State Bill Colorado

Amendments for HB21-1198

House Journal, April 22
18 HB21-1198 be amended as follows, and as so amended, be referred to
19 the Committee on Appropriations with favorable
20 recommendation:
21
22 Amend printed bill, page 3, line 17, strike "AFFILIATED WITH OR" and
23 substitute "THAT IS LICENSED AS AN ON-CAMPUS DEPARTMENT OR SERVICE
24 OF A HOSPITAL OR THAT IS LISTED AS AN OFF-CAMPUS LOCATION UNDER A
25 HOSPITAL'S LICENSE, EXCEPT A FEDERALLY QUALIFIED HEALTH CENTER, AS
26 DEFINED IN THE FEDERAL "SOCIAL SECURITY ACT", 42 U.S.C. SEC. 1395x
27 (aa)(4).".
28
29 Page 3, strike lines 18 and 19.
30
31 Page 4, after line 23 insert:
32
33 "(7) "UNINSURED" MEANS AN UNINSURED INDIVIDUAL, AS DEFINED
34 IN SECTION 10-22-113 (5)(d).".
35
36 Page 5, line 22, after "RULES." insert "A PATIENT'S DECISION TO DECLINE
37 THE SCREENING THAT IS DOCUMENTED AND COMPLIES WITH STATE
38 DEPARTMENT RULES IS A COMPLETE DEFENSE TO A CLAIM BROUGHT BY A
39 PATIENT UNDER SECTION 25.5-3-506 (2) FOR A VIOLATION OF SECTION
40 25.5-3-506 (1)(a) OR (1)(b).".
41
42 Page 6, line 5, strike "EIGHTY" and substitute "THE DISCOUNTED RATE
43 ESTABLISHED IN STATE DEPARTMENT RULE PURSUANT TO SECTION
44 25.5-3-505 (2)(j);".
45
46 Page 6, strike line 6.
47
48 Page 6, line 9, strike "FIVE" and substitute "FOUR".
49
50 Page 6, strike lines 10 and 11 and substitute "MONTHLY HOUSEHOLD
51 INCOME ON A BILL FROM A HEALTH-CARE FACILITY AND NOT PAYING MORE
52 THAN TWO PERCENT OF THE PATIENT'S MONTHLY HOUSEHOLD INCOME ON
53 A BILL FROM A LICENSED HEALTH-CARE PROFESSIONAL; AND".
54
55 Page 7, line 10, strike "VERBALLY" and substitute "VERBALLY, WHICH
56 MAY INCLUDE USING A PROFESSIONAL INTERPRETATION SERVICE,".
1 Page 8, line 11, strike "DOCUMENTING" and substitute "DOCUMENTING,
2 PURSUANT TO SECTION 25.5-3-502 (4),".
3
4 Page 8, strike line 12 and substitute "MADE AN INFORMED DECISION TO
5 DECLINE THE SCREENING, INCLUDING PROCEDURES FOR RETAINING SUCH
6 DOCUMENTATION;".
7
8 Page 9, line 6, strike "AND".
9
10 Page 9, line 10, strike "25.5-3-502." and substitute "25.5-3-502; AND
11 (j) ANNUALLY ESTABLISH RATES FOR DISCOUNTED CARE
12 PURSUANT TO SECTION 25.5-3-503 (1)(a). THE RATES SHOULD
13 APPROXIMATE AND NOT BE LESS THAN EIGHTY PERCENT OF THE MEDICARE
14 RATE OR, IF A MEDICARE RATE IS NOT AVAILABLE, ONE HUNDRED PERCENT
15 OF THE MEDICAID BASE RATE. THE STATE DEPARTMENT SHALL PUBLICLY
16 POST THE ESTABLISHED RATES ON THE STATE DEPARTMENT'S WEBSITE.".
17
18 Page 9, after line 18 insert:
19
20 "(4) PRIOR TO PROMULGATING RULES PURSUANT TO THIS SECTION,
21 THE STATE DEPARTMENT SHALL HOLD AT LEAST ONE STAKEHOLDER
22 MEETING WITH HOSPITAL REPRESENTATIVES, HEALTH-CARE CONSUMERS,
23 AND HEALTH-CARE CONSUMER ADVOCATES THAT IS ACCESSIBLE TO
24 INDIVIDUALS WHOSE PRIMARY LANGUAGE IS NOT ENGLISH, IF
25 REQUESTED.".
26
27 Renumber succeeding subsections accordingly.
28
29 Page 9, line 21, strike "DEVELOP" and substitute "USING FEEDBACK FROM
30 HOSPITAL HEALTH-CARE CONSUMERS AND HEALTH-CARE CONSUMER
31 ADVOCATE STAKEHOLDERS, DEVELOP".
32
33 Page 9, line 25, strike "STATE." and substitute "STATE AND POST THE
34 WRITTEN EXPLANATION IN ALL REQUIRED LANGUAGES ON THE STATE
35 DEPARTMENT'S WEBSITE.".
36
37 Page 11, line 6, strike "(4)(b)(II)" and substitute "(5)(b)(II)".
38
39 Page 11, line 15, strike "(4)(b)" and substitute "(5)(b)".
40
41 Page 11, line 21, strike "(6):" and substitute "(7):".
42
43 Page 11, strike lines 26 and 27 and substitute "PURSUANT TO SECTION
44 25.5-3-503;".
45
46 Page 12, strike line 1.
47
48 Page 12, line 2, strike "PROVIDE" and substitute "A HEALTH-CARE
49 FACILITY AND LICENSED HEALTH-CARE PROFESSIONAL SHALL PROVIDE".
50
51 Page 12, line 4, strike "ACTIONS." and substitute "ACTIONS; AND
52 (d) A HEALTH-CARE FACILITY AND HEALTH-CARE PROFESSIONAL
53 SHALL BILL ANY THIRD-PARTY PAYER THAT IS RESPONSIBLE FOR
54 PROVIDING HEALTH-CARE COVERAGE TO THE PATIENT.".
55
56
1 Page 13, line 21, strike "6-20-203." and substitute "6-20-203 (1), (2),
2 (3)(b), (4)(a), (4)(b)(I), (4)(d), (4)(e), OR (5)(a) TO (5)(c).".
3
4 Page 13, lines 22 and 23, strike "amend (3); and".
5
6 Page 13, strike lines 26 and 27.
7
8 Page 14, strike line 1.
9
10 Page 14, before line 2 insert:
11
12 "(4) "HOSPITAL SERVICES" MEANS HEALTH-CARE SERVICES, AS
13 DEFINED IN SECTION 10-16-102 (33), PROVIDED BY A HEALTH-CARE
14 FACILITY, AS DEFINED IN SECTION 25.5-3-501 (1), OR A LICENSED
15 HEALTH-CARE PROFESSIONAL, AS DEFINED IN SECTION 25.5-3-501 (3).".
16
17 Renumber succeeding subsections accordingly.
18
19 Page 14, strike lines 3 through 6 and substitute "MEANS INITIATING
20 FORECLOSURE ON AN INDIVIDUAL'S PRIMARY RESIDENCE OR HOMESTEAD,
21 INCLUDING A MOBILE HOME, AS DEFINED IN SECTION 38-12-201.5 (5).".
22
23 Page 14, strike lines 7 through 22 and substitute:
24
25 "(6) "MEDICAL CREDITOR" MEANS AN ENTITY THAT ATTEMPTS TO
26 COLLECT ON A MEDICAL DEBT, INCLUDING:
27 (a) A HEALTH-CARE PROVIDER OR HEALTH-CARE PROVIDER'S
28 BILLING OFFICE;
29 (b) A COLLECTION AGENCY, AS DEFINED IN SECTION 5-16-103 (3);
30 (c) A DEBT BUYER, AS DEFINED IN SECTION 5-16-103 (8.5); AND
31 (d) A DEBT COLLECTOR, AS DEFINED IN 15 U.S.C. SEC. 1692a (6).".
32
33 Page 15, strike lines 1 and 2 and substitute "PERSONAL PROPERTY, OR
34 GARNISHING AN INDIVIDUAL'S WAGES.".
35
36 Page 15, line 5, strike "(1) AS".
37
38 Page 15, strike lines 6 through 8.
39
40 Renumber succeeding subsections accordingly.
41
42 Page 15, strike line 11 and substitute "HOSPITAL SERVICES.".
43
44 Page 15, line 12, strike "OR MEDICAL DEBT COLLECTOR".
45
46 Page 15, lines 13 and 14, strike "HEALTH-CARE SERVICES PROVIDED BY A
47 HEALTH-CARE PROVIDER" and substitute "HOSPITAL SERVICES".
48
49 Page 15, line 15, strike "EIGHTY" and substitute "EIGHTY-TWO".
50
51 Page 15, strike line 16 and substitute "AFTER THE DATE THE PATIENT
52 RECEIVES HOSPITAL SERVICES.".
53
54 Page 15, strike lines 17 through 27 and substitute:
55
56
1 "(3) (a) AT LEAST THIRTY DAYS BEFORE TAKING ANY PERMISSIBLE
2 EXTRAORDINARY COLLECTION ACTION, A MEDICAL CREDITOR, AS DEFINED
3 IN SECTION 6-20-201 (6)(a), COLLECTING ON A DEBT FOR HOSPITAL
4 SERVICES SHALL NOTIFY THE PATIENT OF POTENTIAL COLLECTION ACTIONS
5 AND SHALL INCLUDE WITH THE NOTICE A STATEMENT DEVELOPED BY THE
6 DEPARTMENT OF HEALTH CARE POLICY AND FINANCING THAT EXPLAINS
7 THE AVAILABILITY OF DISCOUNTED CARE FOR QUALIFIED INDIVIDUALS AND
8 HOW TO APPLY FOR SUCH CARE.
201 9 (b) (I) A MEDICAL CREDITOR, AS DEFINED IN SECTION 6-20-
10 (6)(b), (6)(c), OR (6)(d), COLLECTING ON A DEBT FOR HOSPITAL SERVICES
11 SHALL INCLUDE THE FOLLOWING STATEMENT IN THE NOTICES THE
12 MEDICAL CREDITOR PROVIDES TO THE PATIENT PURSUANT TO SECTION
13 5-16-109 (1) AND 15 U.S.C. SEC. 1692g (a): "PURSUANT TO COLORADO
14 LAW, DISCOUNTS FOR HOSPITAL SERVICES ARE AVAILABLE FOR QUALIFIED
15 INDIVIDUALS." THE STATEMENT MUST INCLUDE A LINK TO THE WRITTEN
16 EXPLANATION OF THE PATIENT'S RIGHTS THAT IS POSTED TO THE
17 DEPARTMENT OF HEALTH CARE POLICY AND FINANCING'S WEBSITE
18 PURSUANT TO SECTION 25.5-3-505 (4)(a).
19 (II) A MEDICAL CREDITOR, AS DEFINED SECTION 6-20-201 (6)(b),
20 (6)(c), OR (6)(d), SHALL NOT TAKE ANY PERMISSIBLE EXTRAORDINARY
21 COLLECTION ACTIONS UNTIL THE LATER OF THIRTY DAYS FROM THE DATE
22 OF SENDING THE NOTICE REQUIRED PURSUANT TO SUBSECTION (3)(b)(I) OF
23 THIS SECTION OR THE COMPLETION OF THE VALIDATION REQUIREMENTS
24 DESCRIBED IN SECTION 5-16-109 (2) AND 15 U.S.C. SEC. 1692g (b).".
25
26 Page 16, strike lines 1 through 4.
27
28 Page 16, strike line 6 and substitute "HOSPITAL SERVICES BILLS OR".
29
30 Page 16, line 8, strike "FOR DISCOUNTED CARE".
31
32 Page 16, line 10, strike "THE MEDICAL CREDITOR SHALL" and substitute
33 "OR IT IS DETERMINED THAT THE PATIENT'S BILL IS ELIGIBLE FOR
34 REIMBURSEMENT THROUGH A PUBLIC HEALTH-CARE COVERAGE PROGRAM
35 OR THE COLORADO INDIGENT CARE PROGRAM, THE MEDICAL CREDITOR
36 SHALL:".
37
38 Page 16, strike line 11.
39
40 Page 16, line 12, strike "DELETING" and substitute "DELETE".
41
42 Page 16, strike lines 14 through 23 and substitute:
43
44 "(b) (I) UNLESS PROHIBITED BY LAW, IF THE COURT HAS ENTERED
45 A JUDGMENT ON THE MEDICAL DEBT:
46 (A) REQUEST THE COURT VACATE THE JUDGMENT IN ANY
47 COLLECTION LAWSUIT OVER THE MEDICAL DEBT AND ENTER INTO A
48 PAYMENT PLAN WITH THE PATIENT THAT MEETS THE REQUIREMENTS OF
49 SECTION 25.5-3-503 (1)(b);
50 (B) REQUEST THE COURT REDUCE THE AMOUNT OF THE JUDGMENT,
51 INCLUDING ANY FEES AND COSTS RELATED TO THE COLLECTION LAWSUIT,
52 TO THE TOTAL AMOUNT THE PATIENT OWES PURSUANT TO THE PUBLIC
53 HEALTH-CARE COVERAGE PROGRAM OR DISCOUNTED CARE POLICY THAT
54 THE PATIENT QUALIFIES FOR, ENTER INTO A PAYMENT PLAN WITH THE
55 PATIENT THAT MEETS THE REQUIREMENTS OF SECTION 25.5-3-503 (1)(b),
56 AND SUSPEND ALL EXECUTION ON THE JUDGMENT WHILE THE PATIENT IS
1 COMPLIANT WITH THE TERMS OF THE PAYMENT PLAN; OR
2 (C) FILE A SATISFACTION OF JUDGMENT SUCH THAT THE
3 REMAINING UNPAID BALANCE OF THE JUDGMENT, INCLUDING ANY FEES
4 AND COSTS RELATED TO THE COLLECTION LAWSUIT, IS EQUAL TO THE
5 TOTAL AMOUNT THE PATIENT OWES UNDER THE PUBLIC HEALTH-CARE
6 COVERAGE PROGRAM OR DISCOUNTED CARE POLICY THAT THE PATIENT
7 QUALIFIES FOR, ENTER INTO A PAYMENT PLAN WITH THE PATIENT THAT
8 MEETS THE REQUIREMENTS OF SECTION 25.5-3-503 (1)(b), AND SUSPEND
9 ALL EXECUTION ON THE JUDGMENT WHILE THE PATIENT IS COMPLIANT
10 WITH THE TERMS OF THE PAYMENT PLAN.
11 (II) FOR THE PURPOSES OF SUBSECTION (4)(b)(I)(B) AND
12 (4)(b)(I)(C) OF THIS SECTION, THE COURT SHALL REFUND TO THE PARTIES
13 ANY FEES AND COSTS PAID TO THE COURT IN CONNECTION WITH THE
14 LITIGATION OF THE MEDICAL DEBT AND THE HEALTH-CARE PROVIDER
15 SHALL INDEMNIFY THE MEDICAL CREDITOR FOR ANY FEES AWARDED AS
16 PART OF THE JUDGMENT IN CONNECTION WITH THE MEDICAL DEBT.
17 (c) AS THE TERM "MEDICAL CREDITOR" IS DEFINED IN SECTION
18 6-20-201 (6)(a), REFUND ANY EXCESS AMOUNT TO THE PATIENT IF THE
19 PATIENT HAS PAID ANY PART OF THE MEDICAL DEBT OR IF ANY OF THE
20 PATIENT'S MONEY HAS BEEN SEIZED OR LEVIED IN EXCESS OF THE AMOUNT
21 THAT THE PATIENT OWES AFTER APPLICATION OF REQUIRED DISCOUNTS;
22 (d) AS THE TERM "MEDICAL CREDITOR" IS DEFINED IN SECTIONS
23 6-20-201 (6)(b), (6)(c), AND (6)(d), IF THE PATIENT HAS PAID ANY PART OF
24 THE MEDICAL DEBT OR IF ANY OF THE PATIENT'S MONEY HAS BEEN SEIZED
25 OR LEVIED IN EXCESS OF THE AMOUNT THAT THE PATIENT OWES AFTER
26 APPLICATION OF REQUIRED DISCOUNTS, REFUND ANY EXCESS AMOUNT TO
27 THE PATIENT TO THE EXTENT THE MEDICAL CREDITOR HAS NOT ALREADY
28 REMITTED SUCH AN AMOUNT TO THE HEALTH-CARE PROVIDER; AND
29 (e) REMEDY ANY OTHER PERMISSIBLE EXTRAORDINARY
30 COLLECTION ACTION.".
31
32 Page 16, strike line 25 and substitute "HOSPITAL SERVICES SHALL".
33
34 Page 16, line 27, strike "CREDITOR" and substitute "DEBT SELLER".
35
36 Page 17, line 3, strike "OR COLLECTOR".
37
38 Page 17, strike lines 6 through 8.
39
40 Reletter succeeding paragraphs accordingly.
41
42 Page 17, strike lines 10 through 12 and substitute "DEBT SELLER UPON A
43 DETERMINATION THAT THE PATIENT SHOULD HAVE BEEN SCREENED
44 PURSUANT TO SECTION 25.5-3-502 AND IS ELIGIBLE FOR DISCOUNTED CARE
45 PURSUANT TO SECTION 25.5-3-503 OR THAT THE BILL UNDERLYING THE
46 MEDICAL DEBT IS ELIGIBLE FOR REIMBURSEMENT THROUGH A PUBLIC
47 HEALTH-CARE COVERAGE PROGRAM OR THE COLORADO INDIGENT CARE
48 PROGRAM; AND".
49
50 Page 17, strike lines 13 and 14 and substitute:
51
52 "(c) IF IT IS DETERMINED THAT THE PATIENT SHOULD HAVE BEEN
53 SCREENED PURSUANT TO SECTION 25.5-3-502 AND IS ELIGIBLE FOR
54 DISCOUNTED CARE PURSUANT TO SECTION 25.5-3-503 OR THAT THE BILL
55 UNDERLYING THE MEDICAL DEBT IS ELIGIBLE FOR REIMBURSEMENT
56 THROUGH A PUBLIC HEALTH-CARE COVERAGE PROGRAM OR THE
1 COLORADO INDIGENT CARE PROGRAM AND THE DEBT IS".
2
3 Page 17, line 15, strike "CREDITOR," and substitute "DEBT SELLER,".
4
5 Page 17, after line 20 insert:
6
7 "(6) THE MEDICAL DEBT SELLER SHALL INDEMNIFY THE MEDICAL
8 DEBT BUYER FOR ANY AMOUNT PAID FOR A DEBT THAT IS RETURNED TO OR
9 RECALLED BY THE MEDICAL DEBT SELLER.".
10
11 Renumber succeeding subsection accordingly.
12
13 Page 17, line 22, after "PURSUE" insert "AGAINST ANY PARTY OTHER THAN
14 THE PATIENT".
15
16 Page 17, line 25, strike "OR FAULT-BASED INSURANCE." and substitute
17 "FAULT-BASED INSURANCE, SUBROGATED CLAIMS, OR OTHER CLAIMS NOT
18 AGAINST THE PATIENT.".
19
20

House Journal, May 11
10 HB21-1198 be amended as follows, and as so amended, be referred to
11 the Committee of the Whole with favorable
12 recommendation:
13
14 Amend printed bill, page 18, after line 27 insert:
15
16 "SECTION 8. Appropriation - adjustments to 2021 long bill.
17 (1) To implement this act, appropriations made in the annual general
18 appropriation act for the 2021-22 state fiscal year to the department of
19 public health and environment are adjusted as follows:
20 (a) The general fund appropriation for health, life, and dental
21 expenses is decreased by $4,000;
22 (b) The general fund appropriation for short-term disability is
23 decreased by $35;
24 (c) The general fund appropriation for S.B. 04-257 amortization
25 equalization disbursements is decreased by $1,028;
26 (d) The general fund appropriation for S.B. 06-235 supplemental
27 amortization equalization disbursements is decreased by $1,028; and
28 (e) The general fund appropriation for use by the health facilities
29 and emergency medical services division for nursing and acute care
30 facility survey is decreased by $38,113, and the related FTE is decreased
31 by 0.3 FTE.
32 (2) For the 2021-22 state fiscal year, $219,295 is appropriated to
33 the department of health care policy and financing for use by the
34 executive director's office. This appropriation is from the general fund.
35 To implement this act, the office may use this appropriation as follows:
36 (a) $47,855 for personal services, which amount is based on an
37 assumption that the office will require an additional 0.7 FTE;
38 (b) $7,280 for operating expenses; and
39 (c) $164,160 for general professional services and special
40 projects.".
41
42 Renumber succeeding section accordingly.
43
44 Page 1, line 105, strike "PATIENT." and substitute "PATIENT AND MAKING
45 AND REDUCING APPROPRIATIONS.".
46
47

House Journal, May 11
11 Amendment No. 1, Appropriations Report, dated May 11, 2021, and
12 placed in member's bill file; Report also printed in House Journal, May
13 11, 2021.
14
15 Amendment No. 2, Health & Insurance Report, dated April 21, 2021, and
16 placed in member's bill file; Report also printed in House Journal, April
17 22, 2021.
18
19 Amendment No. 3, by Representative Jodeh.
20
21 Amend the Health & Insurance Committee Report, dated April 21, 2021,
22 page 1, after line 15 insert:
23
24 "Page 5, line 27, strike "IF" and substitute "BEGINNING JUNE 1, 2022,
25 IF".".
26
27 Page 2, after line 6 insert:
28
29 "Page 6, line 24, strike "A" and substitute "BEGINNING JUNE 1, 2022, A".".
30
31 Page 2, after line 8 insert:
32
33 "Page 7, line 20, strike "COLLECT AND".".
34
35 Page 3, after line 7 insert:
36
37 "Page 11, line 17, strike "BEFORE" and substitute "BEGINNING JUNE 1,
38 2022, BEFORE".".
39
40 Page 4, line 14, strike "WAGES."." and substitute "WAGES. A PERMISSIBLE
41 EXTRAORDINARY COLLECTION ACTION DOES NOT INCLUDE THE ASSERTION
42 OF A HOSPITAL LIEN PURSUANT TO SECTION 38-27-101.".".
43
44 Amendment No. 4, by Representative Jodeh.
45
46 Amend the Health & Insurance Committee Report, dated April 21, 2021,
47 page 4, after line 17 insert:
48
49 "Page 15, line 9, strike "IMPERMISSIBLE" and substitute "BEGINNING JUNE
50 1, 2022, IMPERMISSIBLE".".
51
52 Page 4, strike line 19 and substitute:
53
54 "Page 15, line 12, strike "NO" and substitute "BEGINNING JUNE 1, 2022,
55 NO" and strike "OR MEDICAL DEBT COLLECTOR".".
1 Page 4, line 26, strike "AT" and substitute "BEGINNING JUNE 1, 2022, AT".
2
3 Page 5, after line 22 insert:
4
5 "Page 16, line 5, strike "IF" and substitute "BEGINNING JUNE 1, 2022,
6 IF".".
7
8 Page 6, line 6, after "(1)(b);" insert "OR".
9
10 Page 7, after line 2, insert:
11
12 "Page 16, line 24, strike "A" and substitute "BEGINNING JUNE 1, 2022,
13 A".".
14
15 Page 8, after line 4 insert:
16
17 "Page 18, line 15, strike "FOR" and substitute "NO LATER THAN JUNE 1,
18 2022, FOR".".
19
20 As amended, ordered engrossed and placed on the Calendar for Third
21 Reading and Final Passage.
22