Colorado 2025 Regular Session

Colorado Senate Bill SB198 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	First Regular Session
2	2	Seventy-fifth General Assembly
3	3	STATE OF COLORADO
4	4	INTRODUCED
5	5
6	6
7	7	LLS NO. 25-0431.01 Josh Schultz x5486
8	8	SENATE BILL 25-198
9	9	Senate Committees House Committees
10	10	Health & Human Services
11	11	A BILL FOR AN ACT
12	12	C
13	13	ONCERNING TRANSPARENCY IN T RANSACTIONS INVOLVING MEDICAL101
14	14	CARE ENTITIES.102
15	15	Bill Summary
16	16	(Note: This summary applies to this bill as introduced and does
17	17	not reflect any amendments that may be subsequently adopted. If this bill
18	18	passes third reading in the house of introduction, a bill summary that
19	19	applies to the reengrossed version of this bill will be available at
20	20	http://leg.colorado.gov
21	21	.)
22	22	The bill repeals and reenacts, with amendments, the current
23	23	requirements for providing notice of transactions involving licensed
24	24	hospitals and requires that the parties to a merger, acquisition, or
25	25	contracting affiliation of one or more health-care entities, long-term care
26	26	entities, or veterinary care entities (material change transaction) submit
27	27	specified notice requirements to the attorney general at least 60 days
28	28	SENATE SPONSORSHIP
29	29	Kipp and Weissman,
30	30	HOUSE SPONSORSHIP
31	31	Brown,
32	32	Shading denotes HOUSE amendment. Double underlining denotes SENATE amendment.
33	33	Capital letters or bold & italic numbers indicate new material to be added to existing law.
34	34	Dashes through the words or numbers indicate deletions from existing law. before the effective date of the material change transaction. If the terms
35	35	of the material change transaction are altered or modified following the
36	36	submission of the written notice, the parties must provide notice to the
37	37	attorney general of the alteration or modification.
38	38	The attorney general may review a required notice of a material
39	39	change transaction and may assess whether the proposed material change
40	40	transaction is contrary to the public interest using factors specified in the
41	41	bill. The attorney general may convert their review of the material change
42	42	transaction to an investigation under the "Colorado State Antitrust Act of
43	43	2023".
44	44	The bill prohibits a material change transaction unless:
45	45	! The attorney general states that a formal assessment and
46	46	review of the material change transaction are not necessary;
47	47	! The attorney general issues an assessment that the material
48	48	change transaction is not likely to be contrary to the public
49	49	interest;
50	50	! A court finds that the material change transaction is not
51	51	likely to be contrary to the public interest;
52	52	! 90 days have elapsed since the parties to the material
53	53	change transaction submitted notice of the material change
54	54	transaction, and the attorney general has not issued an
55	55	assessment and has not notified the parties to the material
56	56	change transaction that more time is required to complete
57	57	an assessment; or
58	58	! The attorney general has notified the parties that more time
59	59	is required to complete the assessment, and 45 days have
60	60	elapsed since the attorney general provided the notice.
61	61	The attorney general may bring an action in district court to enjoin
62	62	or unwind a material change transaction or seek other equitable relief
63	63	necessary to protect the public interest.
64	64	Parties to a material change transaction may challenge the attorney
65	65	general's assessment of a material change transaction in the district court
66	66	for the city and county of Denver. The reviewing court shall affirm the
67	67	attorney general's assessment unless a person seeking judicial review
68	68	proves, by a preponderance of the evidence, specified criteria regarding
69	69	the attorney general's assessment.
70	70	The bill grants the attorney general authority to seek additional
71	71	information regarding a material change transaction, including requiring
72	72	the parties to a material change transaction to:
73	73	! File a statement or report in writing answering, or to
74	74	answer in writing, questions propounded by the attorney
75	75	general as to the facts and circumstances reasonably related
76	76	to an alleged or potential violation of the bill;
77	77	! Appear pursuant to a subpoena or produce relevant
78	78	documents in aid of an investigation or inquiry; and
79	79	SB25-198
80	80	-2- ! Allow the attorney general to make true copies of
81	81	documents that may be offered into evidence.
82	82	If a person fails to comply with an investigation or inquiry
83	83	pursuant to a request or subpoena issued by the attorney general, the
84	84	attorney general may apply to a district court for relief, including a civil
85	85	penalty of up to $5,000, reasonable costs, and attorney fees or a protective
86	86	order.
87	87	For at least 5 years after the effective date of a material change
88	88	transaction, the parties to the material change transaction shall provide the
89	89	attorney general an annual report meeting specified requirements. The
90	90	report must be made available to the public on the attorney general's and
91	91	the parties' websites.
92	92	A person that fails to comply with any provision of the bill is
93	93	subject to a civil penalty of not more than $200 for each day the person
94	94	remains in violation. Failure of a party to a material change transaction to
95	95	provide notice of the material change transaction is an independent and
96	96	sufficient ground for a court to enjoin or unwind the material change
97	97	transaction.
98	98	The bill requires that, if certain health-care providers refer a
99	99	patient to an entity for health-care services and the provider, or an
100	100	immediate family member of the provider, has a financial relationship
101	101	with the entity, the provider shall disclose the nature of the financial
102	102	relationship to the patient at the time of the referral.
103	103	Be it enacted by the General Assembly of the State of Colorado:1
104	104	SECTION 1. In Colorado Revised Statutes, repeal and reenact,2
105	105	with amendments, article 19 of title 6 as follows:3
106	106	ARTICLE 194
107	107	Transactions Involving Medical Entities5
108	108	6-19-101. Definitions. A
109	109	S USED IN THIS ARTICLE 19, UNLESS THE6
110	110	CONTEXT OTHERWISE REQUIRES :7
111	111	(1) (a) "A
112	112	CQUISITION" MEANS AN AGREEMENT, ARRANGEMENT, OR8
113	113	ACTIVITY, THE CONSUMMATION OF WHICH RESULTS IN A PERSON9
114	114	ACQUIRING DIRECTLY OR INDIRECTLY THE OWNERSHIP OR CONTROL OF10
115	115	ANOTHER PERSON.11
116	116	(b) "A
117	117	CQUISITION" INCLUDES:12
118	118	SB25-198-3- (I) ANY ACQUISITION OF THIRTY PERCENT OR MORE OF VOTING1
119	119	SECURITIES OR NONCORPORATE INTERESTS , INCLUDING ASSETS, CAPITAL,2
120	120	STOCK, MEMBERSHIP INTERESTS, OR EQUITY INTERESTS; OR3
121	121	(II) A
122	122	N ARRANGEMENT, WRITTEN OR ORAL, THAT INCLUDES THE4
123	123	SALE OF ANY AMOUNT OF VOTING SECURITIES OR NONCORPORATE5
124	124	INTERESTS THAT ALTERS VOTING CONTROL OF , RESPONSIBILITY FOR, OR6
125	125	CONTROL OF THE GOVERNING BODY OF A PERSON .7
126	126	(2) "C
127	127	HARITABLE PURPOSE" HAS THE MEANING SET FORTH IN8
128	128	SECTION 7-30-101.2.9
129	129	(3) (a) "C
130	130	ONTRACTING AFFILIATION" MEANS A RELATIONSHIP10
131	131	BETWEEN TWO OR MORE ENTITIES THAT PERMITS THE ENTITIES TO11
132	132	NEGOTIATE JOINTLY WITH INSURERS OR THIRD -PARTY ADMINISTRATORS12
133	133	OVER RATES FOR HEALTH-CARE SERVICES, LONG-TERM CARE SERVICES, OR13
134	134	VETERINARY SERVICES OR FOR ONE ENTITY TO NEGOTIATE ON BEHALF OF14
135	135	THE OTHER ENTITY WITH INSURERS OR THIRD -PARTY ADMINISTRATORS15
136	136	OVER RATES FOR HEALTH-CARE SERVICES, LONG-TERM CARE SERVICES, OR16
137	137	VETERINARY SERVICES.17
138	138	(b) "C
139	139	ONTRACTING AFFILIATION " DOES NOT INCLUDE18
140	140	ARRANGEMENTS AMONG ENTITIES UNDER COMMON OWNERSHIP .19
141	141	(4) "H
142	142	EALTH-CARE ENTITY" MEANS A CORPORATION ,20
143	143	PROFESSIONAL SERVICE CORPORATION , PARTNERSHIP, PROVIDER21
144	144	NETWORK, BUSINESS TRUST, ASSOCIATION, ORGANIZATION, FACILITY, OR22
145	145	OTHER ENTITY, WHETHER INCORPORATED OR NOT , THAT PROVIDES23
146	146	HEALTH-CARE SERVICES.24
147	147	(5) "H
148	148	EALTH-CARE SERVICES" MEANS SERVICES RELATING TO THE25
149	149	PREVENTION, CURE, OR TREATMENT OF AN ILLNESS, INJURY, CONDITION,26
150	150	OR DISEASE, INCLUDING MEDICAL, SURGICAL, CHIROPRACTIC, HOSPITAL,27
151	151	SB25-198
152	152	-4- OPTOMETRIC, PODIATRIC, DENTAL, PHARMACEUTICAL, AMBULANCE,1
153	153	MENTAL HEALTH, SUBSTANCE USE DISORDER, THERAPEUTIC, PREVENTIVE,2
154	154	DIAGNOSTIC, CURATIVE, REHABILITATIVE, PALLIATIVE, AND CUSTODIAL3
155	155	SERVICES.4
156	156	(6) "I
157	157	NSURER" MEANS AN ENTITY THAT MEETS THE DEFINITION OF:5
158	158	(a) "I
159	159	NSURER" PROVIDED IN SECTION 10-1-102 (13);6
160	160	(b) "C
161	161	ARRIER" PROVIDED IN SECTION 10-16-102 (8); OR7
162	162	(c) "C
163	163	ARRIER" PROVIDED IN SECTION 24-50-603 (2).8
164	164	(7) "L
165	165	ONG-TERM CARE" MEANS "LONG-TERM SERVICES AND9
166	166	SUPPORTS" AS DEFINED IN SECTION 25.5-6-1702 (10).10
167	167	(8) "L
168	168	ONG-TERM CARE ENTITY " MEANS A CORPORATION ,11
169	169	PROFESSIONAL SERVICE CORPORATION , PARTNERSHIP, PROVIDER12
170	170	NETWORK, BUSINESS TRUST, ASSOCIATION, ORGANIZATION, FACILITY, OR13
171	171	OTHER ENTITY, WHETHER INCORPORATED OR NOT , THAT PROVIDES14
172	172	LONG-TERM CARE.15
173	173	(9) (a) "M
174	174	ATERIAL CHANGE TRANSACTION " MEANS A MERGER,16
175	175	ACQUISITION, OR CONTRACTING AFFILIATION INVOLVING ONE OR MORE :17
176	176	(I) H
177	177	EALTH-CARE ENTITIES, LONG-TERM CARE ENTITIES, OR18
178	178	VETERINARY CARE ENTITIES;19
179	179	(II) E
180	180	NTITIES ORGANIZED OR CONTROLLED BY AN ENTITY LISTED20
181	181	IN SUBSECTION (9)(a)(I) OF THIS SECTION;21
182	182	(III) E
183	183	NTITIES THAT OWN, MANAGE, OR EXERCISE CONTROL OVER22
184	184	AN ENTITY LISTED IN SUBSECTION (9)(a)(I) OF THIS SECTION; OR23
185	185	(IV) E
186	186	NTITIES THAT REPRESENT OR ACT ON BEHALF OF AN ENTITY24
187	187	LISTED IN SUBSECTION (9)(a)(I) OF THIS SECTION IN CONTRACTING WITH25
188	188	INSURERS OR THIRD-PARTY ADMINISTRATORS.26
189	189	(b) A
190	190	SERIES OF TRANSACTIONS TAKING PLACE IN ANY FIVE-YEAR27
191	191	SB25-198
192	192	-5- PERIOD, WHICH TRANSACTIONS , IN THE AGGREGATE, RESULT IN THE1
193	193	TRANSFER OF OWNERSHIP OR CONTROL OF FIFTY PERCENT OR MORE OF A2
194	194	PERSON'S ASSETS, IS A MATERIAL CHANGE TRANSACTION .3
195	195	(10) (a) "M
196	196	ERGER" MEANS A CONSOLIDATION OF TWO OR MORE4
197	197	ORGANIZATIONS, INCLUDING TWO OR MORE ORGANIZATIONS JOINING5
198	198	THROUGH A COMMON PARENT ORGANIZATION OR TWO OR MORE6
199	199	ORGANIZATIONS FORMING A NEW ORGANIZATION .7
200	200	(b) "M
201	201	ERGER" DOES NOT INCLUDE A CORPORATE8
202	202	REORGANIZATION.9
203	203	(11) "T
204	204	HIRD-PARTY ADMINISTRATOR" MEANS AN ENTITY THAT10
205	205	ADMINISTERS PAYMENTS FOR HEALTH -CARE SERVICES ON BEHALF OF A11
206	206	CLIENT IN EXCHANGE FOR AN ADMINISTRATIVE FEE .12
207	207	(12) "V
208	208	ETERINARY CARE ENTITY " MEANS A CORPORATION ,13
209	209	PROFESSIONAL SERVICE CORPORATION , PARTNERSHIP, PROVIDER14
210	210	NETWORK, BUSINESS TRUST, ASSOCIATION, ORGANIZATION, FACILITY, OR15
211	211	OTHER ENTITY, WHETHER INCORPORATED OR NOT , THAT PROVIDES16
212	212	VETERINARY SERVICES.17
213	213	(13) "V
214	214	ETERINARY PROFESSIONAL" HAS THE MEANING SET FORTH18
215	215	IN SECTION 12-315-104 (21.5).19
216	216	(14) "V
217	217	ETERINARY SERVICES" MEANS SERVICES PROVIDED BY A20
218	218	VETERINARY PROFESSIONAL.21
219	219	6-19-102. Notice of material change transaction - form of22
220	220	notice - notice after modification of terms. (1) N
221	221	O LATER THAN SIXTY23
222	222	DAYS BEFORE THE EFFECTIVE DATE OF A MATERIAL CHANGE24
223	223	TRANSACTION, THE PARTIES TO THE MATERIAL CHANGE TRANSACTION25
224	224	SHALL SUBMIT WRITTEN NOTICE TO THE ATTORNEY GENERAL OF THE26
225	225	MATERIAL CHANGE TRANSACTION .27
226	226	SB25-198
227	227	-6- (2) FOR A MATERIAL CHANGE TRANSACTION THAT EITHER1
228	228	INVOLVES AN ENTITY WITH AN AVERAGE ANNUAL REVENUE OF AT LEAST2
229	229	EIGHTY MILLION DOLLARS OR WILL RESULT IN AN ENTITY PROJECTED TO3
230	230	HAVE AN AVERAGE ANNUAL REVENUE OF AT LEAST EIGHTY MILLION4
231	231	DOLLARS, WRITTEN NOTICE PROVIDED BY THE PARTIES AS REQUIRED BY5
232	232	SUBSECTION (1) OF THIS SECTION MUST INCLUDE:6
233	233	(a) T
234	234	HE PARTIES INVOLVED IN THE MATERIAL CHANGE7
235	235	TRANSACTION, INCLUDING THE NAMES , HEADQUARTERS BUSINESS8
236	236	ADDRESSES, AND WEBSITES OF ALL PARTIES, AND THE NAME, CURRENT9
237	237	HEADQUARTERS BUSINESS ADDRESS , AND WEBSITE OF ANY ULTIMATE10
238	238	PARENT ENTITIES OF THE PARTIES , AS DEFINED IN 16 CFR 801.1, AS11
239	239	ADOPTED ON NOVEMBER 12, 2024;12
240	240	(b) T
241	241	HE LEADERSHIP OF THE ENTITIES INVOLVED IN THE MATERIAL13
242	242	CHANGE TRANSACTION , INCLUDING ALL BOARD MEMBERS , MANAGING14
243	243	PARTNERS, MEMBER MANAGERS, AND OFFICERS;15
244	244	(c) T
245	245	HE SERVICES PROVIDED BY EACH ENTITY AND THE16
246	246	ATTRIBUTED REVENUE FOR EACH ENTITY BY LOCATION AND TYPE OF17
247	247	SERVICE;18
248	248	(d) T
249	249	HE PRIMARY SERVICE AREA FOR EACH LOCATION ;19
250	250	(e) T
251	251	HE PROPOSED SERVICE AREA FOR EACH LOCATION ;20
252	252	(f) T
253	253	HE CURRENT RELATIONSHIPS BETWEEN THE ENTITIES AND THE21
254	254	AFFECTED CARE OR SERVICE PROVIDERS , THE LOCATIONS OF AFFECTED22
255	255	CARE OR SERVICE PROVIDERS, THE SERVICES PROVIDED BY AFFECTED CARE23
256	256	OR SERVICE PROVIDERS, AND THE PROPOSED RELATIONSHIPS BETWEEN THE24
257	257	ENTITIES AND THE AFFECTED CARE OR SERVICE PROVIDERS ;25
258	258	(g) T
259	259	HE CURRENT CONTRACTUAL RELATIONSHIPS BETWEEN THE26
260	260	ENTITIES AND INSURERS OR THIRD-PARTY ADMINISTRATORS THAT PROVIDE27
261	261	SB25-198
262	262	-7- FOR COVERAGE OF HEALTH-CARE SERVICES, LONG-TERM CARE SERVICES,1
263	263	OR VETERINARY SERVICES AND THE PROPOSED RELATIONSHIPS BETWEEN2
264	264	THE ENTITIES AND THE AFFECTED INSURERS OR THIRD -PARTY3
265	265	ADMINISTRATORS;4
266	266	(h) T
267	267	HE AGREEMENT OR AGREEMENTS THAT GIVE RISE TO THE5
268	268	MATERIAL CHANGE TRANSACTION AND ALL RELATED AGREEMENTS ,6
269	269	INCLUDING LEASES, MANAGEMENT CONTRACTS , AND SERVICE CONTRACTS;7
270	270	(i) A
271	271	LL CONSIDERATION RELATED TO THE MATERIAL CHANGE8
272	272	TRANSACTION;9
273	273	(j) T
274	274	HE MARKETS IN WHICH THE ENTITIES EXPECT THE MATERIAL10
275	275	CHANGE TRANSACTION TO PRODUCE SYNERGIES OR OTHER COMPETITIVE11
276	276	ADVANTAGES;12
277	277	(k) P
278	278	OTENTIAL AREAS OF EXPANSION , WHETHER IN EXISTING13
279	279	MARKETS OR NEW MARKETS ;14
280	280	(l) A
281	281	NY PLANS TO CLOSE FACILITIES, REDUCE WORKFORCE , OR15
282	282	REDUCE OR ELIMINATE SERVICES;16
283	283	(m) T
284	284	HE NAMES, HEADQUARTERS BUSINESS ADDRESSES , AND17
285	285	WEBSITES OF BROKERS, EXPERTS, AND CONSULTANTS USED TO FACILITATE18
286	286	AND EVALUATE THE MATERIAL CHANGE TRANSACTION ;19
287	287	(n) T
288	288	HE NUMBER OF FULL-TIME EQUIVALENT POSITIONS AT EACH20
289	289	LOCATION BEFORE THE MATERIAL CHANGE TRANSACTION AND THE21
290	290	ANTICIPATED NUMBER OF FULL -TIME EQUIVALENT POSITIONS AT EACH22
291	291	LOCATION AFTER THE MATERIAL CHANGE TRANSACTION , INDICATED BY23
292	292	JOB CATEGORY, INCLUDING ADMINISTRATIVE AND CONTRACT POSITIONS ;24
293	293	(o) A
294	294	BRIEF DESCRIPTION OF THE NATURE AND PURPOSE OF EACH25
295	295	MATERIAL CHANGE TRANSACTION INVOLVING ONE OR MORE OF THE26
296	296	PARTIES THAT OCCURRED IN THE FIVE YEARS PRECEDING THE NOTICE ;27
297	297	SB25-198
298	298	-8- (p) A DESCRIPTION OF ANY COMPLAINTS , GRIEVANCES, OR1
299	299	DISPUTES INVOLVING ONE OR MORE OF THE PARTIES FILED WITH A STATE2
300	300	LICENSING OR OVERSIGHT ENTITY IN THE THREE YEARS PRECEDING THE3
301	301	NOTICE;4
302	302	(q) T
303	303	HE CURRENT GOVERNING DOCUMENTS FOR ALL ENTITIES5
304	304	INVOLVED IN THE MATERIAL CHANGE TRANSACTION AND ANY6
305	305	AMENDMENTS TO THE DOCUMENTS ;7
306	306	(r) A
307	307	NY EXPERT OR CONSULTANT REPORTS , ANALYSES,8
308	308	VALUATIONS, PROJECTIONS, OR MODELING CONDUCTED IN EVALUATING9
309	309	THE MATERIAL CHANGE TRANSACTION , INCLUDING ANY VALUATION OF10
310	310	THE ASSETS THAT ARE SUBJECT TO THE MATERIAL CHANGE TRANSACTION11
311	311	WITHIN THREE YEARS PRECEDING THE NOTICE AND ANY REPORTS BY12
312	312	APPRAISERS, ACCOUNTANTS, INVESTMENT BANKERS , ACTUARIES, AND13
313	313	OTHER EXPERTS;14
314	314	(s) F
315	315	OR A MATERIAL CHANGE TRANSACTION INVOLVING THE SALE ,15
316	316	LEASE, OR TRANSFER OF AT LEAST FORTY PERCENT OF A PARTY 'S ASSETS,16
317	317	VOTING SECURITIES, REVENUES, OR CONTROLLING INTERESTS TO ANOTHER17
318	318	PARTY:18
319	319	(I) A
320	320	FINANCIAL AND ECONOMIC ANALYSIS AND REPORT PREPARED19
321	321	BY AN INDEPENDENT EXPERT OR CONSULTANT CONCERNING THE EFFECTS20
322	322	OF THE MATERIAL CHANGE TRANSACTION ; AND21
323	323	(II) A
324	324	N IMPACT ANALYSIS REPORT PREPARED BY AN INDEPENDENT22
325	325	EXPERT OR CONSULTANT CONCERNING THE EFFECTS OF THE MATERIAL23
326	326	CHANGE TRANSACTION ON COMMUNITIES AND THE WORKFORCE ,24
327	327	INCLUDING ANY CHANGES IN AVAILABILITY OR ACCESSIBILITY OF25
328	328	SERVICES;26
329	329	(t) A
330	330	CERTIFICATION SWORN UNDER OATH BY EACH BOARD27
331	331	SB25-198
332	332	-9- MEMBER AND CHIEF EXECUTIVE OFFICER FOR ANY NONPROFIT ENTITY1
333	333	INVOLVED IN THE MATERIAL CHANGE TRANSACTION CONTAINING THE2
334	334	FOLLOWING:3
335	335	(I) A
336	336	N EXPLANATION OF HOW THE MATERIAL CHANGE4
337	337	TRANSACTION IS IN THE PUBLIC INTEREST , WHICH EXPLANATION5
338	338	ADDRESSES THE FACTORS IN SECTION 6-19-104 (1), AND ANY CHANGE TO6
339	339	AN ENTITY'S CHARITABLE PURPOSE THAT MAY RESULT FROM THE7
340	340	MATERIAL CHANGE TRANSACTION ;8
341	341	(II) A
342	342	DISCLOSURE OF EACH DECLARANT 'S COMPENSATION AND9
343	343	BENEFITS RELATING TO THE MATERIAL CHANGE TRANSACTION FOR THE10
344	344	THREE YEARS FOLLOWING THE MATERIAL CHANGE TRANSACTION 'S11
345	345	ANTICIPATED COMPLETION DATE ; AND12
346	346	(III) A
347	347	DISCLOSURE OF ANY CONFLICTS OF INTEREST ;13
348	348	(u) W
349	349	HERE APPLICABLE, IDENTIFICATION OF ANY ASSETS SUBJECT14
350	350	TO THE MATERIAL CHANGE TRANSACTION THAT ARE CURRENTLY USED FOR15
351	351	A CHARITABLE PURPOSE, ALL DOCUMENTS REFLECTING THE CHARITABLE16
352	352	PURPOSES OF ANY ENTITY I NVOLVED IN THE MATERIAL CHANGE17
353	353	TRANSACTION, AND A DESCRIPTION OF ANY CHANGE TO THE CHARITABLE18
354	354	PURPOSES FOR WHICH AN ASSET IS CURRENTLY USED THAT WILL RESULT19
355	355	FROM THE MATERIAL CHANGE TRANSACTION ;20
356	356	(v) A
357	357	UDITED AND UNAUDITED FINANCIAL STATEMENTS FROM ALL21
358	358	PARTIES INVOLVED IN THE MATERIAL CHANGE TRANSACTION AND TAX22
359	359	FILINGS FOR ALL ENTITIES INVOLVED IN THE MATERIAL CHANGE23
360	360	TRANSACTION COVERING THE PRECEDING FIVE FISCAL YEARS ;24
361	361	(w) A
362	362	CERTIFICATION THAT THE PARTIES WILL MAKE A NOTICE OF25
363	363	THE MATERIAL CHANGE TRANSACTION AVAILABLE ON A PUBLIC WEBSITE26
364	364	WITHIN SEVEN DAYS AFTER THE NOTIFICATION TO THE ATTORNEY27
365	365	SB25-198
366	366	-10- GENERAL; AND1
367	367	(x) A
368	368	NY OTHER INFORMATION RELEVANT TO EVALUATING THE2
369	369	MATERIAL CHANGE TRANSACTION THAT IS REQUESTED BY THE ATTORNEY3
370	370	GENERAL.4
371	371	(3) F
372	372	OR A MATERIAL CHANGE TRANSACTION THAT IS NOT COVERED5
373	373	BY SUBSECTION (2) OF THIS SECTION, AND THAT EITHER INVOLVES AN6
374	374	ENTITY WITH AN AVERAGE ANNUAL REVENUE OF AT LEAST THIRTY7
375	375	MILLION DOLLARS OR WILL RESULT IN AN ENTITY PROJECTED TO HAVE AN8
376	376	AVERAGE ANNUAL REVENUE OF AT LEAST THIRTY MILLION DOLLARS ,9
377	377	WRITTEN NOTICE PROVIDED BY THE PARTIES AS REQUIRED BY SUBSECTION10
378	378	(1)
379	379	OF THIS SECTION MUST INCLUDE:11
380	380	(a) T
381	381	HE PARTIES INVOLVED IN THE MATERIAL CHANGE12
382	382	TRANSACTION, INCLUDING THE NAMES , HEADQUARTERS BUSINESS13
383	383	ADDRESSES, AND WEBSITES OF ALL PARTIES, AND THE NAME, CURRENT14
384	384	HEADQUARTERS BUSINESS ADDRESS , AND WEBSITE OF ANY ULTIMATE15
385	385	PARENT ENTITIES OF THE PARTIES , AS DEFINED IN 16 CFR 801.1, AS16
386	386	ADOPTED ON NOVEMBER 12, 2024;17
387	387	(b) T
388	388	HE LEADERSHIP OF THE ENTITIES INVOLVED IN THE MATERIAL18
389	389	CHANGE TRANSACTION , INCLUDING ALL BOARD MEMBERS , MANAGING19
390	390	PARTNERS, MEMBER MANAGERS, AND OFFICERS;20
391	391	(c) T
392	392	HE SERVICES PROVIDED BY EACH ENTITY AND THE21
393	393	ATTRIBUTED REVENUE FOR EACH ENTITY BY LOCATION AND TYPE OF22
394	394	SERVICE;23
395	395	(d) T
396	396	HE CURRENT CONTRACTUAL RELATIONSHIPS BETWEEN THE24
397	397	ENTITIES AND INSURERS OR THIRD-PARTY ADMINISTRATORS THAT PROVIDE25
398	398	FOR COVERAGE OF HEALTH-CARE SERVICES, LONG-TERM CARE SERVICES,26
399	399	OR VETERINARY SERVICES AND THE PROPOSED RELATIONSHIPS BETWEEN27
400	400	SB25-198
401	401	-11- THE ENTITIES AND THE AFFECTED INSURERS OR THIRD -PARTY1
402	402	ADMINISTRATORS;2
403	403	(e) T
404	404	HE AGREEMENT OR AGREEMENTS THAT GIVE RISE TO THE3
405	405	MATERIAL CHANGE TRANSACTION AND ALL RELATED AGREEMENTS ,4
406	406	INCLUDING LEASES, MANAGEMENT CONTRACTS , AND SERVICE CONTRACTS;5
407	407	(f) T
408	408	HE MARKETS IN WHICH THE ENTITIES EXPECT THE MATERIAL6
409	409	CHANGE TRANSACTION TO PRODUCE SYNERGIES OR OTHER COMPETITIVE7
410	410	ADVANTAGES;8
411	411	(g) P
412	412	OTENTIAL AREAS OF EXPANSION , WHETHER IN EXISTING9
413	413	MARKETS OR NEW MARKETS ;10
414	414	(h) A
415	415	NY PLANS TO CLOSE FACILITIES, REDUCE WORKFORCE, OR11
416	416	REDUCE OR ELIMINATE SERVICES;12
417	417	(i) T
418	418	HE NUMBER OF FULL-TIME EQUIVALENT POSITIONS AT EACH13
419	419	LOCATION BEFORE THE MATERIAL CHANGE TRANSACTION AND THE14
420	420	ANTICIPATED NUMBER OF FULL -TIME EQUIVALENT POSITIONS AT EACH15
421	421	LOCATION AFTER THE MATERIAL CHANGE TRANSACTION , INDICATED BY16
422	422	JOB CATEGORY, INCLUDING ADMINISTRATIVE AND CONTRACT POSITIONS ;17
423	423	(j) A
424	424	BRIEF DESCRIPTION OF THE NATURE AND PURPOSE OF THE18
425	425	PROPOSED MATERIAL CHANGE TRANSACTION , INCLUDING THE NUMBER OF19
426	426	INDIVIDUAL PROVIDERS OF HEALTH-CARE SERVICES, LONG-TERM CARE, OR20
427	427	VETERINARY SERVICES AFFECTED ;21
428	428	(k) A
429	429	BRIEF DESCRIPTION OF THE NATURE AND PURPOSE OF EACH22
430	430	MATERIAL CHANGE TRANSACTION THAT INVOLVES ONE OR MORE OF THE23
431	431	PARTIES AND THAT OCCURRED IN THE FIVE YEARS PRECEDING THE NOTICE ;24
432	432	(l) A
433	433	LL DOCUMENTS REFLECTING THE CHARITABLE PURPOSES OF25
434	434	ANY PARTY TO THE MATERIAL CHANGE TRANSACTION , AND A DESCRIPTION26
435	435	OF ANY CHANGE TO CHARITABLE PURPOSES THAT WILL RESULT FROM THE27
436	436	SB25-198
437	437	-12- MATERIAL CHANGE TRANSACTION ;1
438	438	(m) A
439	439	CERTIFICATION THAT THE PARTIES WILL MAKE A NOTICE OF2
440	440	THE MATERIAL CHANGE TRANSACTION AVAILABLE ON A PUBLIC WEBSITE3
441	441	WITHIN SEVEN DAYS AFTER THE NOTIFICATION TO THE ATTORNEY4
442	442	GENERAL, OR A CERTIFICATION THAT NO PARTY INVOLVED IN THE5
443	443	MATERIAL CHANGE TRANSACTION MAINTAINS A PUBLIC WEBSITE WHERE6
444	444	SUCH NOTICE COULD BE MADE AVAILABLE ; AND7
445	445	(n) T
446	446	HE ANTICIPATED EFFECTIVE DATE OF THE PROPOSED8
447	447	MATERIAL CHANGE TRANSACTION .9
448	448	(4) F
449	449	OR A MATERIAL CHANGE TRANSACTION THAT IS NOT COVERED10
450	450	BY SUBSECTION (2) OR (3) OF THIS SECTION, WRITTEN NOTICE PROVIDED BY11
451	451	THE PARTIES AS REQUIRED BY SUBSECTION (1) OF THIS SECTION MUST12
452	452	INCLUDE:13
453	453	(a) T
454	454	HE NAMES, HEADQUARTERS BUSINESS ADDRESSES , AND14
455	455	WEBSITES OF ALL PARTIES TO THE MATERIAL CHANGE TRANSACTION ;15
456	456	(b) T
457	457	HE NAMES AND CONTACT INFORMATION OF ALL OWNERS ,16
458	458	DIRECTORS, AND OFFICERS OF ALL PARTIES TO THE MATERIAL CHANGE17
459	459	TRANSACTION;18
460	460	(c) I
461	461	DENTIFICATION OF ALL LOCATIONS WHERE HEALTH -CARE19
462	462	SERVICES, LONG-TERM CARE SERVICES, OR VETERINARY SERVICES ARE20
463	463	CURRENTLY PROVIDED BY EACH PARTY AND THE TYPE OF SERVICES21
464	464	PROVIDED AT EACH LOCATION;22
465	465	(d) A
466	466	BRIEF DESCRIPTION OF THE NATURE AND PURPOSE OF THE23
467	467	PROPOSED MATERIAL CHANGE TRANSACTION , INCLUDING THE NUMBER OF24
468	468	INDIVIDUAL PROVIDERS OF HEALTH-CARE SERVICES, LONG-TERM CARE, OR25
469	469	VETERINARY SERVICES AFFECTED ;26
470	470	(e) A
471	471	BRIEF DESCRIPTION OF THE NATURE AND PURPOSE OF EACH27
472	472	SB25-198
473	473	-13- MATERIAL CHANGE TRANSACTION THAT INVOLVES ONE OR MORE OF THE1
474	474	PARTIES AND THAT OCCURRED IN THE FIVE YEARS PRECEDING THE NOTICE ;2
475	475	(f) A
476	476	LL DOCUMENTS REFLECTING THE CHARITABLE PURPOSES OF3
477	477	ANY PARTY TO THE MATERIAL CHANGE TRANSACTION , AND A DESCRIPTION4
478	478	OF ANY CHANGE TO THE CHARITABLE PURPOSES THAT WILL RESULT FROM5
479	479	THE MATERIAL CHANGE TRANSACTION ;6
480	480	(g) A
481	481	CERTIFICATION THAT THE PARTIES WILL MAKE A NOTICE OF7
482	482	THE MATERIAL CHANGE TRANSACTION AVAILABLE ON A PUBLIC WEBSITE8
483	483	WITHIN SEVEN DAYS AFTER THE NOTIFICATION TO THE ATTORNEY9
484	484	GENERAL OR THAT NO ENTITY INVOLVED IN THE MATERIAL CHANGE10
485	485	TRANSACTION MAINTAINS A PUBLIC WEBSITE WHERE SUCH NOTICE COULD11
486	486	BE MADE AVAILABLE; AND12
487	487	(h) T
488	488	HE ANTICIPATED EFFECTIVE DATE OF THE PROPOSED13
489	489	MATERIAL CHANGE TRANSACTION .14
490	490	(5) A
491	491	TRANSACTION OR OTHER DEVICE ENTERED INTO OR15
492	492	EMPLOYED FOR THE PURPOSE OF AVOIDING THE OBLIGATION TO COMPLY16
493	493	WITH THIS SECTION IS VOID, AND WHETHER THE PARTIES MUST COMPLY17
494	494	WITH SUBSECTION (2), (3), OR (4) OF THIS SECTION IS DETERMINED BY18
495	495	APPLYING THIS ARTICLE 19 AND ANY ASSOCIATED RULES TO THE19
496	496	SUBSTANCE OF THE MATERIAL CHANGE TRANSACTION .20
497	497	(6) A
498	498	PARTY TO A MATERIAL CHANGE TRANSACTION MAY REQUEST21
499	499	THAT THE ATTORNEY GENERAL SUBJECT THE MATERIAL CHANGE22
500	500	TRANSACTION TO A DIFFERENT CATEGORY OF NOTICE REQUIREMENT , AS23
501	501	DESCRIBED IN SUBSECTIONS (2), (3), AND (4) OF THIS SECTION, FROM THE24
502	502	NOTICE REQUIREMENT THAT APPLIES DUE TO THE AVERAGE ANNUAL25
503	503	REVENUE CLASSIFICATION OF THE MATERIAL CHANGE TRANSACTION . THE26
504	504	ATTORNEY GENERAL MAY GRANT THE PARTY 'S REQUEST IF THE ATTORNEY27
505	505	SB25-198
506	506	-14- GENERAL DETERMINES THAT THE REQUEST IS IN THE PUBLIC INTEREST .1
507	507	(7) I
508	508	F THE TERMS OF A MATERIAL CHANGE TRANSACTION ARE2
509	509	ALTERED OR MODIFIED FOLLOWING THE SUBMISSION OF A WRITTEN NOTICE3
510	510	PURSUANT TO THIS SECTION, THE PARTIES SHALL PROVIDE NOTICE TO THE4
511	511	ATTORNEY GENERAL OF THE ALTERATION OR MODIFICATION , INCLUDING5
512	512	NEW COPIES OF THE INFORMATION REQUIRED UNDER THIS SECTION THAT6
513	513	IS SUBJECT TO ALTERATION OR MODIFICATION .7
514	514	(8) N
515	515	OTWITHSTANDING ANY PROVISION OF THIS SECTION TO THE8
516	516	CONTRARY, THE ATTORNEY GENERAL MAY WAIVE ALL OR PART OF THE9
517	517	DISCLOSURE REQUIREMENTS DESCRIBED IN THIS SECTION .10
518	518	(9) N
519	519	OTHING IN THIS ARTICLE 19 PROHIBITS THE PARTIES TO A11
520	520	MATERIAL CHANGE TRANSACTION FROM VOLUNTARILY PROVIDING12
521	521	INFORMATION TO THE ATTORNEY GENERAL .13
522	522	6-19-103. Requests for additional information - failure to14
523	523	comply - admissibility - rules. (1) F
524	524	OLLOWING THE RECEIPT OF NOTICE15
525	525	OF A PROPOSED MATERIAL CHANGE TRANSACTION PURSUANT TO SECTION16
526	526	6-19-102,
527	527	THE ATTORNEY GENERAL MAY :17
528	528	(a) R
529	529	EQUIRE A PERSON, UNDER OATH OR OTHERWISE AND ON18
530	530	FORMS PRESCRIBED BY THE ATTORNEY GENERAL , TO FILE A STATEMENT OR19
531	531	REPORT IN WRITING ANSWERING, OR TO ANSWER IN WRITING, QUESTIONS20
532	532	PROPOUNDED BY THE ATTORNEY GENERAL AS TO THE FACTS AND21
533	533	CIRCUMSTANCES REASONABLY RELATED TO AN ALLEGED OR POTENTIAL22
534	534	VIOLATION OF THIS ARTICLE 19 AND TO PROVIDE OTHER DATA AND23
535	535	INFORMATION THE ATTORNEY GENERAL REASONABLY DEEMS NECESSARY ;24
536	536	(b) I
537	537	SSUE SUBPOENAS TO REQUIRE THE ATTENDANCE OF WITNESSES25
538	538	OR THE PRODUCTION OF RELEVANT DOCUMENTS , ADMINISTER OATHS,26
539	539	CONDUCT HEARINGS IN AID OF AN INVESTIGATION OR INQUIRY , AND27
540	540	SB25-198
541	541	-15- PRESCRIBE FORMS AND ADOPT RULES AS MAY REASONABLY BE DEEMED1
542	542	NECESSARY TO ADMINISTER THIS SECTION ; AND2
543	543	(c) M
544	544	AKE TRUE COPIES, AT THE EXPENSE OF THE ATTORNEY3
545	545	GENERAL, OF ANY DOCUMENTS EXAMINED PURSUANT TO SUBSECTION4
546	546	(1)(b)
547	547	OF THIS SECTION, WHICH COPIES MAY BE OFFERED INTO EVIDENCE5
548	548	IN LIEU OF THE ORIGINALS IN A CIVIL ACTION BROUGHT PURSUANT TO THIS6
549	549	ARTICLE 19. THE PERSON PRODUCING THE DOCUMENTS MAY REQUIRE THAT7
550	550	THE ATTORNEY GENERAL MAKE COPIES OF THE DOCUMENTS . IF THE8
551	551	ATTORNEY GENERAL DETERMINES THE USE OF ORIGINALS IS NECESSARY ,9
552	552	THE ATTORNEY GENERAL SHALL PAY TO HAVE COPIES OF THOSE10
553	553	DOCUMENTS MADE FOR USE BY TH E PERSON PRODUCING THE DOCUMENTS .11
554	554	(2) S
555	555	ERVICE OF A REQUEST FOR INFORMATION OR SUBPOENA12
556	556	PURSUANT TO THIS SECTION MUST BE MADE IN THE MANNER PRESCRIBED13
557	557	BY LAW.14
558	558	(3) I
559	559	F A PERSON FAILS TO APPEAR OR FAILS TO COOPERATE WITH AN15
560	560	INVESTIGATION OR INQUIRY MADE OR A SUBPOENA ISSUED PURSUANT TO16
561	561	THIS SECTION, THE ATTORNEY GENERAL MAY APPLY TO A DISTRICT COURT17
562	562	FOR AN APPROPRIATE ORDER TO EFFECT THE PURPOSES OF THIS ARTICLE18
563	563	19.
564	564	THE APPLICATION MUST STATE THAT THERE IS REASONABLE CAUSE TO19
565	565	BELIEVE THAT THE ORDER APPLIED FOR IS NECESSARY TO ENFORCE THIS20
566	566	ARTICLE 19. IF THE COURT IS SATISFIED THAT REASONABLE CAUSE EXISTS ,21
567	567	THE COURT MAY:22
568	568	(a) R
569	569	EQUIRE THE ATTENDANCE OF , OR THE PRODUCTION OF23
570	570	DOCUMENTS BY, THE PERSON, OR BOTH;24
571	571	(b) A
572	572	SSESS A CIVIL PENALTY OF UP TO FIVE THOUSAND DOLLARS25
573	573	FOR THE FAILURE TO APPEAR AND ANSWER QUESTIONS , WRITTEN OR26
574	574	OTHERWISE, OR THE FAILURE TO PRODUCE DOCUMENTS , UNLESS THE27
575	575	SB25-198
576	576	-16- COURT FINDS THAT THE FAILURE TO APPEAR , TO ANSWER QUESTIONS, OR1
577	577	TO PRODUCE DOCUMENTS WAS SUBSTANTIALLY JUSTIFIED OR THAT OTHER2
578	578	CIRCUMSTANCES MAKE AN ASSESSMENT OF A CIVIL PENALTY UNJUST ;3
579	579	(c) A
580	580	WARD THE ATTORNEY GENERAL REASONABLE COSTS AND4
581	581	ATTORNEY FEES IN MAKING THE APPLICATION , UNLESS THE COURT FINDS5
582	582	THAT THE FAILURE TO APPEAR, TO ANSWER QUESTIONS, OR TO PRODUCE6
583	583	DOCUMENTS WAS SUBSTANTIALLY JUSTIFIED OR THAT OTHER7
584	584	CIRCUMSTANCES MAKE AN AWARD OF COSTS AND ATTORNEY FEES UNJUST ;8
585	585	(d) E
586	586	NTER A PROTECTIVE ORDER AS PROVIDED FOR IN THE9
587	587	C
588	588	OLORADO RULES OF CIVIL PROCEDURE ; AND10
589	589	(e) G
590	590	RANT OTHER OR FURTHER RELIEF AS MAY BE NECESSARY TO11
591	591	OBTAIN COMPLIANCE BY THE PERSON .12
592	592	(4) M
593	593	ATERIALS PROVIDED TO THE ATTORNEY GENERAL PURSUANT13
594	594	TO THIS SECTION AND ANY OTHER WRITTEN RESPONSE , TESTIMONY, OR14
595	595	DOCUMENTS OBTAINED BY THE ATTORNEY GENERAL PURSUANT TO THIS15
596	596	SECTION, OR INFORMATION DERIVED DIRECTLY OR INDIRECTLY FROM THE16
597	597	WRITTEN RESPONSE, TESTIMONY, OR DOCUMENTS, ARE NOT ADMISSIBLE IN17
598	598	EVIDENCE IN A CRIMINAL PROSECUTION AGAINST THE PERSON PROVIDING18
599	599	THE WRITTEN RESPONSE, TESTIMONY, OR DOCUMENTS. THIS ARTICLE 1919
600	600	DOES NOT PREVENT A LAW ENFORCEMENT OFFICER FROM PRODUCING OR20
601	601	OBTAINING THE SAME OR SIMILAR FACTS, INFORMATION, OR EVIDENCE FOR21
602	602	USE IN A CRIMINAL PROSECUTION, SO LONG AS THE LAW ENFORCEMENT22
603	603	OFFICER HAS AN INDEPENDENT BASIS FOR DOING SO .23
604	604	(5) N
605	605	OTHING IN THIS SECTION PROHIBITS THE ATTORNEY GENERAL24
606	606	FROM DISCLOSING INFORMATION OBTAINED PURSUANT TO THIS ARTICLE 1925
607	607	TO ANOTHER LAW ENFORCEMENT AGENCY , A DEPARTMENT OF A26
608	608	GOVERNMENTAL OR PUBLIC ENTITY OF THIS OR ANOTHER STATE , OR THE27
609	609	SB25-198
610	610	-17- FEDERAL GOVERNMENT TO ASSIST WITH AN ONGOING INVESTIGATION AND1
611	611	IF THE OTHER LAW ENFORCEMENT AGENCY OR DEPARTMENT EXECUTES AN2
612	612	AGREEMENT STATING THAT THE INFORMATION WILL REMAIN3
613	613	CONFIDENTIAL AND WILL NOT BE ADMITTED AS EVIDENCE IN A CRIMINAL4
614	614	PROSECUTION AGAINST THE PERSON PROVIDING THE WRITTEN RESPONSE ,5
615	615	TESTIMONY, OR DOCUMENTS.6
616	616	(6) N
617	617	OTICES PROVIDED PURSUANT TO SECTION 6-19-102 AND ANY7
618	618	ADDITIONAL INFORMATION RECEIVED PURSUANT TO THIS SECTION ARE8
619	619	INVESTIGATIVE RECORDS . THE ATTORNEY GENERAL MAY DEEM9
620	620	INVESTIGATIVE RECORDS OR RECORDS REGARDING INTELLIGENCE10
621	621	INFORMATION OBTAINED UNDER THIS ARTICLE 19 PUBLIC RECORDS11
622	622	SUBJECT TO PUBLIC INSPECTION IN ACCORDANCE WITH THE "COLORADO12
623	623	O
624	624	PEN RECORDS ACT", PART 2 OF ARTICLE 72 OF TITLE 24.13
625	625	(7) N
626	626	OTHING IN THIS SECTION PREVENTS OR LIMITS THE ATTORNEY14
627	627	GENERAL'S AUTHORITY TO ISSUE PUBLIC STATEMENTS DESCRIBING OR15
628	628	WARNING OF CONDUCT THAT VIOLATES THIS ARTICLE 19, OR ANOTHER16
629	629	ARTICLE OF THIS TITLE 6, REGARDLESS OF WHETHER THE PUBLIC17
630	630	STATEMENTS ARE MADE ON A LOCAL , STATEWIDE, REGIONAL, OR18
631	631	NATIONWIDE BASIS.19
632	632	6-19-104. Assessment of proposed material change transaction20
633	633	by the attorney general - prohibition of proposed material change21
634	634	transaction that is contrary to the public interest - appeal of22
635	635	assessment - enforcement. (1) T
636	636	HE ATTORNEY GENERAL MAY REVIEW A23
637	637	NOTICE PROVIDED PURSUANT TO SECTION 6-19-102. IF THE ATTORNEY24
638	638	GENERAL REVIEWS SUCH A NOTICE, THE ATTORNEY GENERAL MAY ASSESS25
639	639	WHETHER THE PROPOSED MATERIAL CHANGE TRANSACTION IS CONTRARY26
640	640	TO THE PUBLIC INTEREST. AN ASSESSMENT BY THE ATTORNEY GENERAL27
641	641	SB25-198
642	642	-18- MUST CONSIDER WHETHER THE MATERIAL CHANGE TRANSACTION WILL :1
643	643	(a) H
644	644	ARM PUBLIC HEALTH, INCLUDING BY REDUCING AVAILABLE2
645	645	SERVICES, WORKFORCE, OR HEALTH OUTCOMES;3
646	646	(b) R
647	647	EDUCE THE AFFECTED COMMUNITY 'S CONTINUED ACCESS TO4
648	648	AFFORDABLE AND QUALITY CARE AND TO THE RANGE OF SERVICES5
649	649	HISTORICALLY PROVIDED BY THE ENTITIES OR WILL PREVENT MEMBERS IN6
650	650	THE AFFECTED COMMUNITY FROM RECEIVING A COMPARABLE OR BETTER7
651	651	PATIENT EXPERIENCE;8
652	652	(c) H
653	653	AVE A DETRIMENTAL IMPACT ON COMPETING HEALTH -CARE9
654	654	OPTIONS WITHIN PRIMARY AND DISPERSED SERVICE AREAS ;10
655	655	(d) R
656	656	EDUCE DELIVERY OF HEALTH CARE TO DISADVANTAGED ,11
657	657	UNINSURED, UNDERINSURED, AND UNDERSERVED POPULATIONS AND TO12
658	658	POPULATIONS ENROLLED IN PUBLIC HEALTH -CARE PROGRAMS;13
659	659	(e) H
660	660	AVE A SUBSTANTIAL NEGATIVE IMPACT ON MEDICAL14
661	661	EDUCATION AND TEACHING PROGRAMS , HEALTH-CARE WORKFORCE15
662	662	TRAINING, OR MEDICAL RESEARCH;16
663	663	(f) H
664	664	AVE A NEGATIVE IMPACT ON THE MARKETS FOR :17
665	665	(I) H
666	666	EALTH-CARE SERVICES, LONG-TERM CARE SERVICES, OR18
667	667	VETERINARY SERVICES;19
668	668	(II) S
669	669	ERVICES PROVIDED BY INSURERS; OR20
670	670	(III) W
671	671	ORKERS HIRED OR CONTRACTED TO PROVIDE HEALTH -CARE21
672	672	SERVICES, LONG-TERM CARE SERVICES, OR VETERINARY CARE SERVICES;22
673	673	(g) I
674	674	NCREASE HEALTH-CARE, LONG-TERM CARE, OR VETERINARY23
675	675	CARE COSTS FOR PATIENTS;24
676	676	(h) R
677	677	EDUCE BILLING TRANSPARENCY OR INCREASE THE RISK OF25
678	678	UNFAIR, DECEPTIVE, OR ABUSIVE BILLING PRACTICES;26
679	679	(i) A
680	680	DVERSELY IMPACT PROVIDER COST TRENDS AND27
681	681	SB25-198
682	682	-19- CONTAINMENT OF TOTAL HEALTH -CARE SPENDING;1
683	683	(j) H
684	684	AVE A NEGATIVE IMPACT ON WAGES PAID BY, OR THE NUMBER2
685	685	OF EMPLOYEES EMPLOYED BY , A HEALTH-CARE, LONG-TERM CARE, OR3
686	686	VETERINARY CARE ENTITY INVOLVED IN A MATERIAL CHANGE4
687	687	TRANSACTION;5
688	688	(k) H
689	689	AVE A NEGATIVE IMPACT ON WAGES , COLLECTIVE6
690	690	BARGAINING UNITS, AND COLLECTIVE BARGAINING AGREEMENTS OF7
691	691	EXISTING OR FUTURE WORKERS EMPLOYED BY A HEALTH -CARE,8
692	692	LONG-TERM CARE, OR VETERINARY CARE ENTITY INVOLVED IN A MATERIAL9
693	693	CHANGE TRANSACTION;10
694	694	(l) F
695	695	AIL TO ENSURE THAT, IF ASSETS CURRENTLY USED FOR A11
696	696	CHARITABLE PURPOSE WILL NO LONGER BE SUBJECT TO A CHARITABLE12
697	697	PURPOSE, APPROPRIATE STEPS ARE TAKEN TO SAFEGUARD THE VALUE OF13
698	698	THE ASSETS AND TO ENSURE THAT ANY PROCEEDS OF THE MATERIAL14
699	699	CHANGE TRANSACTION ARE DEDICATED TO THE CHARITABLE PURPOSES15
700	700	FOR WHICH THE ASSETS ARE CURRENTLY USED ; OR16
701	701	(m) R
702	702	ESULT IN A DIRECTOR, OFFICER OF THE BOARD, CHIEF17
703	703	EXECUTIVE OFFICER, CHIEF OPERATING OFFICER, OR CHIEF FINANCIAL18
704	704	OFFICER OF A NONPROFIT ENTITY THAT WILL EXPERIENCE A CHANGE IN19
705	705	CHARITABLE PURPOSE AS A RESULT OF THE MATERIAL CHANGE20
706	706	TRANSACTION, OR A NONPROFIT CHARITABLE ORGANIZATION RECEIVING21
707	707	THE PROCEEDS OF THE MATERIAL CHANGE TRANSACTION , BENEFITTING22
708	708	DIRECTLY OR INDIRECTLY FROM THE TRANSACTION .23
709	709	(2) (a) T
710	710	HE ATTORNEY GENERAL MAY ISSUE A WRITTEN24
711	711	ASSESSMENT, BASED ON THE FACTS AND EVIDENCE AVAILABLE , THAT:25
712	712	(I) A
713	713	FORMAL ASSESSMENT AND REVIEW ARE NOT NECESSARY FOR26
714	714	THE MATERIAL CHANGE TRANSACTION OR THAT THE NOTICED CHANGE27
715	715	SB25-198
716	716	-20- DOES NOT CONSTITUTE A MATERIAL CHANGE TRANSACTION ;1
717	717	(II) T
718	718	HE MATERIAL CHANGE TRANSACTION IS NOT LIKELY TO BE2
719	719	CONTRARY TO THE PUBLIC INTEREST ; OR3
720	720	(III) T
721	721	HE MATERIAL CHANGE TRANSACTION IS CONTRARY TO THE4
722	722	PUBLIC INTEREST.5
723	723	(b) T
724	724	HE ATTORNEY GENERAL SHALL INCLUDE IN AN ASSESSMENT6
725	725	SPECIFIC FINDINGS ON EACH OF THE FACTORS PROVIDED IN SUBSECTION (1)7
726	726	OF THIS SECTION OR OTHER FACTORS CONSIDERED THAT WERE RELEVANT8
727	727	TO THE ATTORNEY GENERAL 'S ASSESSMENT.9
728	728	(3) T
729	729	HE ATTORNEY GENERAL MAY ISSUE AN ASSESSMENT10
730	730	PURSUANT TO SUBSECTION (2)(a)(I) OR (2)(a)(II) OF THIS SECTION SUBJECT11
731	731	TO THE AGREEMENT OF THE PARTIES TO CONDITIONS THAT THE ATTORNEY12
732	732	GENERAL DEEMS NECESSARY TO PREVENT THE OUTCOMES DESCRIBED IN13
733	733	SUBSECTION (1) OF THIS SECTION.14
734	734	(4) T
735	735	HE ATTORNEY GENERAL, AT ANY POINT IN THEIR REVIEW OF15
736	736	A MATERIAL CHANGE TRANSACTION UNDER THIS ARTICLE 19, MAY16
737	737	CONVERT THEIR INVESTIGATION OF THE MATERIAL CHANGE TRANSACTION17
738	738	TO AN INVESTIGATION UNDER THE "COLORADO STATE ANTITRUST ACT OF18
739	739	2023",
740	740	ARTICLE 4 OF THIS TITLE 6, WITH ALL POWERS, AUTHORITIES, AND19
741	741	REMEDIES AVAILABLE UNDER THAT ACT .20
742	742	(5) A
743	743	N ASSESSMENT ISSUED PURSUANT TO SUBSECTION (2) OF THIS21
744	744	SECTION IS NOT EFFECTIVE IF THE TERMS OF THE MATERIAL CHANGE22
745	745	TRANSACTION ARE ALTERED OR MODIFIED AFTER THE ATTORNEY GENERAL23
746	746	ISSUES THE ASSESSMENT. IF THE PARTIES TO A MATERIAL CHANGE24
747	747	TRANSACTION ALTER OR MODIFY THE TERMS OF THE MATERIAL CHANGE25
748	748	TRANSACTION FOLLOWING ISSUANCE OF THE ASSESSMENT , THE PARTIES26
749	749	SHALL NOT INSTITUTE OR MAKE EFFECTIVE THE MATERIAL CHANGE27
750	750	SB25-198
751	751	-21- TRANSACTION UNTIL THE ATTORNEY GENERAL HAS :1
752	752	(a) R
753	753	ECEIVED NOTICE AND UPDATED INFORMATION IN COMPLIANCE2
754	754	WITH SECTION 6-19-102 (7) OR WAIVED THE REQUIREMENT FOR THE3
755	755	NOTICE AND UPDATED INFORMATION PURSUANT TO SECTION 6-19-102 (8);4
756	756	AND5
757	757	(b) R
758	758	ENEWED THE PRIOR ASSESSMENT OR ISSUED A NEW6
759	759	ASSESSMENT PURSUANT TO SUBSECTION (2) OF THIS SECTION ON THE BASIS7
760	760	OF THE UPDATED INFORMATION .8
761	761	(6) (a) P
762	762	ARTIES TO A MATERIAL CHANGE TRANSACTION MAY9
763	763	COMMENCE AN ACTION FOR JUDICIAL REVIEW IN THE DISTRICT COURT FOR10
764	764	THE CITY AND COUNTY OF DENVER WITHIN THIRTY-FIVE DAYS AFTER AN11
765	765	ASSESSMENT IS ISSUED PURSUANT TO SUBSECTION (2) OF THIS SECTION.12
766	766	(b) I
767	767	F A PARTY TO A MATERIAL CHANGE TRANSACTION SEEKS13
768	768	JUDICIAL REVIEW, THE REVIEWING COURT SHALL AFFIRM THE ATTORNEY14
769	769	GENERAL'S ASSESSMENT UNLESS THE PERSON SEEKING JUDICIAL REVIEW15
770	770	PROVES, BY A PREPONDERANCE OF THE EVIDENCE , THAT THE ATTORNEY16
771	771	GENERAL'S ASSESSMENT IS:17
772	772	(I) A
773	773	RBITRARY OR CAPRICIOUS;18
774	774	(II) A
775	775	DENIAL OF A STATUTORY RIGHT;19
776	776	(III) C
777	777	ONTRARY TO A CONSTITUTIONAL RIGHT , POWER, PRIVILEGE,20
778	778	OR IMMUNITY;21
779	779	(IV) I
780	780	N EXCESS OF STATUTORY JURISDICTION , AUTHORITY,22
781	781	PURPOSE, OR LIMITATION;23
782	782	(V) N
783	783	OT IN ACCORD WITH THE PROCEDURES OR PROCEDURAL24
784	784	LIMITATIONS OF THIS ARTICLE 19 OR OTHERWISE REQUIRED BY LAW ;25
785	785	(VI) A
786	786	N ABUSE OR CLEARLY UNWARRANTED EXERCISE OF26
787	787	DISCRETION;27
788	788	SB25-198
789	789	-22- (VII) BASED UPON FINDINGS OF FACT THAT ARE CLEARLY1
790	790	ERRONEOUS ON THE WHOLE RECORD ;2
791	791	(VIII) U
792	792	NSUPPORTED BY SUBSTANTIAL EVIDENCE WHEN THE3
793	793	RECORD IS CONSIDERED AS A WHOLE ; OR4
794	794	(IX) O
795	795	THERWISE CONTRARY TO LAW .5
796	796	(c) T
797	797	HE COMPLAINT MADE PURSUANT TO THIS SUBSECTION (6)6
798	798	MUST STATE THE FACTS UPON WHICH THE PLAINTIFF BASES THE CLAIM7
799	799	THAT THE ATTORNEY GENERAL'S ASSESSMENT IS UNLAWFUL, THE REASONS8
800	800	ENTITLING THE PLAINTIFF TO RELIEF, AND THE RELIEF THAT THEY SEEK.9
801	801	(d) T
802	802	HE REVIEWING COURT MAY ISSUE ANY ORDER NECESSARY TO10
803	803	ENSURE THAT THE MATERIAL CHANGE TRANSACTION IS NOT CONTRARY TO11
804	804	THE PUBLIC INTEREST.12
805	805	(7) A
806	806	PARTY TO A MATERIAL CHANGE TRANSACTION SHALL NOT13
807	807	INSTITUTE OR MAKE EFFECTIVE THE MATERIAL CHANGE TRANSACTION14
808	808	UNTIL:15
809	809	(a) T
810	810	HE ATTORNEY GENERAL STATES , PURSUANT TO SUBSECTION16
811	811	(2)(a)(I)
812	812	OF THIS SECTION, THAT A FORMAL ASSESSMENT AND REVIEW ARE17
813	813	NOT NECESSARY OR THAT THE NOTICED CHANGE IS NOT A MATERIAL18
814	814	CHANGE TRANSACTION;19
815	815	(b) T
816	816	HE ATTORNEY GENERAL ISSUES AN ASSESSMENT THAT THE20
817	817	MATERIAL CHANGE TRANSACTION IS NOT LIKELY TO BE CONTRARY TO THE21
818	818	PUBLIC INTEREST PURSUANT SUBSECTION (2)(a)(II) OF THIS SECTION;22
819	819	(c) A
820	820	COURT:23
821	821	(I) A
822	822	FFIRMS THE ATTORNEY GENERAL'S ASSESSMENT PURSUANT TO24
823	823	SUBSECTION (6)(b) OF THIS SECTION THAT THE MATERIAL CHANGE25
824	824	TRANSACTION IS NOT LIKELY TO BE CONTRARY TO THE PUBLIC INTEREST ;26
825	825	OR27
826	826	SB25-198
827	827	-23- (II) FINDS THAT THE MATERIAL CHANGE TRANSACTION IS NOT1
828	828	LIKELY TO BE CONTRARY TO THE PUBLIC INTEREST ;2
829	829	(d) N
830	830	INETY DAYS HAVE ELAPSED SINCE THE PARTIES TO THE3
831	831	MATERIAL CHANGE TRANSACTION LAST SUBMITTED WRITTEN NOTICE TO4
832	832	THE ATTORNEY GENERAL OF THE MATERIAL CHANGE TRANSACTION5
833	833	PURSUANT TO SECTION 6-19-102 OR SUBSECTION (5)(a) OF THIS SECTION,6
834	834	AND THE ATTORNEY GENERAL HAS NOT NOTIFIED THE PARTIES TO THE7
835	835	MATERIAL CHANGE TRANSACTION THAT THE ATTORNEY GENERAL8
836	836	REQUIRES MORE TIME TO COMPLETE AN ASSESSMENT ; OR9
837	837	(e) T
838	838	HE ATTORNEY GENERAL HAS NOTIFIED THE PARTIES THAT10
839	839	MORE TIME IS REQUIRED TO COMPLETE THE ASSESSMENT PURSUANT TO11
840	840	SUBSECTION (7)(d) OF THIS SECTION, AND AT LEAST FORTY-FIVE DAYS12
841	841	HAVE ELAPSED SINCE THE ATTORNEY GENERAL PROVIDED THE NOTICE .13
842	842	(8) T
843	843	HE ATTORNEY GENERAL MAY BRING AN ACTION IN DISTRICT14
844	844	COURT:15
845	845	(a) T
846	846	O PREVENT OR RESTRAIN VIOLATIONS OF THIS SECTION ;16
847	847	(b) T
848	848	O ENFORCE COMPLIANCE WITH CONDITIONS AGREED TO17
849	849	PURSUANT TO SUBSECTION (3) OF THIS SECTION; OR18
850	850	(c) F
851	851	OR OTHER SUCH EQUITABLE RELIEF AS MAY BE NECESSARY TO19
852	852	PROTECT THE PUBLIC INTEREST, INCLUDING AN ORDER UNWINDING THE20
853	853	MATERIAL CHANGE TRANSACTION .21
854	854	(9) A
855	855	N ASSESSMENT ISSUED UNDER THIS SECTION OR A DECISION22
856	856	NOT TO ISSUE AN ASSESSMENT UNDER THIS SECTION DOES NOT PRECLUDE23
857	857	OR OTHERWISE PREJUDICE A SUBSEQUENT ACTION AGAINST ANY PARTIES24
858	858	TO A MATERIAL CHANGE TRANSACTION FOR VIOLATIONS OF STATE OR25
859	859	FEDERAL LAW.26
860	860	6-19-105. Post-change requirements - report. (1) F
861	861	OR AT LEAST27
862	862	SB25-198
863	863	-24- FIVE YEARS AFTER THE EFFECTIVE DATE OF A MATERIAL CHANGE1
864	864	TRANSACTION, THE PARTIES TO A MATERIAL CHANGE TRANSACTION2
865	865	SUBJECT TO SECTION 6-19-102 (2) OR (3) SHALL PROVIDE THE ATTORNEY3
866	866	GENERAL AN ANNUAL REPORT OF :4
867	867	(a) T
868	868	HE ACTIVITIES TO SATISFY ANY CONDITIONS AGREED TO5
869	869	PURSUANT TO SECTION 6-19-104 (3);6
870	870	(b) A
871	871	NY ADDITIONAL MATERIAL CHANGE TRANSACTIONS7
872	872	INVOLVING THE PARTIES; AND8
873	873	(c) I
874	874	F THE MATERIAL CHANGE TRANSACTION RESULTS IN ASSETS9
875	875	THAT WERE FORMERLY USED FOR A CHARITABLE PURPOSE NO LONGER10
876	876	BEING USED FOR SUCH A PURPOSE , THE PARTIES' GRANT-MAKING AND11
877	877	OTHER CHARITABLE ACTIVITIES RELATED TO THE PARTIES ' USE OF THE12
878	878	PROCEEDS OF THE MATERIAL CHANGE TRANSACTION .13
879	879	(2) (a) T
880	880	HE ATTORNEY GENERAL SHALL MAKE THE ANNUAL14
881	881	REPORT CREATED PURSUANT TO SUBSECTION (1) OF THIS SECTION15
882	882	AVAILABLE TO THE PUBLIC ON THE ATTORNEY GENERAL 'S WEBSITE.16
883	883	(b) E
884	884	ACH PARTY TO THE MATERIAL CHANGE TRANSACTION SHALL17
885	885	MAKE THE ANNUAL REPORT CREATED PURSUANT TO SUBSECTION (1) OF18
886	886	THIS SECTION AVAILABLE TO THE PUBLIC ON THE PARTY 'S WEBSITE.19
887	887	(3) E
888	888	ACH PARTY TO A MATERIAL CHANGE TRANSACTION SHALL20
889	889	FILE THE ANNUAL REPORT CREATED PURSUANT TO SUBSECTION (1) OF THIS21
890	890	SECTION NO LATER THAN NINETY DAYS AFTER THE END OF THE YEAR THAT22
891	891	THE REPORT ADDRESSES.23
892	892	6-19-106. Penalties - remedy - injunction. (1) A
893	893	PERSON THAT24
894	894	FAILS TO COMPLY WITH THIS ARTICLE 19 IS SUBJECT TO A CIVIL PENALTY25
895	895	OF NOT MORE THAN TWO HUNDRED DOLLARS FOR EACH DAY THE PERSON26
896	896	REMAINS IN VIOLATION OF THIS ARTICLE 19.27
897	897	SB25-198
898	898	-25- (2) FAILURE OF A PARTY TO A MATERIAL CHANGE TRANSACTION TO1
899	899	PROVIDE NOTICE OF THE MATERIAL CHANGE TRANSACTION AS REQUIRED2
900	900	BY THIS ARTICLE 19 IS AN INDEPENDENT AND SUFFICIENT GROUND FOR THE3
901	901	ATTORNEY GENERAL TO ASSESS THAT THE MATERIAL CHANGE4
902	902	TRANSACTION IS LIKELY TO BE CONTRARY TO THE PUBLIC INTEREST OR FOR5
903	903	A COURT TO ENJOIN OR UNWIND THE MATERIAL CHANGE TRANSACTION OR6
904	904	PROVIDE OTHER EQUITABLE RELIEF.7
905	905	(3) F
906	906	AILURE OF A PARTY TO A MATERIAL CHANGE TRANSACTION TO8
907	907	PROVIDE TIMELY INFORMATION AS REQUIRED BY THE ATTORNEY GENERAL9
908	908	IS AN INDEPENDENT AND SUFFICIENT GROUND FOR THE ATTORNEY10
909	909	GENERAL TO ASSESS THAT THE MATERIAL CHANGE TRANSACTION IS LIKELY11
910	910	TO BE CONTRARY TO THE PUBLIC INTEREST, OR FOR A COURT TO ENJOIN OR12
911	911	UNWIND THE MATERIAL CHANGE TRANSACTION OR PROVIDE OTHER13
912	912	EQUITABLE RELIEF, IF THE ATTORNEY GENERAL NOTIFIED THE ENTITIES OF14
913	913	THE INADEQUACY OF THE INFORMATION PROVIDED AND PROVIDED THE15
914	914	ENTITIES WITH A REASONABLE OPPORTUNITY TO REMEDY THE16
915	915	INADEQUACY.17
916	916	6-19-107. Effect on existing authorities - rules. (1) T
917	917	HE18
918	918	ATTORNEY GENERAL MAY ADOPT RULES FOR THE PURPOSE OF CARRYING19
919	919	OUT THIS ARTICLE 19, INCLUDING:20
920	920	(a) R
921	921	ULES DEFINING THE TERMS USED IN THIS ARTICLE 19;21
922	922	(b) R
923	923	ULES EXEMPTING FROM THE REQUIREMENTS OF THIS ARTICLE22
924	924	19:23
925	925	(I) C
926	926	LASSES OF PERSONS; AND24
927	927	(II) M
928	928	ATERIAL CHANGE TRANSACTIONS THAT ARE NOT LIKELY TO25
929	929	BE CONTRARY TO THE PUBLIC INTEREST ;26
930	930	(c) R
931	931	ULES IDENTIFYING ADDITIONAL FACTORS TO THE FACTORS27
932	932	SB25-198
933	933	-26- DESCRIBED IN SECTION 6-19-104 (1) THAT MAY BE CONSIDERED IN1
934	934	ASSESSING WHETHER A MATERIAL CHANGE TRANSACTION IS IN THE PUBLIC2
935	935	INTEREST;3
936	936	(d) R
937	937	ULES REQUIRING THAT PERSONS PROVIDE ADDITIONAL4
938	938	INFORMATION IN ORDER TO COMPLY WITH SECTION 6-19-102 OR5
939	939	PRESCRIBING THE FORM OF NOTICES SUBMITTED PURSUANT TO SECTION6
940	940	6-19-102;
941	941	AND7
942	942	(e) O
943	943	THER RULES AS MAY BE NECESSARY AND APPROPRIATE TO8
944	944	CARRY OUT THE PURPOSES OF THIS ARTICLE 19.9
945	945	(2) (a) N
946	946	OTHING IN THIS ARTICLE 19 LIMITS THE ATTORNEY10
947	947	GENERAL'S COMMON LAW POWERS .11
948	948	(b) N
949	949	OTHING IN THIS ARTICLE 19 AFFECTS THE REGULATORY12
950	950	AUTHORITY OF A GOVERNMENT AGENCY OTHER THAN THE DEPARTMENT13
951	951	OF LAW.14
952	952	SECTION 2. In Colorado Revised Statutes, add 25-49-107 as15
953	953	follows:16
954	954	25-49-107. Providers - physicians - disclosure of certain17
955	955	referrals - definitions. (1) A
956	956	S USED IN THIS SECTION, UNLESS THE18
957	957	CONTEXT OTHERWISE REQUIRES :19
958	958	(a) "D
959	959	ESIGNATED HEALTH SERVICES" HAS THE MEANING SET FORTH20
960	960	IN SECTION 25.5-4-414 (1)(a).21
961	961	(b) "F
962	962	INANCIAL RELATIONSHIP" MEANS AN OWNERSHIP OR22
963	963	INVESTMENT INTEREST IN AN ENTITY FURNISHING DESIGNATED HEALTH23
964	964	SERVICES. AN OWNERSHIP OR INVESTMENT INTEREST MAY BE REFLECTED24
965	965	IN EQUITY, DEBT, OR OTHER INSTRUMENTS.25
966	966	(c) "I
967	967	MMEDIATE FAMILY MEMBER OF THE PROVIDER " MEANS A26
968	968	SPOUSE, NATURAL OR ADOPTIVE PARENT , NATURAL OR ADOPTIVE CHILD,27
969	969	SB25-198
970	970	-27- STEPPARENT, STEPCHILD, STEPBROTHER , STEPSISTER, IN-LAW,1
971	971	GRANDPARENT, OR GRANDCHILD OF A PROVIDER.2
972	972	(d) "P
973	973	ROVIDER" MEANS:3
974	974	(I) A
975	975	DOCTOR OF MEDICINE OR OSTEOPATHY WHO IS LICENSED TO4
976	976	PRACTICE MEDICINE PURSUANT TO ARTICLE 240 OF TITLE 12;5
977	977	(II) A
978	978	DOCTOR OF DENTAL SURGERY OR OF DENTAL MEDICINE WHO6
979	979	IS LICENSED TO PRACTICE DENTISTRY PURSUANT TO ARTICLE 220 OF TITLE7
980	980	12;8
981	981	(III) A
982	982	DOCTOR OF PODIATRIC MEDICINE WHO IS LICENSED TO9
983	983	PRACTICE PODIATRY PURSUANT TO ARTICLE 290 OF TITLE 12;10
984	984	(IV) A
985	985	DOCTOR OF OPTOMETRY WHO IS LICENSED TO PRACTICE11
986	986	OPTOMETRY PURSUANT TO ARTICLE 275 OF TITLE 12; OR12
987	987	(V) A
988	988	CHIROPRACTOR WHO IS LICENSED TO PRACTICE13
989	989	CHIROPRACTIC PURSUANT TO ARTICLE 215 OF TITLE 12.14
990	990	(2) (a) I
991	991	F A PROVIDER REFERS A PATIENT TO AN ENTITY FOR15
992	992	DESIGNATED HEALTH SERVICES AND THE PROVIDER , OR AN IMMEDIATE16
993	993	FAMILY MEMBER OF THE PROVIDER, HAS A FINANCIAL RELATIONSHIP WITH17
994	994	THE ENTITY, THE PROVIDER SHALL DISCLOSE THE NATURE OF THE18
995	995	FINANCIAL RELATIONSHIP TO THE PATIENT AT THE TIME OF THE REFERRAL .19
996	996	A
997	997	T THE PATIENT'S REQUEST, THE PROVIDER SHALL PROVIDE THE PATIENT20
998	998	WITH REASONABLE ALTERNATIVE REFERRAL OPTIONS FOR ENTITIES WITH21
999	999	WHICH THE PROVIDER, OR AN IMMEDIATE FAMILY MEMBER OF THE22
1000	1000	PROVIDER, DOES NOT HAVE A FINANCIAL RELATIONSHIP .23
1001	1001	(b) S
1002	1002	UBSECTION (2)(a) OF THIS SECTION DOES NOT APPLY TO A24
1003	1003	FINANCIAL RELATIONSHIP THAT M EETS THE REQUIREMENTS OF AN25
1004	1004	EXCEPTION TO THE PROHIBITIONS ESTABLISHED BY 42 U.S.C. SEC. 1395nn26
1005	1005	OR REGULATIONS ADOPTED PURSUANT TO 42 U.S.C. SEC. 1395nn, AS THEY27
1006	1006	SB25-198
1007	1007	-28- EXISTED ON THE EFFECTIVE DATE OF THIS SECTION.1
1008	1008	(c) S
1009	1009	UBSECTION (2)(a) OF THIS SECTION DOES NOT APPLY TO A2
1010	1010	FINANCIAL RELATIONSHIP OR A REFERRAL FOR DESIGNATED HEALTH3
1011	1011	SERVICES IF THE FINANCIAL RELATIONSHIP OR REFERRAL FOR DESIGNATED4
1012	1012	HEALTH SERVICES WOULD NOT VIOLATE 42 U.S.C. SEC. 1395nn OR5
1013	1013	REGULATIONS ADOPTED PURSUANT TO 42 U.S.C. SEC. 1395nn, AS THEY6
1014	1014	EXISTED ON THE EFFECTIVE DATE OF THIS SECTION , IF THE DESIGNATED7
1015	1015	HEALTH SERVICES WERE ELIGIBLE FOR PAYMENT UNDER MEDICARE8
1016	1016	RATHER THAN UNDER THE "COLORADO MEDICAL ASSISTANCE ACT",9
1017	1017	ARTICLES 4 TO 6 OF TITLE 25.5.10
1018	1018	(3) A
1019	1019	N ENTITY THAT PROVIDES DESIGNATED HEALTH SERVICES AS11
1020	1020	A RESULT OF A REFERRAL WITHOUT INFORMING THE PATIENT OF THE12
1021	1021	REFERRING PROVIDER'S FINANCIAL INTEREST, OR AN IMMEDIATE FAMILY13
1022	1022	MEMBER OF THE REFERRING PROVIDER 'S FINANCIAL INTEREST, IN THE14
1023	1023	ENTITY PURSUANT TO SUBSECTION (2)(a) OF THIS SECTION SHALL NOT15
1024	1024	PRESENT A CLAIM OR BILL TO AN INDIVIDUAL, A THIRD-PARTY PAYER, THE16
1025	1025	DEPARTMENT OF HEALTH CARE POLICY AND FINANCING , OR ANY OTHER17
1026	1026	ENTITY FOR THE DESIGNATED HEALTH SERVICES .18
1027	1027	(4) A
1028	1028	PROVIDER THAT REFERS A PATIENT FOR DESIGNATED HEALTH19
1029	1029	SERVICES IN VIOLATION OF SUBSECTION (2)(a) OF THIS SECTION COMMITS20
1030	1030	A DECEPTIVE TRADE PRACTICE UNDER PART 1 OF THE "COLORADO21
1031	1031	C
1032	1032	ONSUMER PROTECTION ACT", ARTICLE 1 OF TITLE 6.22
1033	1033	SECTION 3. In Colorado Revised Statutes, 6-1-105, add (1)(iiii)23
1034	1034	as follows:24
1035	1035	6-1-105. Unfair or deceptive trade practices - definitions.25
1036	1036	(1) A person engages in a deceptive trade practice when, in the course of26
1037	1037	the person's business, vocation, or occupation, the person:27
1038	1038	SB25-198
1039	1039	-29- (iiii) VIOLATES ARTICLE 19 OF THIS TITLE 6.1
1040	1040	SECTION 4. Applicability. Section 6-19-102, Colorado Revised2
1041	1041	Statutes, as enacted in section 1 of this act, applies to material change3
1042	1042	transactions with an anticipated effective date not sooner than ninety days4
1043	1043	after the effective date of this act.5
1044	1044	SECTION 5. Safety clause. The general assembly finds,6
1045	1045	determines, and declares that this act is necessary for the immediate7
1046	1046	preservation of the public peace, health, or safety or for appropriations for8
1047	1047	the support and maintenance of the departments of the state and state9
1048	1048	institutions.10
1049	1049	SB25-198
1050	1050	-30-