not take a collection action against the patient or patient5
	253	+	guarantor while the lawsuit is pending.6
	254	+	(3) A hospital that has been found by IF a judge or jury,7
	255	+	considering compliance standards issued by the federal centers for8
	256	+	medicare and medicaid services,
	257	+	FINDS A HOSPITAL to be materially out of9
	258	+	compliance with hospital price transparency laws, and
	259	+	rules, and OR10
	260	+	regulations,
	261	+	THE HOSPITAL SHALL:11
213	262		(a) Shall
214		-	Refund the payer any amount of the debt the payer has paid
215		-	and shall pay a penalty to the patient or patient guarantor in an amount
216		-	equal to the total amount of the debt;
217		-	(b) Shall
218		-	Dismiss or cause to be dismissed any court action with
219		-	prejudice and pay any attorney fees and costs incurred by the patient or
220		-	PAGE 7-SENATE BILL 23-252 patient guarantor relating to the action; and
221		-	(c) Remove or cause to be removed from the patient's or patient
222		-	guarantor's credit report any report made to a consumer reporting agency
	263	+	Refund the payer any amount of the debt the payer has12
	264	+	paid and shall pay a penalty to the patient or patient guarantor in an13
	265	+	amount equal to the total amount of the debt;14
	266	+	(b) Shall Dismiss or cause to be dismissed any court action with15
	267	+	prejudice and pay any attorney fees and costs incurred by the patient or16
	268	+	patient guarantor relating to the action; and17
	269	+	(c) Remove or cause to be removed from the patient's or patient18
	270	+	guarantor's credit report any report made to a consumer reporting agency19
223	271		relating to the debt;
224		-	AND
225		-	(d) NOTIFY THE STATE DEPARTMENT OF THE MATERIAL
226		-	NONCOMPLIANCE WITH HOSPITAL PRICE TRANSPARENCY LAWS
227		-	, RULES, OR
228		-	REGULATIONS
229		-	.
	272	+	AND20
	273	+	(d) N
	274	+	OTIFY THE STATE DEPARTMENT OF THE MATERIAL21
	275	+	NONCOMPLIANCE WITH HOSPITAL PRICE TRANSPARENCY LAWS , RULES, OR22
	276	+	REGULATIONS.23
230	277		(4) Nothing in this part 8
231		-	PART 9:
232		-	(a) Prohibits a hospital from billing a patient, patient guarantor, or
233		-	third-party payer, including a health insurer, for items or services provided
234		-	to the patient; or
235		-	(b) Requires a hospital to refund any payment made to the hospital
236		-	for items or services provided to the patient, so long as no collection action
237		-	is taken in violation of this part 8
238		-	PART 9.
239		-	25.5-1-904. Transparency - hospitals - standard charges -
240		-	shoppable services - enforcement. (1) O
241		-	N OR BEFORE OCTOBER 1, 2023,
242		-	EACH HOSPITAL SHALL MAKE PUBLIC AND POST THE HOSPITAL 'S MEDICARE
243		-	REIMBURSEMENT RATES
244		-	, IF APPLICABLE.
	278	+	PART 9:24
	279	+	(a) Prohibits a hospital from billing a patient, patient guarantor,25
	280	+	or third-party payer, including a health insurer, for items or services26
	281	+	provided to the patient; or27
	282	+	252
	283	+	-9- (b) Requires a hospital to refund any payment made to the hospital1
	284	+	for items or services provided to the patient, so long as no collection2
	285	+	action is taken in violation of this part 8 PART 9.3
	286	+	25.5-1-904. Transparency - hospitals - standard charges -4
	287	+	shoppable services - enforcement. (1) On or before October 1, 2023,5
	288	+	EACH HOSPITAL SHALL MAKE PUBLIC AND POST THE HOSPITAL 'S6
	289	+	MEDICARE REIMBURSEMENT RATES, IF APPLICABLE.7
245	290		(2) (a) T
246	291		HE STATE DEPARTMENT SHALL CONDUCT PERFORMANCE
247		-	~~ASSESSMENTS FOR ADHERENCE TO FEDERAL TRANSPARENCY RULES BY~~
248		-	:
	292	+	8
	293	+	ASSESSMENTS FOR ADHERENCE TO FEDERAL TRANSPARENCY RULES BY:9
249	294		(I) R
250		-	EVIEWING RELEVANT INFORMATION PROVIDED TO THE STATE
251		-	DEPARTMENT CONCERNING A HOSPITAL
252		-	'S PERFORMANCE ASSESSMENT IN
253		-	CONNECTION WITH THIS SECTION
254		-	;
	295	+	EVIEWING RELEVANT INFORMATION PROVIDED TO THE STATE10
	296	+	DEPARTMENT CONCERNING A HOSPITAL 'S PERFORMANCE ASSESSMENT IN
	297	+	11
	298	+	CONNECTION WITH THIS SECTION;12
255	299		(II) A
256		-	UDITING HOSPITAL WEBSITES FOR ~~PERFORMANCE~~ RELATIVE TO
257		-	~~FEDERAL PRICE TRANSPARENCY RULES~~
258		-	, AND IN ~~EVALUATING PERFORMANCE ,~~
259		-	THE DEPARTMENT SHALL FOLLOW RULES , STANDARDS, ~~AND GUIDANCE~~
260		-	PUBLISHED BY THE FEDERAL CENTERS FOR MEDICARE ~~AND MEDICAID~~
261		-	; ~~AND~~
262		-	(III) ~~CONFIRMING THAT EACH HOSPITAL SUBMITTED THE LISTS~~
263		-	~~REQUIRED BY THIS SECTION~~
264		-	.
265		-	~~PAGE 8-SENATE BILL 23-252~~ (b) ~~IF THE STATE DEPARTMENT DETERMINES THAT A HOSPITAL HAS~~
266		-	~~PERFORMED POORLY IN ITS PERFORMANCE ASSESSMENT~~
267		-	~~, THE STATE~~
268		-	~~DEPARTMENT MAY~~
269		-	:
	300	+	UDITING HOSPITAL WEBSITES FOR PEFORMANCE RELATIVE TO
	301	+	13
	302	+	FEDERAL PRICE TRANSPARENCY RULES , AND IN EVALUATING14
	303	+	PERFORMANCE, THE DEPARTMENT SHALL FOLLOW RULES , STANDARDS,15
	304	+	AND GUIDANCE PUBLISHED BY THE FEDERAL CENTERS FOR MEDICARE AND16
	305	+	MEDICAID; AND17
	306	+	(III) C
	307	+	ONFIRMING THAT EACH HOSPITAL SUBMITTED THE LISTS18
	308	+	REQUIRED BY THIS SECTION.19
	309	+	(b) I
	310	+	F THE STATE DEPARTMENT DETERMINES THAT A HOSPITAL
	311	+	20
	312	+	HAS PERFORMED POORLY IN ITS PERFORMANCE ASSESSMENT , THE STATE21
	313	+	DEPARTMENT MAY:22
270	314		(I) I
271		-	SSUE A WRITTEN NOTICE TO THE HOSPITAL THAT CLEARLY
272		-	EXPLAINS THE MANNER IN WHICH THE DEPARTMENT DETERMINED THAT THE
273		-	HOSPITAL PERFORMED POORLY ON THE ADHERENCE TO PRICE
274		-	TRANSPARENCY
275		-	; AND
276		-	(II) PROVIDE TECHNICAL ASSISTANCE TO THE HOSPITAL TO IMPROVE
277		-	PERFORMANCE
278		-	.
279		-	(3) O
280		-	N OR BEFORE FEBRUARY 1, 2024, THE STATE DEPARTMENT
281		-	SHALL CREATE AND MAINTAIN A PUBLICLY AVAILABLE LIST ON ITS WEBSITE
282		-	OF HOSPITALS THAT PERFORM POORLY ON THE DEPARTMENT
283		-	'S PERFORMANCE
284		-	ASSESSMENT
285		-	. SUCH NOTICES AND COMMUNICATIONS ARE SUBJECT TO PUBLIC
286		-	DISCLOSURE UNDER
287		-	5 U.S.C. SEC. 552, AS AMENDED, NOTWITHSTANDING
288		-	ANY EXEMPTIONS OR EXCLUSIONS TO THE CONTRARY
289		-	, IN FULL WITHOUT
290		-	REDACTION
291		-	. THE STATE DEPARTMENT SHALL UPDATE THE LIST AT LEAST
292		-	ANNUALLY
293		-	.
294		-	(4) A
295		-	PERSON THAT VIOLATES SUBSECTION (1) OF THIS SECTION
296		-	COMMITS A DECEPTIVE TRADE PRACTICE UNDER SECTION
297		-	6-1-105.
298		-	SECTION 4. Act subject to petition - effective date. This act
299		-	takes effect at 12:01 a.m. on the day following the expiration of the
300		-	ninety-day period after final adjournment of the general assembly; except
301		-	that, if a referendum petition is filed pursuant to section 1 (3) of article V
302		-	of the state constitution against this act or an item, section, or part of this act
303		-	within such period, then the act, item, section, or part will not take effect
304		-	unless approved by the people at the general election to be held in
305		-	PAGE 9-SENATE BILL 23-252 November 2024 and, in such case, will take effect on the date of the official
306		-	declaration of the vote thereon by the governor.
307		-	____________________________ ____________________________
308		-	Steve Fenberg Julie McCluskie
309		-	PRESIDENT OF SPEAKER OF THE HOUSE
310		-	THE SENATE OF REPRESENTATIVES
311		-	____________________________ ____________________________
312		-	Cindi L. Markwell Robin Jones
313		-	SECRETARY OF CHIEF CLERK OF THE HOUSE
314		-	THE SENATE OF REPRESENTATIVES
315		-	APPROVED________________________________________
316		-	(Date and Time)
317		-	_________________________________________
318		-	Jared S. Polis
319		-	GOVERNOR OF THE STATE OF COLORADO
320		-	PAGE 10-SENATE BILL 23-252
	315	+	SSUE A WRITTEN NOTICE TO THE HOSPITAL THAT CLEARLY23
	316	+	EXPLAINS THE MANNER IN WHICH THE DEPARTMENT DETERMINED THAT
	317	+	24
	318	+	THE HOSPITAL PERFORMED POORLY ON THE ADHERENCE TO PRICE25
	319	+	TRANSPARENCY; AND26
	320	+	(II) P
	321	+	ROVIDE TECHNICAL ASSISTANCE TO THE HOSPITAL TO
	322	+	27
	323	+	252
	324	+	-10- IMPROVE PERFORMANCE .1
	325	+	(3) ON OR BEFORE FEBRUARY 1, 2024, THE STATE DEPARTMENT2
	326	+	SHALL CREATE AND MAINTAIN A PUBLICLY AVAILABLE LIST ON ITS3
	327	+	WEBSITE OF HOSPITALS THAT PERFORM POORLY ON THE DEPARTMENT 'S4
	328	+	PERFORMANCE ASSESSMENT . SUCH NOTICES AND COMMUNICATIONS ARE5
	329	+	SUBJECT TO PUBLIC DISCLOSURE UNDER 5 U.S.C. SEC. 552, AS AMENDED,6
	330	+	NOTWITHSTANDING ANY EXEMPTIONS OR EXCLUSIONS TO THE CONTRARY ,7
	331	+	IN FULL WITHOUT REDACTION. THE STATE DEPARTMENT SHALL UPDATE8
	332	+	THE LIST AT LEAST ANNUALLY.9
	333	+	(4) A PERSON THAT VIOLATES SUBSECTION (1) OR (5) OF THIS10
	334	+	SECTION COMMITS A DECEPTIVE TRADE PRACTICE UNDER SECTION11
	335	+	6-1-105.12
	336	+	SECTION 4. Act subject to petition - effective date. This act13
	337	+	takes effect at 12:01 a.m. on the day following the expiration of the14
	338	+	ninety-day period after final adjournment of the general assembly; except15
	339	+	that, if a referendum petition is filed pursuant to section 1 (3) of article16
	340	+	V of the state constitution against this act or an item, section, or part of17
	341	+	this act within such period, then the act, item, section, or part will not18
	342	+	take effect unless approved by the people at the general election to be19
	343	+	held in November 2024 and, in such case, will take effect on the date of20
	344	+	the official declaration of the vote thereon by the governor.21
	345	+	252
	346	+	-11-