HB19-1174 (Esgar & Catlin /Gardner & Pettersen) Out of Network Health Care Services

Originally Posted: March 22, 2019
Last Updated: May 3, 2019

Summary

This bill would help protect consumers who unknowingly receive care from an out-of-network provider at an emergency room or while accessing care at an in-network hospital and then receive a surprise bill for this care. Current law in Colorado requires insurers to protect patients from paying for surprise out-of-network services. The bill would prohibit these bills from being sent to consumers in the first place, require that consumers be notified of their rights in surprise billing situations, and set a reasonable rate of payment for out-of-network providers and facilities in cases where consumers unknowingly receive out-of-network care.

Position

The Children’s Campaign supports this bill as a way to protect families’ financial security. Research shows that 69 percent of people billed for out-of-network services did not realize the provider was out-of-network at the time they received care, and that two-thirds of Americans are worried about being able to afford their own or a family member’s unexpected medical bills. Out-of-network bills sent to insurers from physicians can be more than 30 times the average in-network rate for those services. Even though current Colorado law requires that insurers protect consumers from surprise out-of-network billing, many consumers pay these bills in full, or are sent to collections for not paying these bills because they don’t know they have the right to fight the bill. And when insurers pay unreasonable prices for these services, they increase premiums on everybody.

Current Status

Passed the Senate on a bipartisan vote of 31-4 and now heads to the governor’s desk for signature. 

Previous Statuses


March 22, 2019

Passed the House on a bipartisan vote of 60-4 and now heads to the Senate.

April 5, 2019

Assigned to the Senate Judiciary Committee where it is scheduled to be heard on Mon., Apr. 15 at 1:30pm in SCR 352.

April 26, 2019

Passed Senate Appropriations Committee on a bipartisan vote of 9-1 and now heads to the Senate floor for debate.