8577289B6C5AB2F6872586BE006B3C9E Hearing Summary

Representative Jodeh,
bill sponsor, introduced HB21-1198.

The bill repeals, reenacts, and expands hospital requirements around providing
discount care to uninsured patients (discount program) and moves regulatory
authority over the program from the Colorado Department of Public Health
and Environment (CDPHE) to the Department of Health Care Policy and Financing
(HCPF).  Changes to the program include:

Applying regulations
to health care facilities, instead of just hospitals;

• requiring HCPF
  to develop a standard application for health care facilities to screen
  uninsured patients for eligibility for public health insurance programs,
  the Colorado Indigent Care Program (CICP), or discounted care;
• creating an appeals
  process if a patient is found to be ineligible;
• limiting the amount
  a health care facility can charge for eligible patients for emergency and
  other non-CICP services to 80 percent of the Medicare rate, instead of
  the lowest negotiated rate from a private health plan;
• limiting collection
  amounts to monthly payments of no more than 5.0 percent of the patient’s
  monthly household income;
• considering a
  patient’s bill paid in full after  36 months of payments;
• requiring health
  care facilities to post information on patient’s rights under the discount
  program, as developed by HCPF;
• requiring health
  care facilities to collect and report certain information to HCPF to determine
  compliance across demographics;
• requiring HCPF
  to periodically review health care facilities to ensure compliance; and
• requiring HCPF
  to promulgate rules prohibiting hospitals from considering assets when
  determining if a patient’s income eligibility and to ensure the method
  used to determine eligibility is uniform across hospitals. By April 1,
  2022, the State Board of Health in the CDPHE must promulgate rules to implement
  the program and HCPF must develop information on patient’s rights, establish
  a process for patients to appeal a determination of ineligibility, and
  begin to periodically review health-care facilities for compliance.  By
  June 1, 2023, and each June 1 after, each health care facility must collect
  and report data to HCPF on compliance.

Collection
of medical debt.  The bill updates regulations around the collection
of medical debt.  Specifically, before a health care facility can
assign or sell patient debt to a collection agency or before pursing permissible
extraordinary collection action the facility must:  screen the patient
for eligibility for programs listed above; provide discounted care or offer
a payment plan that does not exceed 5.0 percent of the patient’s monthly
household income, and provide an explanation of the services and fees being
billed.  A health care facility that does not follow these steps is
liable to the patient for damages, as specified in the bill.  A medical
creditor or medical debt collector cannot engage in any permissible extraordinary
collection actions until 180 days after the first bill for a medical debt
is sent.  In addition, 30 days before taking an action, a creditor
must provide the patient with a notice developed by HCPF.  If a creditor
fails to follow these steps, the creditor must reverse any collection actions.




Representative Jodeh distributed a handout to the committee (Attachment
A).

The bill sponsor responded to questions from the committee.

Ms. Neswood responded
to questions from the committee.



Submitted written
testimony can be found in Attachment F.

Representative Jodeh provided closing comments on the bill.

Committee members made closing comments on the bill.