A Bill for an Act
Page 1, Line 101Concerning the correction of a defect in law that
Page 1, Line 102incorrectly references the standard for provider
Page 1, Line 103self-pay estimates for health-care services.
Bill Summary
(Note: This summary applies to this bill as introduced and does not reflect any amendments that may be subsequently adopted. If this bill passes third reading in the house of introduction, a bill summary that applies to the reengrossed version of this bill will be available at http://leg.colorado.gov/.)
Statutory Revision Committee. Under current law, an individual may request a self-pay estimate of the total cost of an anticipated health-care service (self-pay estimate) from the designated billing or patient services personnel representing the health-care provider or health-care facility providing the service. Unless the patient suffers a medical emergency or other unforeseen circumstance that affects the services provided, the statute states that the final cost of the health-care service must be no more than 15% higher than the self-pay estimate or $400, whichever is less.
The bill corrects a mistake in the statutory language by clarifying that the $400 qualifier relates to the permissible dollar amount above the cost estimated in the self-pay estimate rather than the maximum allowable cost of the health-care service, regardless of the service provided.
Further, when referencing the exception in statute that, due to an emergency or unforeseen circumstance, the total cost of services may exceed the self-pay estimate by more than 15% or $400, the bill removes the language "whichever is less", as that language is inapplicable when the exception applies.
Page 2, Line 1Be it enacted by the General Assembly of the State of Colorado:
Page 2, Line 2SECTION 1. In Colorado Revised Statutes, 25-49-106, amend (1)(b) as follows:
Page 2, Line 325-49-106. Required disclosure to self-pay recipients - estimate
Page 2, Line 4of total cost of health-care services upon request - deceptive trade
Page 2, Line 5practice - definition. (1) (b) (I) Except as provided in subsection
Page 2, Line 6(1)(b)(II) of this section, the final cost of the health-care service for which
Page 2, Line 7the self-pay estimate was made must be no more than fifteen percent
Page 2, Line 8higher than the total estimated cost indicated in the self-pay estimate or
Page 2, Line 9no more than four hundred dollars higher than the total estimated cost indicated in the self-pay estimate, whichever is less.
Page 2, Line 10(II) The final cost of the health-care service for which the self-pay
Page 2, Line 11estimate was made may be more than fifteen percent higher or more
Page 2, Line 12than four hundred dollars higher than the self-pay estimate
or fourPage 2, Line 13
hundred dollars if a medical emergency occurs that is associated with thePage 2, Line 14health-care service or if an additional, unforeseen, medically necessary
Page 2, Line 15health-care service is required during the provision of the health-care
Page 2, Line 16service. The health-care provider or health-care facility shall make all
Page 3, Line 1reasonable efforts to obtain the consent of the recipient or, if the recipient
Page 3, Line 2is incapacitated, the recipient's authorized agent prior to providing any
Page 3, Line 3emergency or unforeseen, medically necessary health-care service that
Page 3, Line 4will increase by more than fifteen percent or by more than four
Page 3, Line 5hundred dollars the total cost indicated in the self-pay estimate.
or four hundred dollars, whichever is less.Page 3, Line 6SECTION 2. Act subject to petition - effective date. This act
Page 3, Line 7takes effect at 12:01 a.m. on the day following the expiration of the
Page 3, Line 8ninety-day period after final adjournment of the general assembly; except
Page 3, Line 9that, if a referendum petition is filed pursuant to section 1 (3) of article V
Page 3, Line 10of the state constitution against this act or an item, section, or part of this
Page 3, Line 11act within such period, then the act, item, section, or part will not take
Page 3, Line 12effect unless approved by the people at the general election to be held in
Page 3, Line 13November 2026 and, in such case, will take effect on the date of the official declaration of the vote thereon by the governor.