House Bill 21-1198 Health Care Billing Requirements for Indigent Patients
During the 2021 Colorado General Assembly session, House Bill (HB) 21-1198, otherwise known as Health Care Billing Requirements for Indigent Patients, was passed. This bill creates a safety net program for low-income patients at every general acute care and critical access hospital and all free-standing emergency rooms, and includes all health care professionals who work within those facilities.
Under this bill, care received at a general acute care or critical access hospital or free-standing emergency room will be capped at no more than the higher of the Medicaid or Medicare rate for that service. These rates will be set by the Department. Payment plans that are established to cover these bills may not exceed 4% of the patient's household income for the facility charge and 2% of the household income for each health-care professional. Additionally, once a patient has paid the equivalent of 36 payments on their established plan, the remainder of their bill is forgiven.
HB 21-1198 mandates that all uninsured patients must be screened for eligibility for Health First Colorado (Colorado's Medicaid program), Child Health Plan Plus (CHP+), Medicare, Emergency Medicaid, the Colorado Indigent Care Program (CICP), and discounted health care as described within the bill. Uninsured patients must be screened or formally waive their screening. Insured patients may request to be screened. Additionally, the financial screenings for the program created under this legislation must be completed using a uniform application, which will be created by the Department through the Policy Development Team.
Unlike CICP, the program created by HB 21-1198 applies to all Colorado hospitals and free-standing emergency rooms, as well as all health care professionals working within those facilities. Under this legislation, hospitals will look at income only and no liquid resources or other assets will be considered. This legislation applies to all services at the hospital, whereas CICP only mandates that emergency services be discounted.
Rules for HB21-1198 will be presented to the Medical Services Board for approval in March 2022. The program has an effective date of June 1, 2022, per the bill.
