2023 Colorado Revised Statutes › Title 25.5 - HEALTH CARE POLICY AND FINANCING (§§ 25.5-1-101 — 25.5-11-101) › INDIGENT CARE (§§ 25.5-3-101 — 25.5-3-507) › Article 3 - INDIGENT CARE (§§ 25.5-3-101 — 25.5-3-507) › Part 5 - HEALTH-CARE BILLING FOR INDIGENT PATIENTS RECEIVING SERVICES NOT REIMBURSED THROUGH THE COLORADO INDIGENT CARE PROGRAM (§§ 25.5-3-501 — 25.5-3-507) › Section 25.5-3-505 - [Effective Until 8/7/2024] Health-care facility reporting requirements - agency enforcement - report - rules

(1)
Beginning September 1, 2023, and each September 1 thereafter, each health-care facility shall report to the state department data that the state department determines is necessary to evaluate compliance across race, ethnicity, age, and primary-language-spoken patient groups with the screening, discounted care, payment plan, and collections practices required pursuant to this part 5. If a health-care facility is not capable of disaggregating the data required pursuant to this subsection (1) by race, ethnicity, age, and primary language spoken, the health-care facility shall report to the state department the steps the facility is taking to improve race, ethnicity, age, and primary-language-spoken data collection and the date by which the facility will be able to disaggregate the reported data.
(2)
No later than April 1, 2022, the state board shall promulgate rules necessary for the administration and implementation of this part 5. At a minimum, the rules must:
(a)
Outline a process for an insured patient to request a screening pursuant to section
25.5-3-502 (5)
;
(b)
Outline a process for documenting, pursuant to section
25.5-3-502 (4)
, that a patient has made an informed decision to decline the screening, including procedures for retaining such documentation;
(c)
Establish the process for and the maximum number of days that a health-care facility has to:
(I)
Initiate a screening after a patient receives services;
(II)
Request information from the patient needed for the screening process; and
(III)
Complete the screening process;
(d)
Outline the requirements for notifying the patient of the results of the screening, including an explanation of the basis for a denial of discounted care and the process for appealing a denial;
(e)
Establish guidelines for patient appeals regarding eligibility for discounted care pursuant to section
25.5-3-503
;
(f)
Establish a methodology that all health-care facilities must use to determine monthly household income. The methodology must not consider a patient's assets.
(g)
Identify the documents that may be required to establish income eligibility for discounted care using the minimum amount of information needed to determine eligibility;
(h)
Identify the steps a health-care facility and licensed health-care professional must take before sending patient debt to collections;
(i)
Create a single uniform application that a health-care facility shall use when screening a patient for eligibility for the Colorado indigent care program and discounted care, as described in section
25.5-3-502
; and
(j)
Annually establish rates for discounted care pursuant to section
25.5-3-503 (1)(a)
. The rates should approximate and not be less than one hundred percent of the medicare rate or one hundred percent of the medicaid base rate, whichever is greater. The state department shall publicly post the established rates on the state department's website.
(3)
In promulgating rules pursuant to this section, the state department shall:
(a)
Align the processes of qualifying for and appealing denials of eligibility for the Colorado indigent care program with discounted care, as described in section
25.5-3-502
; and
(b)
Consider potential limitations relating to the federal "Emergency Medical Treatment and Labor Act",
42 U.S.C. sec. 1395dd
.
(4)
Prior to promulgating rules pursuant to this section, the state department shall hold at least one stakeholder meeting with hospital representatives, health-care consumers, and health-care consumer advocates that is accessible to individuals whose primary language is not English, if requested.
(5)
No later than April 1, 2022, the state department shall:
(a)
Using feedback from hospital health-care consumers and health-care consumer advocate stakeholders, develop a written explanation of a patient's rights under this section that is written in plain language at a sixth-grade reading level and translated into all languages spoken by ten percent or more of the population in each county of the state and post the written explanation in all required languages on the state department's website. Each health-care facility shall make the explanation available to the public and each patient as provided in section
25.5-3-504
.
(b)
(I)
Establish a process for patients to submit a complaint relating to noncompliance with this part 5 to the state department by phone, mail, or online. The state department shall conduct a review within thirty days after receiving a complaint.
(II)
The state department shall periodically review health-care facilities and licensed health-care professionals to ensure compliance with this section. If the state department finds that a health-care facility or licensed health-care professional is not in compliance with this section, the state department shall notify the health-care facility or licensed health-care professional and the facility or professional has ninety days to file a corrective action plan with the state department that must include measures to inform the patient about the noncompliance and provide a financial correction consistent with this part 5. A health-care facility or licensed health-care professional may request up to one hundred twenty days to submit a corrective action plan. The state department may require a health-care facility or licensed health-care professional that is not in compliance with this part 5 or any state board rules adopted pursuant to this part 5 to develop and operate under a corrective action plan until the state department determines the health-care facility or licensed health-care professional is in compliance.
(III)
If a health-care facility's or licensed health-care professional's noncompliance with this section is determined by the state department to be knowing or willful or there is a repeated pattern of noncompliance, the state department may fine the facility or professional no more than five thousand dollars. If the health-care facility or licensed health-care professional fails to take corrective action or fails to file a corrective action plan with the state department pursuant to subsection (5)(b)(II) of this section, the state department may fine the facility or professional no more than five thousand dollars a week until the facility or professional takes corrective action. The state department shall consider the size of the health-care facility and the seriousness of the violation in setting the fine amount.
(6)
The state department shall make the information reported pursuant to subsection (1) of this section and any corrective action plans for which fines were imposed pursuant to subsection (5)(b) of this section available to the public and shall annually report the information as a part of its presentation to its committees of reference at a hearing held pursuant to section
2-7-203 (2)(a)
of the "State Measurement for Accountable, Responsive, and Transparent (SMART) Government Act".
Amended by 2022 Ch. 203, § 4, eff. 5/20/2022.
Added by 2021 Ch. 435, § 1, eff. 9/7/2021.
L. 2021: Entire part added, (HB 21-1198), ch. 2877, p. 2877, § 1, effective September 7.
2021 Ch. 435, was passed without a safety clause. See Colo. Const. art. V, § 1(3).
This section is set out more than once due to postponed, multiple, or conflicting amendments.