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.
2020 Legislative Session: 1/8/2020 - 5/7/2020 (2020 term). *Current session bill updates are ongoing. Check back weekly for updates.
FY 2019-2020 BUDGETBudgets 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 costs in 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.