Senate Committee of Reference Report
Committee on Health & Human Services
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April 23, 2026
After consideration on the merits, the Committee recommends the following:
SB26-138 be amended as follows, and as so amended, be referred to the Committee on Appropriations with favorable recommendation:
Page 1, Line 1Amend printed bill, strike everything below the enacting clause and
Page 1, Line 2substitute:
Page 1, Line 3"SECTION 1. Legislative declaration. (1) The general
Page 1, Line 4assembly finds and declares that:
Page 1, Line 5(a) Every Colorado family deserves a fair, dignified, and
Page 1, Line 6understandable path to financial assistance when seeking health care.
Page 1, Line 7Patients benefit from hospitals' discounted care programs and these
Page 1, Line 8programs increase access to affordable care. Reducing duplication and
Page 1, Line 9confusion in navigating the process for both patients and health-care
Page 1, Line 10providers is essential to ensure the process does not create barriers for the
Page 1, Line 11very people the law was intended to help.
Page 1, Line 12(b) Rising insurance premiums and the impacts of H.R. 1 of the
Page 1, Line 13119th congress (2025-2026), Pub.L. 119-21, are likely to increase the
Page 1, Line 14number of uninsured and underinsured Coloradans seeking discounted
Page 1, Line 15care. At a time when more families are struggling to afford basic
Page 1, Line 16health-care services, Colorado must ensure that access to financial relief
Page 1, Line 17is simple, timely, and centered on the needs of patients.
Page 1, Line 18(c) It is the intent of the general assembly to reduce unnecessary
Page 1, Line 19paperwork, eliminate avoidable burdens, and create a process that
Page 1, Line 20respects people's time, circumstances, and dignity. Streamlining and
Page 1, Line 21clarifying these pathways will allow health-care providers to focus more
Page 1, Line 22resources on helping families instead of on navigating shifting rules or
Page 1, Line 23administrative obstacles.
Page 1, Line 24(d) The general assembly affirms that all patient rights, including
Page 1, Line 25the right to appeal and to provide information demonstrating eligibility
Page 1, Line 26for public health-care coverage or discounted care, must remain fully
Page 1, Line 27protected; and
Page 2, Line 1(e) This act strengthens the promise that discounted care in our
Page 2, Line 2state will be accessible and rooted in compassion.
Page 2, Line 3SECTION 2. In Colorado Revised Statutes, amend 12-30-114 as
Page 2, Line 4follows:
Page 2, Line 512-30-114. Demonstrated competency - repeal of rules -
Page 2, Line 6repeal.
Page 2, Line 7(1) (a) The regulator for each licensed health-care provider, in
Page 2, Line 8consultation with the center for research into substance use disorder
Page 2, Line 9prevention, treatment, and recovery support strategies created in section
Page 2, Line 1027-80-118, shall promulgate rules that require each licensed health-care
Page 2, Line 11provider, as a condition of renewing, reactivating, or reinstating a license
Page 2, Line 12on or after October 1, 2022, to complete up to four credit hours of
Page 2, Line 13training per licensing cycle in order to demonstrate competency
Page 2, Line 14regarding:
Page 2, Line 15(I) Best practices for opioid prescribing, according to the most
Page 2, Line 16recent version of the division's guidelines for the safe prescribing and
Page 2, Line 17dispensing of opioids;
Page 2, Line 18(II) The potential harm of inappropriately limiting prescriptions
Page 2, Line 19to chronic pain patients;
Page 2, Line 20(III) Best practices for prescribing benzodiazepines;
Page 2, Line 21(IV) Recognition of substance use disorders;
Page 2, Line 22(V) Referral of patients with substance use disorders for
Page 2, Line 23treatment; and
Page 2, Line 24(VI) The use of the electronic prescription drug monitoring
Page 2, Line 25program created in part 4 of article 280 of this title 12.
Page 2, Line 26(b) The rules promulgated by each regulator shall exempt a
Page 2, Line 27licensed health-care provider who:
Page 2, Line 28(I) Maintains a national board certification that requires equivalent
Page 2, Line 29substance use prevention training; or
Page 2, Line 30(II) Attests to the regulator that the health-care provider does not
Page 2, Line 31prescribe opioids.
Page 2, Line 32(2) For the purposes of this section, "licensed health-care
Page 2, Line 33provider" includes any of the following providers who are licensed
Page 2, Line 34pursuant to this title 12:
Page 2, Line 35(a) A physician;
Page 2, Line 36(b) A physician assistant;
Page 2, Line 37(c) A podiatrist;
Page 2, Line 38(d) A dentist;
Page 2, Line 39(e) An advanced practice registered nurse or certified midwife
Page 2, Line 40with prescriptive authority;
Page 2, Line 41(f) An optometrist; and
Page 2, Line 42(g) A veterinarian.
Page 2, Line 43(3) Each regulator that adopted rules pursuant to this
Page 3, Line 1section before the effective date of this subsection (3), which
Page 3, Line 2rules require a licensed health-care provider, as a condition of
Page 3, Line 3renewing, reactivating, or reinstating a license, to complete up
Page 3, Line 4to four credit hours of training per licensing cycle in order to
Page 3, Line 5demonstrate opiate prescriber competency shall repeal the
Page 3, Line 6rules on or before July 1, 2027.
Page 3, Line 7(4) This section is repealed, effective September 1, 2029.
Page 3, Line 8SECTION 3. In Colorado Revised Statutes, 25-3-102, amend
Page 3, Line 9(1)(a); and repeal (1)(d) as follows:
Page 3, Line 1025-3-102. License - application - issuance - waiver - certificate
Page 3, Line 11of compliance required - rules.
Page 3, Line 12(1) (a) (I) An applicant for a license described in section 25-3-101
Page 3, Line 13shall apply to the department of public health and environment annually
Page 3, Line 14every two years upon such form and in such manner as prescribed by
Page 3, Line 15the department; except that a community residential home shall make
Page 3, Line 16application for a license pursuant to section 25.5-10-214. C.R.S.
Page 3, Line 17(II) On or before July 1, 2030, notwithstanding subsection
Page 3, Line 18(1)(a)(I) of this section, the department may issue a license
Page 3, Line 19described in section 25-3-101 to an applicant and require the
Page 3, Line 20applicant to apply to the department after a one-year period as
Page 3, Line 21the department deems appropriate.
Page 3, Line 22(d) The license expires one year after the date of issuance.
Page 3, Line 23SECTION 4. In Colorado Revised Statutes, 25.5-3-501, amend
Page 3, Line 24(6); and add (6.7) as follows:
Page 3, Line 2525.5-3-501. Definitions.
Page 3, Line 26As used in this part 5, unless the context otherwise requires:
Page 3, Line 27(6) "Screen" or "screening" means a process identified in rule by
Page 3, Line 28the state department described in section 25.5-3-502 whereby
Page 3, Line 29health-care facilities assess a patient's circumstances related to eligibility
Page 3, Line 30criteria and determine whether the patient has qualified or is likely to
Page 3, Line 31qualify for public health-care coverage or discounted care and, at the
Page 3, Line 32option of the health-care facility, is eligible or is likely eligible
Page 3, Line 33for the health-care facility's financial assistance program;
Page 3, Line 34inform the patient of the health-care facility's determination; and provide
Page 3, Line 35information to the patient about how the patient can enroll in public
Page 3, Line 36health-care coverage or the health-care facility's financial
Page 3, Line 37assistance program.
Page 3, Line 38(6.7) "Uniform application" or "application" means a
Page 3, Line 39uniform form that is developed by the state department to
Page 3, Line 40determine whether a patient is a qualified patient and is
Page 3, Line 41completed following a screening or when required by section
Page 3, Line 4225.5-3-502.5.
Page 3, Line 43SECTION 5. In Colorado Revised Statutes, amend 25.5-3-502
Page 4, Line 1as follows:
Page 4, Line 225.5-3-502. Requirement to screen patients for eligibility for
Page 4, Line 3financial assistance - questionnaire - definition - rules.
Page 4, Line 4(1) Beginning September 1, 2022, a health-care facility shall
Page 4, Line 5screen, unless a patient declines, each uninsured patient for eligibility for:
Page 4, Line 6(a) Public health insurance programs, including but not limited to
Page 4, Line 7medicare; the state medical assistance program described in articles 4,
Page 4, Line 85, and 6 of this title 25.5; emergency medicaid; and the children's basic
Page 4, Line 9health plan described in article 8 of this title 25.5; and
Page 4, Line 10(b) Repealed.
Page 4, Line 11(c) (b) Discounted care, as described in section 25.5-3-503; and
Page 4, Line 12(c) At the option of the health-care facility, the
Page 4, Line 13health-care facility's financial assistance program, which often
Page 4, Line 14offers broader eligibility than public health insurance
Page 4, Line 15programs.
Page 4, Line 16(2) Health-care facilities shall use a single uniform application
Page 4, Line 17developed by the state department when screening a patient pursuant to
Page 4, Line 18subsection (1) of this section. A health-care facility may conduct
Page 4, Line 19screenings pursuant to subsection (1) of this section through:
Page 4, Line 20(a) Accessing eligibility information through an
Page 4, Line 21industry-standard third-party resource, such as a major credit
Page 4, Line 22bureau;
Page 4, Line 23(b) Requesting the patient complete a uniform screening
Page 4, Line 24questionnaire developed by the state department; or
Page 4, Line 25(c) A combination of information obtained through
Page 4, Line 26subsections (2)(a) and (2)(b) of this section.
Page 4, Line 27(3) If a health-care facility determines that a patient is ineligible
Page 4, Line 28for discounted care, the facility shall provide the patient notice of the
Page 4, Line 29determination and an opportunity for the patient to appeal the
Page 4, Line 30determination in accordance with state department rules If a
Page 4, Line 31health-care facility determines it has obtained sufficient
Page 4, Line 32information through the screening conducted pursuant to
Page 4, Line 33subsection (1) of this section, the health-care facility may make
Page 4, Line 34a determination of whether the patient is a qualified patient or
Page 4, Line 35is likely eligible for public health-care coverage without
Page 4, Line 36requiring the patient to provide further information through a
Page 4, Line 37uniform application pursuant to section 25.5-3-502.5.
Page 4, Line 38(3.5) Upon completion of the screening conducted
Page 4, Line 39pursuant to subsection (1) of this section, a health-care facility
Page 4, Line 40shall:
Page 4, Line 41(a) If the health-care facility determines that a patient
Page 4, Line 42is a qualified patient, provide the patient notice of the
Page 4, Line 43determination, the patient's identified federal poverty guideline
Page 5, Line 1percentage, and the patient's monthly installment maximum
Page 5, Line 2payment as described in section 25.5-3-503;
Page 5, Line 3(b) If the health-care facility determines that a patient
Page 5, Line 4is likely not a qualified patient, inform the patient of the
Page 5, Line 5results of the screening and provide the patient with:
Page 5, Line 6(I) Information on how to complete an application
Page 5, Line 7pursuant to section 25.5-3-502.5; and
Page 5, Line 8(II) If applicable, at the option of the health-care facility,
Page 5, Line 9information regarding the patient's eligibility for the
Page 5, Line 10health-care facility's financial assistance program and the
Page 5, Line 11amount of any discount offered through the program;
Page 5, Line 12(c) If the health-care facility is certified by the state
Page 5, Line 13department as a medical assistance site and determines that the
Page 5, Line 14patient is presumptively eligible for medical assistance, inform
Page 5, Line 15the patient of the determination and provide the patient with
Page 5, Line 16information on how the patient can enroll in public health-care
Page 5, Line 17coverage;
Page 5, Line 18(d) If the health-care facility determines that a patient
Page 5, Line 19is likely eligible for public health-care coverage inform the
Page 5, Line 20patient of the determination and:
Page 5, Line 21(I) Provide the patient with information explaining how to
Page 5, Line 22apply for public health-care coverage, including at least one
Page 5, Line 23available method for submitting an application;
Page 5, Line 24(II) Offer reasonable assistance or referral for support
Page 5, Line 25to complete an application for public-health care coverage; and
Page 5, Line 26(III) Treat completion of an application for public
Page 5, Line 27health-care coverage as the primary pathway for resolving the
Page 5, Line 28patient's financial responsibility for hospital services until the
Page 5, Line 29patient is denied public health-care coverage or 45 days after
Page 5, Line 30the date of discharge, whichever occurs first; and
Page 5, Line 31(e) If the health-care facility needs more information to
Page 5, Line 32make a determination of whether the patient has qualified or is
Page 5, Line 33likely to qualify for discounted care or a financial assistance
Page 5, Line 34program, notify the patient that the patient must provide
Page 5, Line 35additional information to complete an application pursuant to
Page 5, Line 36section 25.5-3-502.5.
Page 5, Line 37(3.7) (a) If a patient has not been determined eligible for
Page 5, Line 38public health-care coverage pursuant to subsection (3.5)(d) of
Page 5, Line 39this section within 45 days after the date of discharge, a
Page 5, Line 40health-care facility shall proceed with a determination of
Page 5, Line 41whether the patient is a qualified patient.
Page 5, Line 42(b) Subsection (3.5)(d) of this section does not prohibit a
Page 5, Line 43patient or health-care facility from completing an application
Page 6, Line 1pursuant to section 25.5-3-502.5 while a determination of the
Page 6, Line 2patient's eligibility for public health-care coverage is pending.
Page 6, Line 3(c) While a determination of a patient's eligibility for
Page 6, Line 4public health-care coverage is pending, a health-care facility
Page 6, Line 5may defer completion of a final determination for discounted
Page 6, Line 6care if the patient is afforded the protections from billing and
Page 6, Line 7collection activity required by section 25.5-3-506.
Page 6, Line 8(d) A health-care facility shall not deny eligibility for
Page 6, Line 9discounted care solely because a patient did not apply for public
Page 6, Line 10health-care coverage.
Page 6, Line 11(4) If the patient declines the screening described in subsection (1)
Page 6, Line 12of this section, the health-care facility shall document the patient's
Page 6, Line 13decision in accordance with state department rules. A patient's decision
Page 6, Line 14to decline the screening that is documented and complies with state
Page 6, Line 15department rules is a complete defense to a claim brought by a patient
Page 6, Line 16under section 25.5-3-506 (2) for a violation of section 25.5-3-506 (1)(a)
Page 6, Line 17or (1)(b).
Page 6, Line 18(5) If requested by the an insured patient, a health-care facility
Page 6, Line 19shall screen an insured patient for discounted care pursuant to subsections
Page 6, Line 20(1)(b) and (1)(c) of this section perform the screening described in
Page 6, Line 21this section and, if applicable, complete the application pursuant
Page 6, Line 22to section 25.5-3-502.5 to determine if the insured patient is a
Page 6, Line 23qualified patient.
Page 6, Line 24(6) As used in this section, "inform" means to convey
Page 6, Line 25required information, unless otherwise specified in this section,
Page 6, Line 26including through verbal, electronic, or other formats. The
Page 6, Line 27health-care facility shall document the manner in which the
Page 6, Line 28information was provided.
Page 6, Line 29(7) A health-care facility may use the same
Page 6, Line 30communication to comply with both state and federal
Page 6, Line 31requirements.
Page 6, Line 32SECTION 6. In Colorado Revised Statutes, add 25.5-3-502.5 as
Page 6, Line 33follows:
Page 6, Line 3425.5-3-502.5. Uniform application for discounted care.
Page 6, Line 35(1) After completion of the screening conducted pursuant
Page 6, Line 36to section 25.5-3-502, a health-care facility shall request
Page 6, Line 37information from a patient to complete a uniform application
Page 6, Line 38for discounted care if:
Page 6, Line 39(a) The health-care facility needs more information to
Page 6, Line 40make a determination of whether the patient has qualified or is
Page 6, Line 41likely to qualify for discounted care or the health-care
Page 6, Line 42facility's financial assistance program, including if the
Page 6, Line 43health-care facility's policy is to require an application prior to
Page 7, Line 1making a final determination; or
Page 7, Line 2(b) The patient requests an application, unless the patient
Page 7, Line 3has no balance remaining after applying any discounts pursuant
Page 7, Line 4to section 25.5-3-503 or the health-care facility's financial
Page 7, Line 5assistance program.
Page 7, Line 6(2) A health-care facility shall use the uniform
Page 7, Line 7application developed by the state department to complete the
Page 7, Line 8application required by this section.
Page 7, Line 9(3) Upon completion and review of the application, a
Page 7, Line 10health-care facility shall:
Page 7, Line 11(a) If the health-care facility determines that a patient
Page 7, Line 12is a qualified patient, provide the patient notice of the
Page 7, Line 13determination, the patient's identified federal poverty guideline
Page 7, Line 14percentage, and the patient's monthly installment maximum
Page 7, Line 15payment as described in section 25.5-3-503;
Page 7, Line 16(b) If the health-care facility determines that a patient
Page 7, Line 17is not a qualified patient, provide the patient notice of the
Page 7, Line 18determination, which, if applicable, may also include notice that
Page 7, Line 19the patient is eligible for the health-care facility's financial
Page 7, Line 20assistance program and the amount of any discount offered
Page 7, Line 21through that program, and shall provide either:
Page 7, Line 22(I) An opportunity for the patient to appeal the
Page 7, Line 23determination in accordance with state department rules; or
Page 7, Line 24(II) A statement that the patient has no balance due after
Page 7, Line 25applying any discounts from the health-care facility's financial
Page 7, Line 26assistance program; and
Page 7, Line 27(c) If the health-care facility is certified by the state
Page 7, Line 28department as a medical assistance site and determines that the
Page 7, Line 29patient is presumptively eligible for medical assistance, provide
Page 7, Line 30the patient notice of the determination and information on how
Page 7, Line 31the patient can enroll in public health-care coverage.
Page 7, Line 32SECTION 7. In Colorado Revised Statutes, 25.5-3-503, amend
Page 7, Line 33(1) introductory portion and (2)(a) as follows:
Page 7, Line 3425.5-3-503. Health-care discounts on services not eligible for
Page 7, Line 35Colorado indigent care program reimbursement - definition.
Page 7, Line 36(1) Beginning September 1, 2022, if a patient is screened pursuant
Page 7, Line 37to section 25.5-3-502 or has completed a uniform application
Page 7, Line 38pursuant to section 25.5-3-502.5 and is determined to be a qualified
Page 7, Line 39patient, a health-care facility and a licensed health-care professional shall,
Page 7, Line 40for emergency hospital and other health-care services:
Page 7, Line 41(2) A health-care facility shall not:
Page 7, Line 42(a) Deny discounted care on the basis that the patient has not
Page 7, Line 43applied for any public benefits program, unless during the initial
Page 8, Line 1screening the patient is determined to be presumptively eligible for the
Page 8, Line 2state medical assistance program; or
Page 8, Line 3SECTION 8. In Colorado Revised Statutes, 25.5-3-504, amend
Page 8, Line 4(1) introductory portion; and add (2) as follows:
Page 8, Line 525.5-3-504. Notification of patients' rights - website link.
Page 8, Line 6(1) Beginning September 1, 2022, A health-care facility shall
Page 8, Line 7make information developed by the state department about patients' rights
Page 8, Line 8under this part 5 and the uniform application a link on the state
Page 8, Line 9department website to access the uniform application developed
Page 8, Line 10by the state department pursuant to section 25.5-3-505 (2)(i) available to
Page 8, Line 11the public and to each patient. At a minimum, the health-care facility
Page 8, Line 12shall:
Page 8, Line 13(2) The state department shall post the uniform
Page 8, Line 14application developed pursuant to section 25.5-3-505 (2)(i) in all
Page 8, Line 15required languages on a publicly accessible website.
Page 8, Line 16SECTION 9. In Colorado Revised Statutes, 25.5-3-505, amend
Page 8, Line 17(2) introductory portion, (2)(c)(II), (2)(d), (2)(e), (2)(f), (2)(g), (2)(i), (5)
Page 8, Line 18introductory portion, (5)(b)(I), and (5)(b)(II); and add (2)(d.5) and (7) as
Page 8, Line 19follows:
Page 8, Line 2025.5-3-505. Health-care facility reporting requirements -
Page 8, Line 21agency enforcement - report - rules.
Page 8, Line 22(2) No later than April 1, 2022 July 1, 2027, the state board shall
Page 8, Line 23promulgate adopt rules necessary for the administration and
Page 8, Line 24implementation of this part 5. At a minimum, the rules must:
Page 8, Line 25(c) Establish the process for and the maximum number of days
Page 8, Line 26that a health-care facility has to:
Page 8, Line 27(II) Request information from the a patient needed for the
Page 8, Line 28screening process if the health-care facility conducts a screening
Page 8, Line 29using the uniform screening questionnaire as described in
Page 8, Line 30section 25.5-3-502 (2); and
Page 8, Line 31(d) Outline the requirements for notifying the patient of the results
Page 8, Line 32of the screening, including:
Page 8, Line 33(I) An explanation of the basis for a denial of discounted care; and
Page 8, Line 34(II) The process for appealing a denial completing an
Page 8, Line 35application to provide more information to determine whether
Page 8, Line 36the patient is a qualified patient;
Page 8, Line 37(d.5) Establish a process for and the maximum number of
Page 8, Line 38days that a health-care facility has to:
Page 8, Line 39(I) Request information from the patient to complete an
Page 8, Line 40application, if the application is required pursuant to section
Page 8, Line 4125.5-3-502.5; and
Page 8, Line 42(II) Complete the application process as described in
Page 8, Line 43section 25.5-3-502.5;
Page 9, Line 1(e) Establish guidelines for patient appeals regarding eligibility for
Page 9, Line 2discounted care pursuant to section 25.5-3-503 25.5-3-502.5;
Page 9, Line 3(f) Establish a methodology that all acceptable methodologies
Page 9, Line 4for health-care facilities must use to determine monthly household
Page 9, Line 5income. For purposes of the screening conducted pursuant to
Page 9, Line 6section 25.5-3-502, the use of an industry-standard third-party
Page 9, Line 7resource, including major credit bureaus, is an acceptable
Page 9, Line 8methodology. The methodology methodologies must not consider a
Page 9, Line 9patient's assets.
Page 9, Line 10(g) For purposes of the application, identify the documents
Page 9, Line 11that may be required to establish income eligibility for discounted care
Page 9, Line 12using the minimum amount of information needed to determine
Page 9, Line 13eligibility;
Page 9, Line 14(i) Create a uniform application that a health-care facility must use
Page 9, Line 15when an application is required after screening a patient for
Page 9, Line 16eligibility for discounted care, as described in section 25.5-3-502
Page 9, Line 17sections 25.5-3-502 and 25.5-3-502.5; and
Page 9, Line 18(5) No later than April 1, 2022, The state department: shall:
Page 9, Line 19(b) (I) Shall establish a process for patients to submit a
Page 9, Line 20complaint relating to noncompliance with this part 5 to the state
Page 9, Line 21department by phone, by mail, or online. The state department shall
Page 9, Line 22conduct a review of a patient's complaint within thirty days after
Page 9, Line 23receiving a the complaint.
Page 9, Line 24(II) (A) The state department Shall periodically review health-care
Page 9, Line 25facilities and licensed health-care professionals to ensure compliance with
Page 9, Line 26this section qualified patients are identified in compliance with
Page 9, Line 27this part 5 and are not charged more than the discounted rate
Page 9, Line 28established in state board rules pursuant to subsection (2)(j) of
Page 9, Line 29this section. The review shall be conducted in accordance with
Page 9, Line 30state department rules, and the frequency, sample size, and
Page 9, Line 31timeline of the review must be reasonable considering the size
Page 9, Line 32and resources of the health-care facility.
Page 9, Line 33(B) If the state department finds that a health-care facility or
Page 9, Line 34licensed health-care professional is not in compliance with this section,
Page 9, Line 35and the noncompliance has resulted in a delay or denial of a
Page 9, Line 36discount owed to a patient as a result of the screening required
Page 9, Line 37pursuant to section 25.5-3-502, the state department shall notify the
Page 9, Line 38health-care facility or licensed health-care professional and the facility or
Page 9, Line 39professional has ninety days after notification to file a corrective
Page 9, Line 40action plan with the state department. that If the noncompliance
Page 9, Line 41resulted in excess charges to the patient, the corrective action
Page 9, Line 42plan must include measures to inform the patient about the
Page 9, Line 43noncompliance and provide a financial correction consistent with this part
Page 10, Line 15. A health-care facility or licensed health-care professional may request
Page 10, Line 2up to one hundred twenty days to submit a corrective action plan. The
Page 10, Line 3state department may require a health-care facility or licensed health-care
Page 10, Line 4professional that is not in compliance with this part 5 or any state board
Page 10, Line 5rules adopted pursuant to this part 5 to develop and operate under a
Page 10, Line 6corrective action plan until the state department determines the
Page 10, Line 7health-care facility or licensed health-care professional is in compliance.
Page 10, Line 8(C) If a health-care facility's or licensed health-care
Page 10, Line 9professional's noncompliance with this part 5 did not result in a
Page 10, Line 10delay or denial of a discount owed to a patient as a result of the
Page 10, Line 11screening required pursuant to section 25.5-3-502, the state
Page 10, Line 12department may notify the health-care facility or licensed
Page 10, Line 13health-care professional of the noncompliance for purposes of
Page 10, Line 14quality improvement.
Page 10, Line 15(7) (a) The state department or the state board shall not
Page 10, Line 16impose changes to the uniform screening questionnaire, changes
Page 10, Line 17to the application, new requirements, new reporting obligations,
Page 10, Line 18new documentation standards, new data elements, or new
Page 10, Line 19program criteria through manuals, policy, or other
Page 10, Line 20subregulatory issuances unless the changes or new
Page 10, Line 21requirements have been:
Page 10, Line 22(I) Adopted by rule pursuant to the "State Administrative
Page 10, Line 23Procedure Act", article 4 of title 24 , by September 1, 2026, for a
Page 10, Line 24rule that will go into effect during to the 2026-27 state fiscal
Page 10, Line 25year and every year thereafter by June 1 prior to the state
Page 10, Line 26fiscal year for which the rule will go into effect; and
Page 10, Line 27(II) Subject to stakeholder engagement pursuant to
Page 10, Line 28subsection (4) of this section.
Page 10, Line 29(b) Any change or new requirement described in
Page 10, Line 30subsection (7)(a) of this section that was not adopted through
Page 10, Line 31rule-making is advisory only and does not serve as the basis for
Page 10, Line 32enforcement.
Page 10, Line 33(c) The state department shall maintain an updated public
Page 10, Line 34archive of all manuals and subregulatory issuances, including
Page 10, Line 35the rationale for changes and citations to statutory or
Page 10, Line 36regulatory authority for each change or new requirement.
Page 10, Line 37(d) This subsection (7) does not apply to rules adopted by
Page 10, Line 38the state department or the state board to update annual
Page 10, Line 39federal poverty guidelines or in response to emergent and
Page 10, Line 40immediate trends that are identified by consumers or hospitals
Page 10, Line 41as limiting the program's effectiveness and are demonstrated by
Page 10, Line 42data submitted to the state department or the state board.
Page 10, Line 43SECTION 10. In Colorado Revised Statutes, 25.5-4-402.8,
Page 11, Line 1amend (2)(b) introductory portion, (2)(b)(II)(A), and (2)(e) as follows:
Page 11, Line 225.5-4-402.8. Hospital transparency report and requirements
Page 11, Line 3- definitions - rules.
Page 11, Line 4(2) (b) Except as provided in subsection (2)(c) of this section,
Page 11, Line 5each hospital licensed pursuant to part 1 of article 3 of title 25, or certified
Page 11, Line 6pursuant to section 25-1.5-103 (1)(a)(II), shall make information available
Page 11, Line 7to the state department for purposes of preparing the annual hospital
Page 11, Line 8transparency report. The state board shall establish the content and
Page 11, Line 9format of the information provided by each hospital on an annual basis by
Page 11, Line 10rule, establishing the format for information for the 2026
Page 11, Line 11annual report as the default format unless modified by rule.
Page 11, Line 12Each hospital shall provide the following information to the state
Page 11, Line 13department on an annual basis using the most recent content and
Page 11, Line 14format requirements that were adopted by the state board at
Page 11, Line 15least thirty days prior to the beginning of the hospital's fiscal
Page 11, Line 16year:
Page 11, Line 17(II) (A) Annual audited financial statements, prepared in
Page 11, Line 18accordance with generally accepted accounting principles. Each hospital
Page 11, Line 19shall submit the statements within one hundred twenty fifty days after
Page 11, Line 20the end of its fiscal year unless the state department grants an extension
Page 11, Line 21in writing in advance of that date.
Page 11, Line 22(e) Prior to issuing the hospital transparency report, the state
Page 11, Line 23department shall provide any hospital referenced in the hospital
Page 11, Line 24transparency report a copy of the draft report by December 1 of each
Page 11, Line 25year. Each hospital and a statewide hospital association must have
Page 11, Line 26a minimum of fifteen business days to review the hospital transparency
Page 11, Line 27report and any underlying data and submit corrections or clarifications to
Page 11, Line 28the state department.
Page 11, Line 29SECTION 11. In Colorado Revised Statutes, 6-20-203, amend
Page 11, Line 30(5)(b) and (5)(c) as follows:
Page 11, Line 316-20-203. Limitations on collection actions - definition.
Page 11, Line 32(5) Beginning September 1, 2022, a medical creditor collecting on
Page 11, Line 33a debt for hospital services shall not sell a medical debt to another party
Page 11, Line 34unless, prior to the sale, the medical debt seller has entered into a legally
Page 11, Line 35binding written agreement with the medical debt buyer of the debt
Page 11, Line 36pursuant to which:
Page 11, Line 37(b) The debt is returnable to or recallable by the medical debt
Page 11, Line 38seller upon a determination that the patient should have been screened
Page 11, Line 39pursuant to section 25.5-3-502 sections 25.5-3-502 and 25.5-3-502.5
Page 11, Line 40and is eligible for discounted care pursuant to section 25.5-3-503 or that
Page 11, Line 41the bill underlying the medical debt is eligible for reimbursement through
Page 11, Line 42a public health-care coverage program; and
Page 11, Line 43(c) If it is determined that the patient should have been screened
Page 12, Line 1pursuant to section 25.5-3-502 sections 25.5-3-502 and 25.5-3-502.5
Page 12, Line 2and is eligible for discounted care pursuant to section 25.5-3-503 or that
Page 12, Line 3the bill underlying the medical debt is eligible for reimbursement through
Page 12, Line 4a public health-care coverage program and the debt is not returned to or
Page 12, Line 5recalled by the medical debt seller, the medical debt buyer shall adhere to
Page 12, Line 6procedures that must be specified in the agreement that ensures the
Page 12, Line 7patient will not pay, and has no obligation to pay, the medical debt buyer
Page 12, Line 8and the medical creditor together more than the patient is personally
Page 12, Line 9responsible for paying.
Page 12, Line 10SECTION 12. In Colorado Revised Statutes, 12-220-306, amend
Page 12, Line 11(4) as follows:
Page 12, Line 1212-220-306. Dentists may prescribe drugs - surgical operations
Page 12, Line 13- anesthesia - limits on prescriptions - rules.
Page 12, Line 14(4) A licensed dentist is strongly encouraged to purchase or utilize
Page 12, Line 15an electronic health product that includes integration of a tool that
Page 12, Line 16facilitates dentists' compliance with prescription drug monitoring
Page 12, Line 17standards. required by section 12-30-114 (1)(a)(IV).
Page 12, Line 18SECTION 13. In Colorado Revised Statutes, 12-240-130, amend
Page 12, Line 19(2)(a)(II); and repeal (2)(a)(III) and (5) as follows:
Page 12, Line 2012-240-130. Renewal, reinstatement, reactivation -
Page 12, Line 21delinquency - fees - questionnaire.
Page 12, Line 22(2) (a) The board shall design a questionnaire to accompany the
Page 12, Line 23renewal form for the purpose of determining whether a licensee has acted
Page 12, Line 24in violation of this article 240 or has been disciplined for any action that
Page 12, Line 25might be considered a violation of this article 240 or that might make the
Page 12, Line 26licensee unfit to practice medicine with reasonable care and safety. The
Page 12, Line 27board shall include on the questionnaire a question regarding whether:
Page 12, Line 28(II) The licensee is in compliance with section 12-280-403 (2)(a)
Page 12, Line 29and is aware of the penalties for failing to comply with that section; and
Page 12, Line 30(III) The licensee is in compliance with section 12-30-114; and
Page 12, Line 31(5) On and after October 1, 2022, as a condition of renewal,
Page 12, Line 32reinstatement, or reactivation of a license, each licensee or applicant shall
Page 12, Line 33attest that the licensee or applicant is in compliance with section
Page 12, Line 3412-30-114 and that the licensee or applicant is aware of the penalties for
Page 12, Line 35noncompliance with that section.
Page 12, Line 36SECTION 14. In Colorado Revised Statutes, 12-240-130.5,
Page 12, Line 37amend (6) as follows:
Page 12, Line 3812-240-130.5. Continuing medical education - requirement -
Page 12, Line 39compliance - legislative declaration - rules - definitions.
Page 12, Line 40(6) As part of the CME requirement established pursuant to this
Page 12, Line 41section, in addition to CME programs covering topics selected by the
Page 12, Line 42physician, a physician's CME credit hours must include
Page 12, Line 43(a) CME credit hours that comply with section 12-30-114 and
Page 13, Line 1related board rules; and
Page 13, Line 2(b) CME credit hours covering a topic specified by the board by
Page 13, Line 3rule pursuant to subsection (7)(b) of this section.
Page 13, Line 4SECTION 15. In Colorado Revised Statutes, 25-1.5-103, amend
Page 13, Line 5(1)(a)(I)(A) and (1)(a)(I)(F) as follows:
Page 13, Line 625-1.5-103. Health facilities - powers and duties of department
Page 13, Line 7- rules - limitations on rules - definitions - repeal.
Page 13, Line 8(1) The department has, in addition to all other powers and duties
Page 13, Line 9imposed upon it by law, the powers and duties provided in this section as
Page 13, Line 10follows:
Page 13, Line 11(a) (I) (A) To annually license and to establish and enforce
Page 13, Line 12standards for the operation of general hospitals, hospital units as defined
Page 13, Line 13in section 25-3-101 (2)(b), freestanding emergency departments as
Page 13, Line 14defined in section 25-1.5-114 (5)(b)(I), critical access hospitals as defined
Page 13, Line 15in section 25-1.5-114.5 (1)(b), psychiatric hospitals, community clinics,
Page 13, Line 16rehabilitation hospitals, convalescent centers, facilities for persons with
Page 13, Line 17intellectual and developmental disabilities, nursing care facilities, hospice
Page 13, Line 18care, assisted living residences, dialysis treatment clinics, ambulatory
Page 13, Line 19surgical centers, birthing centers, home care agencies, and other facilities
Page 13, Line 20of a like nature, except those wholly owned and operated by a
Page 13, Line 21governmental unit or agency.
Page 13, Line 22(F) Sections 24-4-104 C.R.S., and 25-3-102 govern the issuance,
Page 13, Line 23suspension, renewal, revocation, annulment, or modification of licenses.
Page 13, Line 24All licenses issued by the department must contain the date of issue. and
Page 13, Line 25cover a twelve-month period. Nothing contained in this paragraph (a)
Page 13, Line 26subsection (1)(a) prevents the department from adopting and enforcing,
Page 13, Line 27with respect to projects for which federal assistance has been obtained or
Page 13, Line 28is requested, higher standards as may be required by applicable federal
Page 13, Line 29laws or regulations of federal agencies responsible for the administration
Page 13, Line 30of applicable federal laws.
Page 13, Line 31SECTION 16. Act subject to petition - effective date. Section
Page 13, Line 3225-3-102, Colorado Revised Statutes, as amended in section 3 of this act,
Page 13, Line 33and section 25-1.5-103, Colorado Revised Statutes, as amended in section
Page 13, Line 3415 of this act, take effect July 1, 2028, and the remainder of this act takes
Page 13, Line 35effect at 12:01 a.m. on the day following the expiration of the ninety-day
Page 13, Line 36period after final adjournment of the general assembly; except that, if a
Page 13, Line 37referendum petition is filed pursuant to section 1 (3) of article V of the
Page 13, Line 38state constitution against this act or an item, section, or part of this act
Page 13, Line 39within such period, then the act, item, section, or part will not take effect
Page 13, Line 40unless approved by the people at the general election to be held in
Page 13, Line 41November 2026 and, in such case, will take effect on the date of the
Page 13, Line 42official declaration of the vote thereon by the governor; except that
Page 13, Line 43section 25-3-102, Colorado Revised Statutes, as amended in section 3 of
Page 14, Line 1this act, and section 25-1.5-103, Colorado Revised Statutes, as amended
Page 14, Line 2in section 15 of this act, take effect July 1, 2028.".