COLORADO

Overview

Colorado is a state to watch on healthcare transparency and costs. Colorado has a working All-Payer Claims Database, which calls itself “the most comprehensive source of health claims data from public and private payers in Colorado.” Indeed, Colorado’s APCD includes a full scope of providers and paid amounts, and has an easily accessible website for consumers. In the enforcement realm, the state has not been too active. It has allowed a few recent sales of non-profit hospitals on the grounds that they complied with the state’s statutory requirements.

In the 2018 legislative term, Colorado was very active and passed several bills to promote price transparency and broaden coverage. The legislature introduced the Colorado Prescription Drug Price Transparency Act of 2018 (HB 1260), which would require makers of prescription drugs to provide notice when they hike prices on certain drugs by more than 10 percent in a two-year period. The bill passed in House but was postponed indefinitely in the Republican-controlled Senate.

However, the state was successful in passing a number of other price transparency bills, including disclosure of prescription costs at pharmacies (HB 1284) and allowing the general assembly to pay for expenses related to the all-payer health claims database (HB 1327). Additionally, bipartisan efforts tackled confusing practices and hidden pricing at freestanding emergency departments (FSEDs) by passing SB 146, which requires FSEDs to provide disclosures to enable patients to make better-informed decisions before incurring charges, and HB 1282, which assigns a unique facility identifier to all FSEDs in Colorado for billing purposes.

The State Database

The Source tracks state activities impacting healthcare price and competition in both legislation and litigation in a searchable database to help stakeholders at the state level understand their legal and regulatory environment as they make efforts to improve access, quality, and efficiency, and reduce costs in healthcare.

LEGISLATION: The Database of State Laws Impacting Healthcare Cost and Quality (SLIHCQ), created by The Source on Healthcare Price & Competition and Catalyst for Payment Reform, catalogues state legislation governing price transparency, provider market power, provider payment, provider networks, and benefit design. The database also includes pharmaceutical legislation beginning in the 2017-2018 legislative session. *Note: Current legislative session bill updates are ongoing. Check back weekly for updates. 

LITIGATION: The Source tracks major litigation and antitrust enforcement action by federal entities (FTC or DOJ), state attorney generals, and private parties in the main provider and insurer markets, particularly legal challenges of healthcare consolidation and anticompetitive contract provisions. Additionally, the database contains major pharmaceutical cases including legislation challenges and significant appellate cases.

Search the database across all jurisdictions on the State Overview page, or view and filter existing legislation or litigation on individual state pages. The database allows customized search and filter by keyword, status, and/or key issue category. *Multiple filter/selections enabled. Click here for User Guide.

 

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© 2018-2019 The SLIHCQ DatabaseInitial funding for this project was provided by the Robert Wood Johnson Foundation. The views expressed here do not necessarily reflect the views of the Foundation.
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© 2018-2019 The SLIHCQ DatabaseInitial funding for this project was provided by the Robert Wood Johnson Foundation. The views expressed here do not necessarily reflect the views of the Foundation.
Filter by Key Issue

Additional Resources

LEGISLATIVE CALENDAR

Colorado’s latest legislative term ran from 1/4/2019 – 5/4/2019. Colorado’s next legislative session will convene in 2020.

FY 2019-2020 BUDGET

Budgets are set for a fiscal year. The fiscal year is the 12‐month period beginning on July 1 and ending June 30 of the following year. To view Colorado’s FY 2019-2020 Budget Package and Long Appropriation Act, click here.

REGULATION & ENFORCEMENT

  • Controlling Healthcare Costs to Consumers: As of February 2014, the Colorado Division of Insurance will study healthcare costsin the state in response to concern about higher premiums in certain areas of the state. The Division of Insurance explained that it needed new data to justify rate changes to HHS for 2015.
  • Colorado Attorney General John W. Suthers has allowed three recent transactions involving non-profit hospitals to proceed without further review under the Hospital Transfer Act, R.S § 6-19-101, et seq., which requires nonprofit hospitals, when sold to for-profit entities, to use the sale proceeds toward a similar charitable activity.
  • On August 1, 2014, the AG announced that his office had issued an opinion under the Hospital Transfer Act relating to the proposed transaction between the Sisters of Charity of Leavenworth Health System Inc. (d/b/a SCL Health), Saint Joseph Hospital Inc., and National Jewish Health. This matter was noticed on July 10, 2014. The Attorney General’s office determined that the transaction meets the relevant criteria of the Act and may proceed without further review by the Attorney General.
  • On June 28, 2013,
the AG announced that his office had issued an opinion under the Hospital Transfer Act relating to the proposed transaction between the Lutheran Hospital Association of San Luis Valley doing business as San Luis Valley Regional Medical Center and Conejos County Hospital Corporation. This matter was noticed on June 24, 2013.
  • On October 1, 2012 the AG announced that his office had issued an opinion under the Hospital Transfer Act relating to the proposed transaction between Community First Foundation and Sisters of Charity of Leavenworth Health System, Inc. regarding the Exempla healthcare system. This matter was noticed on July 31, 2012. The Attorney General’s office determined that the transaction had met the relevant criteria of the Act and may proceed without further review by the Attorney General.

KEY RESOURCES