(1) Each hospital shall make information available to each patient about the hospital's financial assistance, charity care, and payment plan policies. Each hospital shall communicate this information in a clear and understandable manner and in languages appropriate to the communities and patients the hospital serves. The hospital shall:
Post the information conspicuously on its website;
Make the information available in patient waiting areas;
Make the information available to each patient, when possible, before the patient'sdischarge from the hospital; and
Inform each patient on each billing statement of his or her rights pursuant to thissection and that financial assistance or charity care may be available and, where applicable, provide the website, e-mail address, and telephone number where the information may be obtained.
(2) (a) When possible, each hospital shall offer to screen each uninsured patient for eligibility for financial assistance as described by this subsection (2). Each hospital shall offer financial assistance for qualified patients on a community-specific basis. In determining eligibility for financial assistance, each hospital shall, at a minimum, take into consideration federal, state, and local government requirements.
(b) For purposes of this section, a qualified patient is an individual:
Who is uninsured;
Whose annual family income is not more than two hundred fifty percent of the federal poverty guidelines; and
Who received a service at a hospital for which the "Colorado Indigent Care Program" established in part 1 of article 3 of title 25.5, C.R.S., was not available.
(3) A hospital shall limit the amounts charged for emergency or other medically necessary care provided to individuals eligible for assistance under the financial assistance policy described in subsection (2) of this section to not more than the lowest negotiated rate from a private health plan.
(3.5) If a hospital discovers an omission of required information, incorrect billing, or other noncompliance with this section by the hospital, the hospital shall correct the error or omission, inform the patient, and provide a financial correction consistent with this section to the persons affected by the error or omission. The hospital shall inform the department of the errors, omissions, and corrective actions taken by the hospital in the same manner and form as the reports required in section 25-1-124. The department shall not investigate a hospital because that hospital has corrected an error, omission, or noncompliance with this section, unless there is good cause to open an investigation. If the department investigates a self-reported incident, the department shall investigate, document, and identify the self-reported errors, omissions, or noncompliance related to this section as a self-reported incident investigation, and not as a complaint investigation. The department shall make information concerning investigations and complaints available to the public in the same manner as section 25-1-124 (6) and (7). The department shall make hospital self-reported incidents submitted to the department pursuant to this section available to the public upon request.
(3.7) (a) If the department receives a valid complaint regarding a hospital's compliance with this section, the department may conduct a review. In addition, the department shall periodically review hospitals to ensure compliance with this section.
If the department finds that a hospital is not in compliance with this section, including the rules adopted pursuant to paragraph (c) of subsection (7) of this section, the department shall notify the hospital, and the hospital has ninety days to file with the department a corrective action plan that includes measures to inform the patient or patients, and provide a financial correction consistent with this section to the persons affected by the noncompliance. A hospital may request up to one hundred twenty days to submit a corrective action plan if necessary. The department may require a hospital that is not in compliance with this section, or with rules adopted pursuant to paragraph (c) of subsection (7) of this section, to develop and operate under a corrective action plan until the hospital is in compliance.
If a hospital's noncompliance with this section is determined by the department to beknowing or willful, the department may fine the hospital up to five thousand dollars. In addition, if the hospital fails to take corrective action or fails to file a corrective action plan with the department within ninety days, or up to one hundred twenty days if approved by the department, the department may fine the hospital up to five thousand additional dollars. The department shall consider the size of the hospital and the seriousness of the violation in setting the fine amount.
(4) (a) Before initiating collection proceedings, a hospital shall:
Offer a qualified patient a reasonable payment plan; and
Allow for at least thirty days past the due date of any scheduled payment that is notpaid in full. A hospital must allow the thirty-day period only for the first late payment.
(b) A hospital shall not initiate collections proceedings once the hospital is notified that it must submit a corrective action plan or when the hospital is operating pursuant to a corrective action plan pursuant to subsection (3.7) of this section.
Nothing in this section limits or affects a hospital's right to pursue the collection ofpersonal injury, bodily injury, liability, uninsured, underinsured, medical payment rehabilitation, disability, homeowner's, business owner's, workers' compensation, or fault-based insurance.
For the purposes of this section, "hospital" means a hospital licensed pursuant to part1 of article 3 of this title or certified pursuant to section 25-1.5-103 (1)(a)(II).
Repealed.
The department shall make information available regarding any corrective actions forwhich fines were imposed pursuant to this section. Any information regarding the lowest negotiated rate provided to the department pursuant to this section is confidential and not a public record.
Nothing in this section affects a license issued to a hospital pursuant to section 25-3101. The department shall not charge a hospital an additional license fee for costs associated with this section.
Source: L. 2012: Entire section added, (SB 12-134), ch. 162, p. 569, § 1, effective August 8. L. 2014: (1)(d) amended and (3.5), (3.7), (4)(b), (7), (8), and (9) added, (SB 14-050), ch. 269, p. 1080, § 1, effective August 6.
Editor's note: (1) Subsection (4)(b) was enacted as subsection (4)(c) in Senate Bill 14050 but was relettered when the provisions within subsection (4) were relettered and renumbered on revision in 2014 to conform to statutory format.
(2) Subsection (7)(d) provided for the repeal of subsection (7), effective December 31, 2014. (See L. 2014, p. 1080.)