Colorado health-care facilities guide patients through coverage and discounted care

Health-care facilities screen uninsured patients for public coverage and discounted care, and may also screen for their own aid programs. These provisions apply to health-care facilities and patients seeking public coverage or discounted care. A facility screens an uninsured patient unless the patient declines; it may also screen for its own financial assistance program. Facilities screen insured patients if asked. They may decide from screening alone when they have enough information. A facility requests the state application when it needs more information or the patient requests one, unless discounts leave no balance. The screening provisions state a start date of September 1, 2022.

Facilities tell patients screening results and next steps, and offer help applying when a patient may qualify for public coverage. These duties apply to health-care facilities and patients screened for public coverage or discounted care. Facilities tell patients the identified poverty-guideline percentage and, when applicable, the maximum monthly installment payment. When a patient may qualify for public coverage, the facility explains how to apply and offers reasonable help or a referral. The application is the main way to resolve hospital bills until coverage is denied or 45 days after discharge, whichever comes first. A facility may defer a final discounted-care decision while coverage is pending only if the patient receives required billing and collection protections. It may not deny discounted care solely because the patient did not apply for public coverage. The 45-day period begins on the patient's discharge date.

The law sets health-care license training provisions and changes how often certain facilities apply to renew licenses. The training provisions cover dentists, dental therapists, dental hygienists, veterinarians, and providers subject to the specified existing training rules. The licensing provisions cover applicants for certain health-care facility licenses. The dental board may require up to four training hours per licensing cycle on prescribing, substance-use disorders, referrals, or the prescription monitoring program. It must count up to four hours of opioid competency training toward required continuing education. Veterinarians complete at least one hour of substance-use prevention training per renewal period. This does not apply to veterinarians with equivalent national board training or who attest they do not prescribe opioids. The department may issue certain facility licenses for one year through July 1, 2030. Certain regulators must repeal existing rules requiring up to four hours of opioid competency training for licensed providers by July 1, 2027. The specified regulators must repeal existing provider training rules by July 1, 2027. The one-year facility license option runs through July 1, 2030.

The law sets state rules for discounted-care applications and oversight, medical-debt sales, and hospital transparency reports. These provisions involve the state department and board, health-care facilities, hospital medical creditors and debt buyers, hospitals, and a statewide hospital association. The state posts the uniform application in required languages. Facilities use it when an application is required and provide decision notices and, in specified cases, an appeal opportunity. The state board sets application and screening rules. Certain changes to forms and program requirements must go through rulemaking and stakeholder engagement; annual poverty-guideline updates and certain urgent changes are exempt. Hospitals provide annual information for state transparency reports. Hospitals and a statewide hospital association get at least 15 business days to review draft reports and submit corrections or clarifications. Before selling hospital medical debt, creditors must have a written agreement allowing debt to be returned or recalled in specified cases and protecting patients from paying more than they personally owe. The state board must adopt the specified rules by July 1, 2027. Hospitals receive draft reports by December 1 each year and at least 15 business days to review them.