Colorado § 25-49-104 - Transparency - health-care facility charges.

§ 25-49-104. Transparency - health-care facility charges.

(1) (a) A health-care facility shall make available to the public, in a single document, either electronically or by posting conspicuously on its website if one exists, the health-care prices for at least:

(I) The fifty most used, diagnosis-related group codes or other codes for in-patient health-care services used by the health-care facility for billing or, if those codes are not used, the codes under another coding system for in-patient health-care services commonly used by the facility and accepted as a national standard for billing; and

(II) The twenty-five most used out-patient CPT codes or health-care services procedure codes used for billing or, if those codes are not used, the codes under another coding system for out-patient health-care services commonly used by the facility and accepted as a national standard for billing.

(b) If a health-care facility did not use fifty codes for in-patient health-care services at least eleven times in the previous twelve months or did not use twenty-five codes for out-patient health-care services at least eleven times in the previous twelve months, the health-care facility shall make available the health-care price for only those most common in-patient and out-patient health-care services or procedure codes that the health-care facility used at least eleven times in the previous twelve months.

(c) A health-care facility shall include with the health-care price provided pursuant to this subsection (1) a plain English description of the service for which the health-care price is provided.

(d) The health-care facility shall update the document as frequently as it deems appropriate, but at least annually.

(2) The health-care facility 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 at this health-care facility. If you are not covered by health insurance, you are strongly encouraged to contact (insert office name and telephone number) to discuss payment options prior to receiving a health-care service from this health-care facility since posted health-care prices may not reflect the actual amount of your financial responsibility.

(3) A health-care facility may disclose the basis for its health-care prices and may take into consideration all payer sources when determining a health-care price.

Source: L. 2017: Entire article added, (SB 17-065), ch. 113, p. 406, § 1, effective January 1, 2018.