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May 3, 2023 SB 23-298
Legislative Council Staff
Nonpartisan Services for Colorado’s Legislature
Revised Fiscal Note
(replaces fiscal note dated April 26, 2023)
Drafting Number:
Prime Sponsors:
LLS 23-0468
Sen. Gardner; Roberts
Rep. McCormick;
Bockenfeld
Date:
Bill Status:
Fiscal Analyst:
May 3, 2023
House Public & Behavioral Health
Kristine McLaughlin | 303-866-4776
kristine.mclaughlin@coleg.gov
Bill Topic: ALLOW PUBLIC HOSPITAL COLLABORATION AGREEMENTS
Summary of
Fiscal Impact:
☐ State Revenue
☒ State Expenditure
☐ State Transfer
☐ TABOR Refund
☒ Local Government
☐ Statutory Public Entity
The bill exempts hospitals with fewer than 50 beds from select antitrust requirements
for the purpose of improving healthcare access in rural or frontier communities. The
bill increases state expenditures and potential local savings on an ongoing basis.
Appropriation
Summary:
For FY 2023-24, the bill requires and includes an appropriation of $60,519 to the
Department of Health Care Policy and Financing.
Fiscal Note
Status:
The revised fiscal note reflects the reengrossed bill.
Table 1
State Fiscal Impacts Under SB 23-298
Budget Year
FY 2023-24
Out Year
FY 2024-25
Revenue - -
Expenditures Cash Funds $30,260 $32,336
Federal Funds $30,259 $32,336
Centrally Appropriated $13,754 $16,945
Total Expenditures $74,273 $81,617
Total FTE 0.8 FTE 1.0 FTE
Transfers - -
Other Budget Impacts - -
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May 3, 2023 SB 23-298
Summary of Legislation
The bill exempts hospitals with fewer than 50 beds from select antitrust requirements for the purpose
of improving healthcare access in rural or frontier communities. The bill specifies this exemption does
not extend to actions that have the effect of setting reimbursement rates, dividing services among
hospitals, or reducing the wages of hospital staff. To qualify, hospitals must submit proposals to the
Department of Health Care Policy and Financing (HCPF) and to the Department of Regulatory
Agencies (DORA) if the proposed agreement involves negotiating with health insurance payers.
Proposals of merit must be referred to the Attorney General within 15 days. Proposals must be
approved or denied within 45 days and may be reviewed annually. The bill specifies an appeals
process for denied proposals.
State Expenditures
The bill increases state expenditures in HCPF by $74,000 in FY 2023-24 and $82,000 in FY 2024-25 and
ongoing, paid from the Healthcare Affordability and Sustainability Cash Fund and federal funds. The
bill also increases workload in DORA and the Department of Law. Expenditures are shown in Table 2
and detailed below.
Table 2
Expenditures Under SB 23-298
FY 2023-24 FY 2024-25
Department of Health Care Policy and Financing
Personal Services $52,769 $63,322
Operating Expenses $1,080 $1,350
Capital Outlay Costs $6,670 -
Centrally Appropriated Costs
1
$13,754 $16,945
Total Cost $74,273 $81,617
Total FTE 0.8 FTE 1.0 FTE
1
Centrally appropriated costs are not included in the bill's appropriation.
Department of Health Care Policy and Financing. HCPF requires 1.0 FTE to evaluate proposals and
study the effectiveness of approved proposals including economy-wide impacts. Standard operating
and capital outlay costs are included and costs are prorated for the bill’s effective date. Additionally,
HCPF may require legal services for rulemaking purposes; however, this is assumed to require fewer
than 100 hours and can be absorbed within existing resources.
Department of Regulatory Agencies. Workload will increase in the Division of Insurance in DORA
to evaluate the relevant proposals. This fiscal note assumes that this work will consist primarily of
assisting HCPF and can be accommodated within existing resources.
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May 3, 2023 SB 23-298
Department of Law. Workload will increase in the Consumer Protection Unit of DOL to evaluate
proposals that have been referred to the unit from HCPF. These evaluations are assumed to require
fewer than 40 hours each and can be accommodated within existing resources.
Centrally appropriated costs. Pursuant to a Joint Budget Committee policy, certain costs associated
with this bill are addressed through the annual budget process and centrally appropriated in the Long
Bill or supplemental appropriations bills, rather than in this bill. These costs, which include employee
insurance and supplemental employee retirement payments, are shown in Table 2.
Local Government and Special Districts
Certain county public hospitals and health services districts may experience cost savings due to
participation in the cooperative activities authorized in the bill.
Effective Date
The bill takes effect 90 days following adjournment of the General Assembly sine die, assuming no
referendum petition is filed.
State Appropriations
For FY 2023-24, the bill requires and includes an appropriation of $60,519 split evenly between the
Healthcare Affordability and Sustainability Cash Fund and federal funds, to the Department of Health
Care Policy and Financing, and 0.8 FTE.
State and Local Government Contacts
Counties Health Care Policy and Financing Information Technology
Judicial Law 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.