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Legislative Year: 2021 Change

Bill Detail: HB21-1198

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Title Health-care Billing Requirements For Indigent Patients
Status Governor Signed (07/06/2021)
Bill Subjects
  • Health Care & Health Insurance
House Sponsors I. Jodeh (D)
Senate Sponsors J. Buckner (D)
C. Kolker (D)
House Committee Health and Insurance
Senate Committee Health and Human Services
Date Introduced 03/04/2021

No later than June 1, 2022, a health-care facility shall screen each
uninsured patient for eligibility for public health insurance programs,

discounted care through the Colorado indigent care program (CICP), and
discounted care as described in the bill. Health-care facilities shall use a
single uniform application developed by the department of health care
policy and financing (department) when screening a patient. If a
health-care facility determines a patient is ineligible for discounted care,
the facility shall provide the patient notice of the determination and an
opportunity for the patient to appeal the determination.
For emergency and other non-CICP health-care services provided
to qualified patients, a health-care facility and licensed health-care
professional shall limit the amounts charged to not more than 80% of the
medicare rate if the patient is uninsured; collect amounts charged in
monthly installments such that a patient is not paying more than 5% of the
patient's household income; and after a cumulative 36 months of
payments, consider the patient's bill paid in full and permanently cease
any and all collection activities on any balance that remains unpaid.
A health-care facility shall make information about patient's rights
and the uniform application for discounted care available to the public
and to each patient.
Beginning June 1, 2023, and each June 1 thereafter, each
health-care facility shall collect and report to the department data that the
department determines is necessary to evaluate compliance across patient
groups based on race, ethnicity, and primary language spoken with the
required screening, discounted care, payment plan, and collections
No later than April 1, 2022, the department shall develop a written
explanation of a patient's rights, make the explanation available to the
public and each patient, and establish a process for patients to submit a
complaint relating to noncompliance with the requirements. The
department shall periodically review health-care facilities and licensed
health-care professionals (hospital providers) to ensure compliance, and
the department shall notify the hospital provider if the hospital provider
is not in compliance that the hospital provider has 90 days to file a
corrective action plan with the department. A hospital provider may
request up to 120 days to submit a corrective action plan. The department
may require a hospital provider that is not in compliance to develop and
operate under a corrective action plan until the department determines the
hospital provider is in compliance. The bill implements fines for hospital
providers if the department determines the hospital provider's
noncompliance is knowing or willful.
The bill imposes requirements on hospital providers before
assigning or selling patient debt to a medical creditor or before pursuing
any permissible extraordinary collection action and imposes fines for any
hospital provider that fails to comply with the requirements.
The bill prohibits a medical creditor from using impermissible
extraordinary collection action to collect debts owed for health-care
services provided by a hospital provider. A medical creditor may engage
in permissible extraordinary collection actions 180 days after the first bill
for a medical debt is sent to the patient. At least 30 days before taking any
permissible extraordinary collection action, a medical creditor shall
provide the patient with a notice about the discounted care policy, the
permissible extraordinary collection actions that will be initiated, and a
deadline after which such permissible extraordinary collection actions
will be initiated. If a patient is later found eligible for discounted care, the
medical creditor shall reverse any permissible extraordinary collection

Committee Reports
with Amendments
Full Text
Full Text of Bill (pdf) (most recent)
Fiscal Notes Fiscal Notes (09/13/2021) (most recent)  
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