Transparency in Health Care Prices Act

Colorado Revised Statutes C.R.S. 25-49-101
Title 25. Public health and Environment
Health Care
Article 49. Transparency in Health Care Prices

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 Codes and Pricing coming soon.

 

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25-49-103. Transparency - charges for services rendered by health care providers


[Editor's note: This section is effective January 1, 2018.]
(1) (a) (I) Except as provided in subsection (1)(a)(II) or (1)(a)(III) of this section, a health care provider shall make available to the public, in a single document, either electronically or by posting conspicuously on the provider's website if one exists, the health care prices for at least the fifteen most common health care services the health care provider provides. If the health care provider, in the normal course of his or her practice, regularly provides fewer than fifteen health care services, the health care provider shall make available the health care prices for the health care services the provider most commonly provides.

(II) A health care provider practicing in a solo practice or in a medical group, independent practice association, or professional corporation comprised of not more than six individual health care providers with the same license type may comply with the requirements of this section by making the health care prices described in subsection (1)(a)(I) of this section available in patient waiting areas.

(III) A health care provider who is a member of a professional corporation that contracts with a single health maintenance organization, as defined in section 10-16-102 (35), complies with this section if the professional corporation or its contracting health maintenance organization makes available to the public, in a single document, either electronically or by posting conspicuously on its website, the health care prices for at least the fifteen most common health care services that the health care provider or health maintenance organization would charge individuals who are not members of the health maintenance organization.

(b) The health care provider shall identify the services by:

(I) A common procedural terminology code or other coding system commonly used by the health care provider and accepted as a national standard for billing; and

(II) A plain English description.

(c) The health care provider shall update the document as frequently as the health care provider deems appropriate, but at least annually.

(2) The health care provider shall include:

(a) A disclosure specifying that the health care price for any given health care service is an estimate and that the actual charges for the health care service are dependent on the circumstances at the time the service is rendered; and

(b) The following statement or a statement containing substantially similar information:

If you are covered by health insurance, you are strongly encouraged to consult with your health insurer to determine accurate information about your financial responsibility for a particular health care service provided by a health care provider at this office. If you are not covered by health insurance, you are strongly encouraged to contact our billing office at (insert telephone number) to discuss payment options prior to receiving a health care service from a health care provider at this office since posted health care prices may not reflect the actual amount of your financial responsibility.

(3) A hospital-based health care provider that is not an employee of the hospital where the services are being delivered is not required to provide health care prices in the manner specified in this section for the health care services the health care provider renders in the hospital setting.

(4) Nothing in this section precludes a health care provider from informing a current or potential patient, upon request of the patient, of the health care price for a health care service that the health care provider renders.

HISTORY: Source: L. 2017: Entire article added, (SB 17-065), ch. 113, p. 405, § 1, effective January 1, 2018.