Colorado § 25-3-705 - Health-care charge transparency - hospital charge report - definitions.

§ 25-3-705. Health-care charge transparency - hospital charge report - definitions.

(1) The commissioner of insurance shall work with the duly constituted association of hospitals selected by the executive director for assistance in carrying out the purposes of this section.

(2) (a) On or before August 1, 2009, and on or before each August 1 thereafter, each hospital licensed pursuant to part 1 of this article shall report annually to the association of hospitals the information necessary to allow the association to determine the charges for the twenty-five most common inpatient diagnostic-related groups for which there are at least ten cases rendered by the hospital during the calendar year immediately preceding the release of the hospital charge report. If a hospital does not have twenty-five of the most common diagnostic-related groups with at least ten or more cases rendered, the hospital shall report only on those most common diagnostic-related groups that have at least ten cases rendered.

(b) A hospital that does not use diagnostic-related groups is exempt from paragraph (a) of this subsection (2).

(3) (a) The commissioner of insurance shall work with the association of hospitals to incorporate the information reported pursuant to this section on the website.

(b) The commissioner of insurance shall require the association of hospitals to submit a plan to the commissioner on or before November 30, 2008, that states the implementation status of a plan to make the hospital charges reported pursuant to this section available to the public on the website. The plan shall identify the process and time periods for implementation, any barriers to implementation, and recommendations of changes in the law that may be enacted by the general assembly to eliminate the barriers.

(c) When developing the required plan, the association of hospitals shall consider:

(I) The method for hospitals to report charges to the association;

(II) Standards that provide for the validity and comparability of hospital charges; and

(III) The format for making hospital charges available to the public.

(4) (a) The association of hospitals shall make the information reported by the hospitals pursuant to this section available on the website on or before August 1, 2009, and on or before August 1 of each year thereafter. The information reported by the hospitals shall include disclaimers regarding factors including case severity ratings and individual patient variations that may affect actual charges to a patient for services provided.

(b) The information reported by the hospitals that is published in accordance with this section shall include:

(I) Volume of cases by diagnostic-related group required to be reported by the hospital;

(II) Rank by volume of the top twenty-five diagnostic-related groups required to be reported by the hospital;

(III) Mean charge for each of the top twenty-five diagnostic-related groups with more than ten occurrences by hospital;

(IV) Case severity rating by hospital by diagnostic-related group; and

(V) A general disclaimer statement regarding the hospital variations and patient variations that affect the actual charges to patients.

(c) Before publication of the information published pursuant to this section on the website, the commissioner shall ensure that every hospital is allowed thirty days within which to examine the data and submit comments for consideration and inclusion in the final hospital charge report.

(5) (a) The commissioner of insurance shall approve the publication of information on the website consisting of public disclosure of charge data assembled pursuant to this section. At a minimum, the information shall be made available on the website in a manner that allows consumers to conduct an interactive search to view and compare the information for specific hospitals. The website shall include any additional information necessary to ensure that the website information is available to consumers and health-care purchasers. The information shall include, at a minimum, appropriate guidance on how to use the data and an explanation of why the data may vary from hospital to hospital. The report specified in this subsection (5) shall be released on the website on or before August 1, 2009, and on or before each August 1 thereafter.

(b) The commissioner of insurance shall make the website available by hyperlink on the division of insurance website.

(c) The division of insurance shall review the information posted on the website to ensure that the website and information provided by the association is easy to navigate, contains consumer-friendly language, and fulfills the intent of this section. The division shall also ensure that the hyperlink from the division's website to the website is easily accessible.

(6) There shall be no liability on the association of hospitals or a cause of action against the association or its agents, employees, or directors or authorized designees of the commissioner for actions taken or omitted in the performance of duties pursuant to this section.

(7) Repealed.

(8) As used in this section:

(a) "Charge" means the amount that a hospital expects to charge for an inpatient diagnostic-related group. A charge that is required to be reported to the public shall be the mean charge for all cases of the diagnostic-related group occurring in the calendar year prior to the release of the hospital charge report.

(b) "Diagnostic-related group" means the classification assigned to an inpatient hospital service claim based on the patient's age and sex, the principal and secondary diagnoses, the procedures performed, and the discharge status.

(c) "Website" means a website established by the association of hospitals that links to the website created pursuant to section 25-3-703.

Source: L. 2008: Entire section added, p. 1262, § 3, effective May 27. L. 2011: (7) repealed, (HB 11-1303), ch. 264, p. 1165, § 60, effective August 10. L. 2022: (1) amended, (HB 22-1401), ch. 178, p. 1183, § 8, effective May 18.

Cross references: In 2008, this section was added by the "Health Care Transparency Act". For the short title and legislative declaration, see sections 1 and 2 of chapter 294, Session Laws of Colorado 2008.

PART 8

CONSUMER PROTECTION RELATING TO HOSPITAL PRICE TRANSPARENCY

Editor's note: This part 8 was added in 2022 and was not amended prior to its repeal in 2023. For the text of this part 8 prior to 2023, consult the 2022 Colorado Revised Statutes and the Colorado statutory research explanatory note beginning on page vii in the front of this volume. This part 8 was relocated to part 9 of article 1 of title 25.5. Former C.R.S. section numbers are shown in editor's notes following those sections that were relocated.

25-3-801 to 25-3-803. (Repealed)

Source: L. 2023: Entire part repealed, (SB 23-252), ch. 305, p. 1864, § 2, effective August 7.

25-3.5 ARTICLE 3.5

Emergency Medical and Trauma Services

PART 1

GENERAL AND ADMINISTRATIVE

25-3.5-101. Short title.

25-3.5-102. Legislative declaration.

25-3.5-103. Definitions.

25-3.5-104. Emergency medical and trauma services advisory council - creation - duties.

25-3.5-104.3. State trauma advisory council - duties. (Repealed)

25-3.5-104.5. Joint advisory council - duties. (Repealed)

25-3.5-105. Rules and regulations.

25-3.5-106. Local standards - uninterrupted service - repeal. (Repealed)

25-3.5-107. Religious exception.

25-3.5-108. EMS system sustainability task force - created - powers and duties - membership - reports - repeal.

PART 2

TREATMENT SUBSYSTEM

25-3.5-201. Training programs.

25-3.5-202. Personnel - basic requirements.

25-3.5-203. Emergency medical service providers - licensure - renewal of license - duties of department - rules - record checks - definitions.

25-3.5-203.5. Community paramedic endorsement - rules.

25-3.5-204. Emergency medical services for children.

25-3.5-205. Emergency medical service providers - investigation - discipline.

25-3.5-206. Emergency medical practice advisory council - creation - powers and duties - emergency medical service provider scope of practice - definitions - rules.

25-3.5-207. Ability of certified or licensed emergency medical service providers to work in clinical settings - restrictions - definitions - rules.

25-3.5-208. Emergency medical service providers' peer health assistance program - fund - rules.

25-3.5-209. Use of ketamine in prehospital setting when peace officer is present - definition.

25-3.5-210. Report on statewide use of ketamine.

PART 3

TRANSPORTATION SUBSYSTEM

25-3.5-301. Number of individuals needed for ambulance operation - exception.

25-3.5-302. Issuance of licenses and permits - term - requirements - repeal. (Repealed)

25-3.5-303. Vehicular liability insurance required - repeal. (Repealed)

25-3.5-304. Suspension - revocation - hearings - repeal. (Repealed)

25-3.5-305. Alleged negligence.

25-3.5-306. Violation - penalty.

25-3.5-307. Licensure of fixed-wing and rotor-wing air ambulances - cash fund created - rules - repeal.

25-3.5-307.5. Standards for air ambulance services - rules - civil penalties - disciplinary actions.

25-3.5-308. Rules - repeal. (Repealed)

25-3.5-309. Secure transportation - license required - fees - exceptions.

25-3.5-310. Secure transportation - issuance of licenses and permits - term - requirements.

25-3.5-311. Secure transportation - rules.

25-3.5-312. Funding.

25-3.5-313. Reporting.

25-3.5-314. Ambulance service - license required - exceptions - rules - local authorization to operate - penalties - liability insurance.

25-3.5-315. Minimum standards for ambulance services - rules.

25-3.5-316. Ambulance services cash fund - created.

25-3.5-317. License - application - inspection - criminal history record check - issuance - investigation - definitions.

25-3.5-318. License denial, suspension, revocation, or refusal to renew.

PART 4

TELECOMMUNICATIONS SUBSYSTEM

25-3.5-401. Responsibility for coordination.

25-3.5-402. Local government participation.

25-3.5-403. Poison information center - state funding. (Repealed)

PART 5

DOCUMENTATION SUBSYSTEM

25-3.5-501. Records - ambulance services to report - access to patient information.

25-3.5-502. Forms and reports - repeal. (Repealed)

PART 6

LOCAL EMERGENCY MEDICAL SERVICES

25-3.5-601. Legislative declaration.

25-3.5-602. Definitions.

25-3.5-603. Emergency medical services account - creation - allocation of money - rules.

25-3.5-604. EMTS grant program - EMS account - role of council and department - rules - awards.

25-3.5-605. Improvement of county emergency medical and trauma services - eligibility for county funding - manner of distributing funds.

25-3.5-606. Annual report.

25-3.5-607. Repeal of part. (Repealed)

PART 7

STATEWIDE TRAUMA SYSTEM

25-3.5-701. Short title.

25-3.5-702. Legislative declaration.

25-3.5-703. Definitions.

25-3.5-704. Statewide emergency medical and trauma care system - development and implementation - duties of department - rules.

25-3.5-705. Creation of fee - creation of trauma system cash fund.

25-3.5-706. Immunity from liability.

25-3.5-707. False representation as trauma facility - penalty.

25-3.5-708. Financing for statewide trauma system.

25-3.5-709. Annual report.

PART 8

TOBACCO EDUCATION, PREVENTION, AND CESSATION PROGRAMS

25-3.5-801. Short title.

25-3.5-802. Legislative declaration.

25-3.5-803. Definitions.

25-3.5-804. Tobacco education, prevention, and cessation programs - review committee - grants - reimbursement for expenses - rules.

25-3.5-805. Tobacco education, prevention, and cessation programs - requirements.

25-3.5-806. Tobacco education, prevention, and cessation programs - reporting requirements.

25-3.5-807. Tobacco program fund - created. (Repealed)

25-3.5-807.5. Transfer of balance of tobacco program fund - repeal. (Repealed)

25-3.5-808. Administration - limitation.

25-3.5-809. Tobacco education, prevention, and cessation programs - funding.

25-3.5-810. Nicotine products education, prevention, and cessation programs.

PART 9

QUALITY MANAGEMENT

25-3.5-901. Short title.

25-3.5-902. Legislative declaration.

25-3.5-903. Definitions.

25-3.5-904. Quality management programs - creation - assessments - confidentiality of information - exceptions - immunity for good faith participants.

PART 10

STATEWIDE MARIJUANA EDUCATION CAMPAIGN

25-3.5-1001. Legislative declaration.

25-3.5-1002. Definitions.

25-3.5-1003. Eighteen-month public awareness and education campaign - legalization of marijuana - repeal. (Repealed)

25-3.5-1004. Ongoing prevention and education campaign - training - marijuana.

25-3.5-1005. Website - primary state resource for information.

25-3.5-1006. Align marijuana messaging - integration of information across state agencies.

25-3.5-1007. Evaluation of marijuana campaigns.

PART 11

EMERGENCY MEDICAL RESPONDERS

25-3.5-1101. Legislative declaration.

25-3.5-1102. Definitions.

25-3.5-1103. Registration - rules - funds.

25-3.5-1104. Training programs - rules.

25-3.5-1105. Investigation and discipline.

PART 12

COMMUNITY ASSISTANCE REFERRAL AND EDUCATION SERVICES (CARES) PROGRAM

25-3.5-1201. Short title.

25-3.5-1202. Definitions.

25-3.5-1203. Community assistance referral and education services programs - authorization - scope.

25-3.5-1204. Reports.

PART 13

COMMUNITY INTEGRATED HEALTH-CARE SERVICE AGENCIES

25-3.5-1301. Definitions - rules.

25-3.5-1302. Community integrated health-care service agency license required - rules - civil and criminal penalties - liability insurance.

25-3.5-1303. Minimum standards for community integrated health-care service agencies - adult protective services data system check - rules.

25-3.5-1304. Community integrated health care service agencies cash fund - created.

25-3.5-1305. License - application - inspection - record check - issuance - definition.

25-3.5-1306. License denial - suspension - revocation - definition - penalty.

25-3.5-1307. Repeal of part - review of functions.

PART 14

STOP THE BLEED SCHOOL CONTROL KITS

25-3.5-1401. (Repealed)

PART 1

GENERAL AND ADMINISTRATIVE