Read the full stored bill text
Second Regular Session
Seventy-fifth General Assembly
STATE OF COLORADO
INTRODUCED
LLS NO. 26-0023.01 Shelby Ross x4510 HOUSE BILL 26-1267
House Committees Senate Committees
Health & Human Services
A BILL FOR AN ACT
CONCERNING LIMITATIONS ON COLLECTION ACTIONS FOR MEDICAL101
DEBT.102
Bill Summary
(Note: This summary applies to this bill as introduced and does
not reflect any amendments that may be subsequently adopted. If this bill
passes third reading in the house of introduction, a bill summary that
applies to the reengrossed version of this bill will be available at
http://leg.colorado.gov.)
The bill adds to the list of impermissible collection actions that a
medical creditor is prohibited from using when collecting on a medical
debt. Current law requires a medical creditor to comply with certain
conditions and notify a patient with medical debt 30 days before taking
any permissible extraordinary collection actions. In addition to providing
notice before taking any permissible extraordinary collection actions, the
HOUSE SPONSORSHIP
Joseph and Mabrey,
SENATE SPONSORSHIP
Jodeh and Weissman,
Shading denotes HOUSE amendment. Double underlining denotes SENATE amendment.
Capital letters or bold & italic numbers indicate new material to be added to existing law.
Dashes through the words or numbers indicate deletions from existing law.
bill requires a medical creditor to notify a patient 30 days before
collecting, transferring, selling, or assigning a medical debt, and to verify
the patient has been screened for public health insurance programs and
discounted care. The bill requires a medical creditor to offer a reasonable
payment plan to each patient with medical debt. If the medical creditor
violates the requirements for selling, transferring, or assigning medical
debt, or undertaking collection activities, the patient is entitled to
damages in the amount of $3,000 or actual damages, whichever is greater.
Be it enacted by the General Assembly of the State of Colorado:1
SECTION 1. In Colorado Revised Statutes, 25.5-3-501, amend2
(6) as follows:3
25.5-3-501. Definitions.4
As used in this part 5, unless the context otherwise requires:5
(6) "Screen" or "screening" means a process identified in rule by6
the state department whereby health-care facilities assess a patient's7
circumstances related to eligibility criteria and determine whether the8
patient is likely to qualify for public health-care coverage HEALTH9
INSURANCE PROGRAMS or discounted care, inform the patient of the10
health-care facility's determination, and provide information to the patient11
about how the patient can enroll in A public health-care coverage HEALTH12
INSURANCE PROGRAM.13
SECTION 2. In Colorado Revised Statutes, amend 25.5-3-50214
as follows:15
25.5-3-502. Requirement to screen patients for eligibility for16
public health-care programs and discounted care - rules.17
(1) Beginning September 1, 2022, A health-care facility shall18
screen, unless a patient declines, each uninsured patient for eligibility for:19
(a) Public health insurance programs, including, but not limited20
to, medicare; the state medical assistance program, articles 4, 5, and 6 of21
HB26-1267-2-
this title 25.5; emergency medicaid; and the children's basic health plan,1
article 8 of this title 25.5; and2
(b) Repealed.3
(c) Discounted care, as described in section 25.5-3-503.4
(1.5) I F REQUESTED BY AN INSURED PATIENT , A HEALTH -CARE5
FACILITY SHALL SCREEN THE PATIENT FOR DISCOUNTED CARE , AS6
DESCRIBED IN SECTION 25.5-3-503.7
(2) Health-care facilities shall use a single uniform application8
developed by the state department when screening a patient pursuant to9
subsection (1) SUBSECTIONS (1) AND (1.5) of this section.10
(3) If a health-care facility determines that a patient is ineligible11
for discounted care, the facility shall provide the patient notice of the12
determination and an opportunity for the patient to appeal the13
determination in accordance with state department rules.14
(4) If the patient declines the screening described in subsection (1)15
of this section, the health-care facility shall document the patient's16
decision in accordance with state department rules. A patient's decision17
to decline the screening that is documented and complies with state18
department rules is a complete defense to a claim brought by a patient19
under PURSUANT TO section 25.5- 3-506 (2) for a violation of section20
25.5-3-506 (1)(a) or (1)(b) OR (1)(c).21
(5) If requested by the patient, a health-care facility shall screen22
an insured patient for discounted care pursuant to subsections (1)(b) and23
(1)(c) of this section.24
SECTION 3. In Colorado Revised Statutes, 25.5-3-503, amend25
(1) introductory portion and (1)(b) as follows:26
25.5-3-503. Discounted care for qualified patients - definition.27
HB26-1267-3-
(1) Beginning September 1, 2022, If a patient is screened pursuant1
to section 25.5-3-502 and is determined to be a qualified patient, a2
health-care facility and a licensed health-care professional shall, for3
emergency hospital and other health-care services:4
(b) Collect amounts charged, not including amounts owed by5
third-party payers, in monthly installments such that the patient is not6
paying more than:7
(I) Four percent of the patient's monthly household income on a8
bill from a health-care facility; not paying more than9
(II) Two percent of the patient's monthly household income on a10
bill from each licensed health-care professional; and not paying more than11
(III) Six percent of the patient's household income on a12
comprehensive bill containing all health-care facility and licensed13
health-care professional charges; and14
SECTION 4. In Colorado Revised Statutes, 25.5-3-504, amend15
(1) introductory portion and (1)(a) as follows:16
25.5-3-504. Notification of patients' rights.17
(1) Beginning September 1, 2022, A health-care facility shall18
make information developed by the state department about patients' rights19
under this part 5 PURSUANT TO SECTION 25.5-3-505 (5)(a) and the uniform20
application developed by the state department pursuant to section21
25.5-3-505 (2)(i) available to the public and to each patient. At a22
minimum, the health-care facility shall:23
(a) Post the information in all required languages pursuant to this24
subsection (1) IN ALL REQUIRED LANGUAGES conspicuously on the25
health-care facility's website, including a link to the information on the26
health-care facility's main landing page;27
HB26-1267-4-
SECTION 5. In Colorado Revised Statutes, 25.5-3-505, amend1
(1), (2) introductory portion, (2)(a), (2)(b), (2)(c) introductory portion,2
(2)(c)(I), (2)(e), (2)(g), (2)(h), (3), (4), (5) introductory portion, and (5)(a)3
as follows:4
25.5-3-505. Reporting requirements - rules.5
(1) Beginning September 1, 2023, and each September 16
thereafter, each health-care facility and licensed health-care professional7
shall report to the state department data ACROSS RACE, ETHNICITY, AGE,8
AND PRIMARY -LANGUAGE-SPOKEN PATIENT GROUPS that the state9
department determines is necessary to evaluate compliance across race,10
ethnicity, age, and primary-language-spoken patient groups with the11
screening, discounted care, payment plan, and collections practices12
required pursuant to this part 5. If a health-care facility or licensed13
health-care professional is not capable of disaggregating the data required14
pursuant to this subsection (1) by race, ethnicity, age, and primary15
language spoken, the health-care facility or licensed health-care16
professional shall report to the state department the steps the17
HEALTH-CARE facility or licensed health-care professional is taking to18
improve race, ethnicity, age, and primary-language-spoken data collection19
and the date by which the HEALTH-CARE facility or licensed health-care20
professional will be able to disaggregate the reported data.21
(2) No later than April 1, 2022, The state board shall promulgate22
ADOPT rules necessary for the administration and implementation of this23
part 5. At a minimum, the rules must:24
(a) Outline a process for an insured patient to request a screening25
pursuant to section 25.5-3-502 (5) SECTION 25.5-3-502 (1.5);26
(b) Outline a process for documenting pursuant to section27
HB26-1267-5-
25.5-3-502 (4), that a patient has made an informed decision to decline1
the screening PURSUANT TO SECTION 25.5-3-502 (4), including procedures2
for retaining such THE documentation;3
(c) Establish the A process for A HEALTH-CARE FACILITY TO, and4
ESTABLISH the maximum number of days that a health-care facility has to,5
DO THE FOLLOWING:6
(I) Initiate a screening after a patient receives HEALTH-CARE7
GOODS OR services;8
(e) Establish guidelines for A patient appeals regarding TO APPEAL9
THE DETERMINATION FOR eligibility for discounted care pursuant to10
section 25.5-3-503;11
(g) Identify the documents, USING THE MINIMUM AMOUNT OF12
INFORMATION NEEDED , that may be required to establish income13
eligibility for discounted care; using the minimum amount of information14
needed to determine eligibility;15
(h) Identify the steps a health-care facility and licensed health-care16
professional must take before sending patient A PATIENT'S MEDICAL debt17
to collections, INCLUDING COMPLYING WITH THE REQUIREMENTS18
DESCRIBED IN PART 2 OF ARTICLE 20 OF TITLE 6;19
(3) In promulgating ADOPTING rules pursuant to this section, the20
state department shall consider potential limitations relating to the federal21
"Emergency Medical Treatment and Labor Act", 42 U.S.C. sec. 1395dd.22
(4) Prior to promulgating ADOPTING rules pursuant to this section,23
the state department shall hold at least one stakeholder meeting with24
hospital representatives, health-care consumers, and health-care consumer25
advocates that is accessible to individuals whose primary language is not26
English, if requested.27
HB26-1267-6-
(5) No later than April 1, 2022, The state department shall:1
(a) Using feedback from hospital health-care consumers and2
health-care consumer advocate stakeholders ADVOCATES, develop a3
written explanation of a patient's rights under PURSUANT TO this section4
that is written in plain language at a sixth-grade reading level and5
translated into all la nguages spoken by ten percent or more of the6
population in each county of the state and post the written explanation in7
all required languages on the state department's website. Each health-care8
facility shall make the explanation available to the public and each patient9
as provided in section 25.5-3-504.10
SECTION 6. In Colorado Revised Statutes, 25.5-3-506, amend11
(1) as follows:12
25.5-3-506. Limitations on collection actions - private13
enforcement.14
(1) Beginning September 1, 2022, before assigning, or selling15
patient debt, to a collection agency, as defined in section 5-16-103 (3)(a),16
or a debt buyer, as defined in section 5-16-103 (8.5) BEFORE ASSIGNING,17
SELLING, OR OTHERWISE TRANSFERRING MEDICAL DEBT , AS DEFINED IN18
SECTION 6-20-201, TO A MEDICAL CREDITOR , AS DEFINED IN SECTION19
6-20-201, or before pursuing, either directly or indirectly, any permissible20
extraordinary collection action, as defined in section 6-20-201 (7)21
SECTION 6-20-201:22
(a) A health-care facility shall meet the screening requirements in23
section 25.5-3-502;24
(b) A health-care facility and licensed health-care professional25
shall provide discounted care to THE PATIENT IF THE PATIENT IS a26
QUALIFIED patient pursuant to section 25.5-3-503, IF APPLICABLE;27
HB26-1267-7-
(c) A health-care facility and licensed health-care professional1
shall provide a plain language explanation of the health-care services and2
fees being billed and notify the patient of potential collection actions3
COMPLY WITH THE REQUIREMENTS DESCRIBED IN PART 2 OF ARTICLE 20 OF4
TITLE 6, INCLUDING THE NOTICE REQUIREMENT AND REQUIREMENT TO5
OFFER THE PATIENT A REASONABLE PAYMENT PLAN, IN RELATION TO THE6
MEDICAL DEBT BEING SOLD, ASSIGNED, TRANSFERRED, OR COLLECTED; and7
(d) A health-care facility and LICENSED health-care professional8
shall bill any third-party payer that is responsible for providing9
health-care HEALTH INSURANCE coverage to the patient. If a health-care10
professional is an out-of-network provider OUT OF NETWORK under a11
qualified patient's health insurance plan, the health-care professional and12
health insurance carrier shall comply with the out-of-network billing13
requirements described in sections 10-16-704 (3) and 12-30-113.14
SECTION 7. In Colorado Revised Statutes, amend part 2 of15
article 20 of title 6 as follows:16
PART 217
LIMITATIONS ON MEDICAL DEBT COLLECTION18
6-20-201. Definitions.19
For the purposes of AS USED IN this part 2, unless the context20
otherwise requires:21
(1) "Collection activity" means only those activities provided or22
performed by a licensed collection agency, using a business name other23
than the name of the health-care provider, MEDICAL CREDITOR for24
purposes of collecting a MEDICAL debt. The term does not include any25
standard billing procedures used by the health-care provider or its agent26
in the normal course of business on current, nondelinquent accounts.27
HB26-1267-8-
(2) "Collection agency" shall have the same meaning as in section1
5-16-103 (3). "HEALTH-CARE GOODS OR SERVICES" MEANS HEALTH-CARE2
GOODS OR HEALTH-CARE SERVICES, AS DEFINED IN SECTION 10-16-102.3
(3) "Health-care provider" includes a health-care facility licensed4
pursuant to article 3 of title 25, C.R.S., and any other health-care provider5
MEANS A HEALTH -CARE PROFESSIONAL REGISTERED , CERTIFIED , OR6
LICENSED PURSUANT TO TITLE 12; A HEALTH-CARE FACILITY, AS DEFINED7
IN SECTION 25.5-3-501; OR ANY OTHER FACILITY THAT PROVIDES8
HEALTH-CARE GOODS OR SERVICES TO A PATIENT.9
(4) "Hospital services" means health-care services, as defined in10
section 10-16-102 (33) provided by a health-care facility, as defined in11
section 25.5-3-501 (1), or a licensed health-care professional, as defined12
in section 25.5-3-501 (3).13
(5) (4) "Impermissible extraordinary collection action" means:14
(a) Initiating OR THREATENING TO INITIATE foreclosure on, OR15
ASSERTING A LIEN ON , ATTACHING , OR SEIZING , OR THREATENING TO16
ATTACH OR SEIZE , an individual's primary residence or homestead,17
including a mobile home, as defined in section 38-12-201.5 (5) SECTION18
38-12-201.5;19
(b) I NITIATING OR THREATENING TO INITIATE COLLECTION20
ACTIVITY AGAINST AN INDIVIDUAL WHO IS NOT A PATIENT;21
(c) I NITIATING OR THREATENING TO INITIATE ATTACHMENT OR22
FORECLOSURE ON AN INDIVIDUAL'S TANGIBLE PERSONAL PROPERTY;23
(d) T HREATENING AN INDIVIDUAL WITH DEPORTATION , OR24
CONTACTING AUTHORITIES , BASED ON PERCEIVED OR ACTUAL25
IMMIGRATION STATUS ; WITHHOLDING DOCUMENTS REQUIRED FOR26
IMMIGRATION; OR THREATENING TO INTERFERE WITH AN ACTIVE27
HB26-1267-9-
IMMIGRATION APPLICATION OR PROCESS;1
(e) S EEKING OR SUPPORTING A WARRANT FOR , OR OTHERWISE2
PROMOTING, THE ARREST OR DETAINMENT OF AN INDIVIDUAL IN ANY3
LEGAL ACTION AGAINST THE INDIVIDUAL IN CONNECTION WITH AN ACTION4
TO COLLECT OR ATTEMPT TO COLLECT MEDICAL DEBT , INCLUDING ON5
MOTIONS RELATED TO DISCOVERY OR CONTEMPT OF COURT;6
(f) GARNISHING OR THREATENING TO GARNISH AN INDIVIDUAL 'S7
WAGES;8
(g) A SSERTING A LIEN ON , ATTACHING , OR SEIZING , OR9
THREATENING TO ATTACH OR SEIZE, ANY AMOUNTS IN OR INCOME FROM10
A RETIREMENT ACCOUNT; A PENSION FUND; AN EDUCATIONAL SAVINGS OR11
EXPENSE ACCOUNT; A STOCK BONUS; A PROFIT-SHARING PLAN; ANNUITY12
BENEFITS; OR AN ACHIEVING A BETTER LIFE EXPERIENCE SAVINGS13
ACCOUNT, CREATED IN ACCORDANCE WITH SECTION 23-3.1-311, OR A14
SIMILAR TYPE OF SAVINGS ACCOUNT FOR AN INDIVI DUAL WITH A15
DISABILITY; OR16
(h) I N ADDITION TO AMOUNTS EXEMPTED PURSUANT TO17
SUBSECTION (4)(g) OF THIS SECTION, ASSERTING A LIEN ON, ATTACHING,18
OR SEIZING, OR THREATENING TO ATTACH OR SEIZE , ANY AMOUNT IN AN19
INDIVIDUAL'S ACCOUNT AT A BANK OR OTHER FINANCIAL INSTITUTION ,20
UNLESS:21
(I) THE ACCOUNT BELONGS TO THE PATIENT;22
(II) THE LIEN, ATTACHMENT, OR SEIZURE DOES NOT REDUCE THE23
OVERALL BALANCE IN THE PATIENT'S ACCOUNTS WITH THE BANK OR OTHER24
FINANCIAL INSTITUTION BELOW THIRTY THOUSAND DOLLARS; AND25
(III) A JUDGE ISSUES AN ORDER AGAINST A B ANK OR OTHER26
FINANCIAL INSTITUTION THAT HOLDS A PATIENT'S ACCOUNT INSTRUCTING27
HB26-1267-10-
THE BANK OR OTHER FINANCIAL INSTITUTION THAT THE LIEN ,1
ATTACHMENT, OR SEIZURE APPLIES ONLY TO AN AMOUNT THAT THE2
PATIENT HOLDS IN ACCOUNTS WITH THE BANK OR OTHER FINANCIAL3
INSTITUTION THAT EXCEEDS THIRTY THOUSAND DOLLARS; EXCEPT THAT4
THIS SUBSECTION (4)(g)(III) DOES NOT APPLY IF THE JUDGMENT CREDITOR5
ESTABLISHES BY A PREPONDERANCE OF EVIDENCE THAT THE PATIENT HAS6
ALREADY CLAIMED THE EXEMPTION FOR ACCOUNTS WITH A DIFFERENT7
INSTITUTION FOR THE DEBT.8
(6) (5) "Medical creditor" means AN INDIVIDUAL OR ENTITY THAT9
CLAIMS ENTITLEMENT TO PAYMENTS ON A MEDICAL DEBT . an entity that10
attempts to collect on a medical debt, including:11
(a) A health-care provider or health-care provider's billing office;12
(b) A collection agency, as defined in section 5-16-103 (3);13
(c) A debt buyer, as defined in section 5-16-103 (8.5); and14
(d) A debt collector, as defined in 15 U.S.C. sec. 1692a (6).15
(6) "M EDICAL DEBT" HAS THE MEANING SET FORTH IN SECTION16
5-18-103.17
(7) "P ATIENT" MEANS AN INDIVIDUAL WHO RECEIVES18
HEALTH-CARE GOODS OR SERVICES OR THE LEGAL GUARDIAN OF A MINOR19
WHO RECEIVES HEALTH-CARE GOODS OR SERVICES.20
(7) (8) "Permissible extraordinary collection action" means an21
action other than an impermissible extraordinary collection action that22
requires a legal or judicial process including but not limited to placing a23
lien on an individual's real property, attaching or seizing an individual's24
bank account or any other personal property, or garnishing an individual's25
wages TO COLLECT MEDICAL DEBT FROM A PATIENT . A permissible26
extraordinary collection action does not include the assertion of a hospital27
HB26-1267-11-
lien pursuant to section 38-27-101.1
6-20-202. Notice to patient of debt.2
(1) (a) When a person has health benefit coverage to provide3
payment for care or treatment rendered by a health-care provider and the4
person has notified the health-care provider of coverage within thirty days5
after the date the care or treatment was rendered, and if the health6
coverage plan, as defined in section 10-16-102 (34), C.R.S., pays only a7
portion of the debt, prior to the assignment of the debt to a licensed8
collection agency, the health-care provider shall mail written notice to the9
last-known address of the person responsible for payment of the debt at10
least thirty days before any collection activity on any amount due and11
owing the health-care provider.12
(b) The notice required of health-care providers by paragraph (a)13
of this subsection (1) shall include the amount due and owing; the name,14
address, and telephone number of the health-care provider; where15
payment may be made; the date of service; and the last date or number of16
days after the date of the notice the health-care provider will accept17
payment prior to the debt being submitted to a collection agency or18
reporting adverse information to a consumer reporting agency for the debt19
for which notice was provided.20
(2) (a) If the health-care provider fails to provide the person with21
notice of such debt and all other information required by subsection (1)22
of this section, the health-care provider shall not pursue any rights to23
collect such outstanding amount either through a collection agency or by24
any further efforts of the health-care provider to collect the debt. In25
addition, the health-care provider may not report adverse information to26
a consumer reporting agency for the debt for which notice was provided27
HB26-1267-12-
without providing notice to the person pursuant to subsection (1) of this1
section. The health-care provider shall assist the person in correcting any2
adverse credit information because of the health-care provider's failure to3
provide notice pursuant to subsection (1) of this section.4
(b) Notwithstanding any provision of this section to the contrary,5
a health-care provider may remedy a failure to give notice by providing6
a written report to the collection agency to withhold any collection7
activity and withholding any of the health-care provider's own collection8
efforts until the provider complies with the notice and time requirements9
pursuant to subsection (1) of this section.10
(c) Nothing in this subsection (2) shall be construed to require a11
health-care provider to perform additional attempts to notify a person of12
the person's portion of the debt other than mailing the notice required13
pursuant to subsection (1) of this section to the person's last-known14
address and maintaining a record of such mailing.15
(d) The failure of a health-care provider or its agent to provide the16
notice required by subsection (1) of this section shall not create a cause17
of action or remedy against a collection agency under the "Colorado Fair18
Debt Collection Practices Act", article 16 of title 5.19
6-20-203. Limitations on collection actions - notice20
requirement - definition.21
(1) Beginning June 1, 2022, A MEDICAL CREDITOR COLLECTING ON22
A MEDICAL DEBT FOR HEALTH -CARE GOODS OR SERVICES SHALL NOT23
ENGAGE IN impermissible extraordinary collection actions. may not be24
used by any medical creditor to collect debts owed for hospital services.25
(2) Beginning June 1, 2022, no medical creditor collecting on a26
debt for hospital services shall engage in any permissible extraordinary27
HB26-1267-13-
collection actions until one hundred eighty-two days after the date the1
patient receives hospital services.2
(3) (a) (2) (a) Beginning September 1, 2022, At least thirty days3
before SELLING, ASSIGNING, OR OTHERWISE TRANSFERRING A MEDICAL4
DEBT, OR taking any permissible extraordinary collection action, a5
medical creditor as defined in section 6-20-201 (6)(a), collecting on a6
debt for hospital services shall notify VERIFY THE PATIENT HAS BEEN7
SCREENED IN ACCORDANCE WITH SECTION 25.5-3-502 (1) AND (1.5); IF THE8
PATIENT IS INSURED , INFORM THE PATIENT OF THE PATIENT 'S RIGHT TO9
REQUEST A SCREENING PURSUANT TO SECTION 25.5-3-502 (1.5); PROVIDE10
the patient WITH A PLAIN LANGUAGE EXPLANATION OF THE MEDICAL DEBT;11
AND NOTIFY THE PATIENT of potential collection actions and shall include12
with the notice a statement developed by the department of health care13
policy and financing that explains the availability of discounted care for14
qualified individuals and how to apply for such care BY AT LEAST TWO15
MEANS OF COMMUNICATION , INCLUDING THE PATIENT 'S PREFERRED16
METHOD OF COMMUNICATION, IF KNOWN.17
(b) T HE NOTICE REQUIRED PURSUANT TO SUBSECTION (2)(a) OF18
THIS SECTION MUST INCLUDE THE FOLLOWING INFORMATION:19
(I) THE PATIENT'S NAME AND CONTACT INFORMATION;20
(II) INFORMATION ABOUT THE SCREENING REQUIREMENTS AND THE21
AVAILABILITY OF DISC OUNTED CARE , AS DESCRIBED IN SECTIONS22
25.5-3-502 AND 25.5-3-503;23
(III) A DESCRIPTION OF EACH HEALTH -CARE GOOD OR SERVICE24
PROVIDED TO THE PATIENT , INCLUDING THE DATE EACH HEALTH -CARE25
GOOD OR SERVICE WAS PROVIDED TO THE PATIENT AND THE AMOUNT26
CHARGED FOR EACH HEALTH-CARE GOOD OR SERVICE;27
HB26-1267-14-
(IV) THE NAME, ADDRESS, AND CONTACT INFORMATION FOR THE1
HEALTH-CARE PROVIDER THAT PROVIDED EACH HEALTH -CARE GOOD OR2
SERVICE TO THE PATIENT;3
(V) A DETAILED DESCRIPTION OF ALL REDUCTIONS, ADJUSTMENTS,4
OFFSETS, AND PAYMENTS BY THIRD -PARTY PAYERS THAT ADJUST THE5
INITIAL CHARGES FOR THE HEALTH-CARE GOODS OR SERVICES, INCLUDING6
PAYMENTS RECEIVED FROM THE PATIENT;7
(VI) T HE NAME OF THE THIRD -PARTY PAYERS TO WHOM THE8
INITIAL CHARGES FOR HEALTH -CARE GOODS OR SERVICES WERE9
SUBMITTED;10
(VII) I NFORMATION ABOUT THE POTENTIAL AVAILABILITY OF11
RETROACTIVE COVERAGE IF THE PATIENT ENROLLED IN THE STATE12
MEDICAL ASSISTANCE PROGRAM , ARTICLES 4, 5, AND 6 OF TITLE 25.5,13
AFTER RECEIVING THE HEALTH-CARE GOODS OR SERVICES;14
(VIII) AN ITEMIZATION OF ANY INTEREST THAT HAS ACCRUED ON15
THE MEDICAL DEBT AND ANY OTHER ADDITIONAL FEES OR COSTS BEING16
CHARGED IN ASSOCIATION WITH THE MEDICAL DEBT , INCLUDING ANY17
ATTORNEY FEES;18
(IX) THE FINAL AMOUNT THE PATIENT IS LIABLE TO PAY , WHICH19
MUST BE PROMINENTLY DISPLAYED , AFTER TAKING INTO ACCOUNT ALL20
APPLICABLE REDUCTIONS;21
(X) A PLAIN LANGUAGE EXPL ANATION OF THE POTENTIAL22
CONSEQUENCES OF DEFAULT; AND23
(XI) A CLEAR DESCRIPTION OF THE METHODS BY WHICH PAYMENT24
FOR THE MEDICAL DEBT CAN BE MADE , INCLUDING AN OFFER TO ENTER25
INTO A REASONABLE PAYMENT PLAN PURSUANT TO SECTION 6-20-204 AND26
HOW TO ACCEPT THE OFFER . AT LEAST ONE OF THE METHODS FOR27
HB26-1267-15-
PAYMENT MUST NOT INCLUDE ANY SERVICE CHARGE OR ADDITIONAL FEES.1
(b) (I) A medical creditor as defined in section 6-20-201 (6)(b),2
(6)(c), or (6)(d), collecting on a debt for hospital services shall include the3
following statement in the notices the medical creditor provides to the4
patient pursuant to section 5-16-109 (1) and 15 U.S.C. sec. 1692g (a):5
"Pursuant to Colorado law, discounts for hospital services are available6
for qualified individuals." The statement must include a link to the written7
explanation of the patient's rights that is posted to the department of8
health care policy and financing's website pursuant to section 25.5-3-5059
(5)(a).10
(II) (c) A medical creditor as defined section 6-20-201 (6)(b),11
(6)(c), or (6)(d), shall not take any permissible extraordinary collection12
actions until the later of thirty days from the date of sending the notice13
required pursuant to subsection (3)(b)(I) of this section or the completion14
of the validation requirements described in section 5-16-109 (2) and 1515
U.S.C. sec. 1692g (b) UNLESS:16
(I) T HE MEDICAL CREDITOR DEMONSTRATES COMPLIANCE WITH17
THE NOTICE REQUIREMENT IN SUBSECTION (2)(a) OF THIS SECTION ,18
INCLUDING THE DATE AND MANNER BY WHICH THE NOTICE WAS SENT TO19
THE PATIENT;20
(II) LESS THAN THREE YEARS HAVE PASSED SINCE THE PATIENT21
INCURRED THE MEDICAL DEBT; AND22
(III) T HE MEDICAL CREDITOR DID NOT KNOW AND SHOULD NOT23
HAVE KNOWN ABOUT AN INTERNAL REVIEW, EXTERNAL REVIEW, OR OTHER24
APPEAL OF A HEALTH INSURANCE DECISION THAT IS PENDING OR WAS25
PENDING WITHIN THE PREVIOUS SIXTY-THREE DAYS.26
(3) A MEDICAL CREDITOR MAY REQUEST PAYMENT OF MEDICAL27
HB26-1267-16-
DEBT ONLY IF THE MEDICAL CREDITOR:1
(a) (I) VERIFIED THE PATIENT, IF THE PATIENT IS UNINSURED, HAS2
BEEN SCREENED FOR PUBLIC HEALTH INSURANCE PROGRAMS AND3
DISCOUNTED CARE IN ACCORDANCE WITH SECTION 25.5-3-502 AND IS NOT4
A QUALIFIED PATIENT, AS DEFINED IN SECTION 25.5-3-501; OR5
(II) VERIFIED THE PATIENT, IF THE PATIENT IS INSURED, HAS BEEN6
NOTIFIED OF THE PATIENT'S RIGHT TO BE SCREENED FOR DISCOUNTED CARE7
IN ACCORDANCE WITH SECTION 25.5-3-502 (1.5); AND8
(b) O FFERED THE PATIENT A REASONABLE PAYMENT PLAN9
PURSUANT TO SECTION 6-20-204; AND10
(c) GAVE THE PATIENT THIRTY DAYS TO RESPOND TO THE OFFER TO11
ENTER INTO A REASONABLE PAYMENT PLAN.12
(4) Beginning September 1, 2022, If a medical creditor collecting13
on a debt for hospital services bills or initiates collection activities and it14
is later determined that the patient should have been screened pursuant to15
section 25.5-3-503 SECTION 25.5-3-502 and is determined to be a16
qualified patient, as defined in section 25.5-3-501 (5) SECTION17
25.5-3-501, or it is determined that the patient's bill is eligible for18
reimbursement through a public health-care coverage HEALTH INSURANCE19
program, the medical creditor shall:20
(a) Delete any negative reports to consumer reporting agencies;21
(b) (I) Unless prohibited by law, if the court has entered a22
judgment on the medical debt:23
(A) Request the court vacate the judgment in any collection24
lawsuit over the medical debt and enter into a payment plan with the25
patient that meets the requirements of section 25.5-3-503 (1)(b); or26
(B) Request the court reduce the amount of the judgment,27
HB26-1267-17-
including any fees and costs related to the collection lawsuit, to the total1
amount the patient owes pursuant to the public health-care coverage2
HEALTH INSURANCE program or discounted care policy that the patient3
qualifies for, enter into a payment plan with the patient that meets the4
requirements of section 25.5-3-503 (1)(b), and suspend all execution on5
the judgment while the patient is compliant with the terms of the payment6
plan; or7
(C) File a satisfaction of judgment such that the remaining unpaid8
balance of the judgment, including any fees and costs related to the9
collection lawsuit, is equal to the total amount the patient owes under the10
public health-care coverage HEALTH INSURANCE program or discounted11
care policy that the patient qualifies for, enter into a payment plan with12
the patient that meets the requirements of section 25.5-3-503 (1)(b), and13
suspend all execution on the judgment while the patient is compliant with14
the terms of the payment plan.15
(II) For the purposes of subsections (4)(b)(I)(B) and (4)(b)(I)(C)16
SUBSECTIONS (3)(b)(I)(B) AND (3)(b)(I)(C) of this section, the court shall17
refund to the parties any fees and costs paid to the court in connection18
with the litigation of the medical debt and the health-care provider shall19
indemnify the medical creditor for any fees awarded as part of the20
judgment in connection with the medical debt.21
(c) As the term "medical creditor" is defined in section 6-20-20122
(6)(a), Refund any excess amount to the patient if the patient has paid any23
part of the medical debt or if any of the patient's money has been seized24
or levied in excess of the amount that the patient owes after application25
of required discounts;26
(d) As the term "medical creditor" is defined in sections 6-20-20127
HB26-1267-18-
(6)(b), (6)(c), and (6)(d), If the patient has paid any part of the medical1
debt or if any of the patient's money has been seized or levied in excess2
of the amount that the patient owes after application of required3
discounts, ref und any exce ss amount to the patient to the extent the4
medical creditor has not already remitted such an THE amount to the5
health-care provider; and6
(e) Remedy any other permissible extraordinary collection action.7
(5) Beginning September 1, 2022, A medical creditor collecting8
on a debt for hospital services shall not sell, ASSIGN, OR TRANSFER a9
medical debt to another A THIRD party unless, prior to the sale,10
ASSIGNMENT, OR TRANSFER, the medical debt seller CREDITOR INITIATING11
THE SALE, ASSIGNMENT, OR TRANSFER has entered into a legally binding12
written agreement with the medical debt buyer of the debt pursuant to13
which:14
(a) The medical debt buyer agrees not to pursue impermissible15
extraordinary collection actions to obtain payment for the care;16
(b) The MEDICAL debt is returnable to or recallable by the medical17
debt seller CREDITOR INITIATING THE SALE, ASSIGNMENT, OR TRANSFER,18
upon a determination that the patient should have been screened pursuant19
to section 25.5-3-502 and is eligible for discounted care pursuant to20
section 25.5-3-503 or that the bill underlying the medical debt is eligible21
for reimbursement through a public health-care coverage HEALTH22
INSURANCE program; and23
(c) If it is determined that the patient should have been screened24
pursuant to section 25.5-3-502 and is eligible for discounted care pursuant25
to section 25.5-3-503 or that the bill underlying the medical debt is26
eligible for reimbursement through a public health-care coverage HEALTH27
HB26-1267-19-
INSURANCE program and the MEDICAL debt is not returned to or recalled1
by the medical debt seller CREDITOR INITIATING THE SALE, ASSIGNMENT,2
OR TRANSFER, the medical debt buyer shall adhere to procedures that must3
be specified in the agreement that ensures the patient will not pay, and has4
no obligation to pay, the medical debt buyer and the medical creditor5
together more than the patient is personally responsible for paying.6
(6) The medical debt seller shall indemnify the medical debt buyer7
for any amount paid for a debt that is returned to or recalled by the8
medical debt seller.9
(7) Nothing in this section limits or affects THIS SECTION DOES10
NOT LIMIT OR AFFECT a health-care provider's right to pursue against any11
party other than the patient the collection of personal injury, liability,12
uninsured, underinsured, medical payment rehabilitation, disability,13
homeowner's, business owner's, workers' compensation, fault-based14
insurance, subrogated claims, or other claims not against the patient, AS15
LONG AS THE COLLECTION ACTIONS TAKEN ARE NOT IMPERMISSIBLE16
EXTRAORDINARY COLLECTION ACTIONS.17
(8) A NY SALE , ASSIGNMENT , TRANSFER , OR COLLECTION18
ACTIVITIES THAT DO NOT COMPLY WITH THIS PART 2 ARE VOID OR19
DISMISSED, AND THE MEDICAL CREDITOR INITIATING THE SALE ,20
ASSIGNMENT, TRANSFER, OR COLLECTION ACTIVITIES IS LIABLE TO THE21
PATIENT FOR THREE THOUSAND DOLLARS OR ANY ACTUAL DAMAGES22
SUSTAINED AS A RESULT OF NONCOMPLIANCE , WHICHEVER IS GREATER ,23
AND ANY ATTORNEY FEES OR COSTS INCURRED BY THE PATIENT.24
(9) A PATIENT'S FULL OR PARTIAL PAYMENT OF A MEDICAL DEBT25
OR ACCEPTANCE OF A REASONABLE PAYMENT PLAN PURSUANT TO SECTION26
6-20-204 DOES NOT CONSTITUTE ADMISSION THAT THE MEDICAL DEBT IS27
HB26-1267-20-
VALID. A PATIENT WHO MAKES A PAYMENT ON A MEDICAL DEBT OR1
ACCEPTS A REASONABLE PAYMENT PLAN RETAINS ANY LEGAL DEFENSES2
THAT WOULD OTHERWISE BE AVAILABLE IN A COLLECTION ACTION.3
(10) T HIS SECTION DOES NOT LIMIT ANY OTHER LEGAL OR4
EQUITABLE REMEDIES AVAILABLE TO THE PATIENT.5
6-20-204. Reasonable payment plan - conditions to require full6
payment of balance of medical debt.7
(1) (a) A MEDICAL CREDITOR SHALL OFFER A REASONABLE8
PAYMENT PLAN TO EACH PATIENT WITH MEDICAL DEBT . AT A MINIMUM,9
THE REASONABLE PAYMENT PLAN MUST:10
(I) BE PAYABLE IN INSTALLMENTS SUCH THAT THE PATIENT IS NOT11
PAYING MORE THAN FOUR PERCENT OF THE PATIENT 'S WEEKLY NET12
INCOME TOWARD MEDICAL DEBT;13
(II) PROMINENTLY DISCLOSE THE DATE BY WHICH THE MEDICAL14
DEBT WILL BE PAID IN FULL IF PAYMENTS SET BY THE SCHEDULE IN THE15
PAYMENT PLAN ARE MADE WITHOUT DELAY OR INTERRUPTION;16
(III) I NCLUDE A PROVISION FOR ADJUSTING THE INSTALLMENT17
AMOUNTS AND DURATION TO ACCOUNT FOR SIGNIFICANT CHANGES IN THE18
PATIENT'S FINANCIAL CIRCUMSTANCES; AND19
(IV) P ROVIDE A SIXTY -DAY GRACE PERIOD FOR ANY LATE20
PAYMENT.21
(b) THE MEDICAL CREDITOR SHALL PROVIDE A WRITTEN COPY OF22
THE REASONABLE PAYMENT PLAN TO THE PATIENT NO LATER THAN SEVEN23
DAYS AFTER ENTERING INTO THE PAYMENT PLAN.24
(c) A REASONABLE PAYMENT PLAN MUST NOT INCLUDE A25
REQUIREMENT TO PAY PRE-JUDGMENT INTEREST.26
SECTION 8. In Colorado Revised Statutes, 5-16-103, amend27
HB26-1267-21-
(3)(d) as follows:1
5-16-103. Definitions.2
As used in this article 16, unless the context otherwise requires:3
(3) (d) (I) For the purposes of section 5-16-108 (1)(f), "collection4
agency" includes any person engaged in any business the principal5
purpose of which is the enforcement of security interests. For purposes of6
sections 5-16-104, 5-16-105, 5-16-106, 5-16-107, 5-16-108, and 5-16-1097
only, "collection agency" includes a debt collector for the department of8
personnel.9
(II) FOR THE PURPOSES OF SECTIONS 5-16-108 (1)(l) AND 5-16-113,10
"COLLECTION AGENCY" INCLUDES A MEDICAL CREDITOR , AS DEFINED IN11
SECTION 6-20-201.12
SECTION 9. In Colorado Revised Statutes, 5-16-108, amend13
(1)(l) as follows:14
5-16-108. Unfair practices.15
(1) A debt collector or collection agency shall not use unfair or16
unconscionable means to collect or attempt to collect any debt, including,17
but not limited to, the following conduct:18
(l) An attempt to collect a debt that violates the provisions of19
section 6-20-203 (1), (2), (3)(b), (4)(a), (4)(b)(I), (4)(d), (4)(e), or (5)(a)20
to (5)(c) SECTION 6-20-203.21
SECTION 10. In Colorado Revised Statutes, 5-16-111, amend22
(1.5)(a) as follows:23
5-16-111. Legal actions by collection agencies.24
(1.5) A debt collector, or collection agency that is not a creditor25
or debt buyer, shall not be the named plaintiff in a legal action or take any26
legal action on a debt against a consumer unless the debt collector or27
HB26-1267-22-
collection agency:1
(a) Ensures that the name of the original creditor or assignor and2
the name of the debt collector or collection agency are included in the3
case caption of the complaint, in that order. and IF THERE ARE MULTIPLE4
ORIGINAL CREDITORS OR ASSIGNORS , EACH ORIGINAL CREDITOR OR5
ASSIGNOR MUST BE LISTED IN THE CASE CAPTION AS A SEPARATE PLAINTIFF6
AND THEIR INCLUSION IN THE ACTION MUST COMPLY WITH THE RULES OF7
PERMISSIVE JOINDER PURSUANT TO COLORADO RULES OF CIVIL8
PROCEDURE. JOINDER OF ACTIONS SUA SPONTE BY A COURT DOES NOT9
VIOLATE THIS SUBSECTION (1.5).10
SECTION 11. In Colorado Revised Statutes, 13-80-101, add11
(1)(q) as follows:12
13-80-101. General limitation of actions - three years.13
(1) The following civil actions, regardless of the theory upon14
which suit is brought, or against whom suit is brought, shall be15
commenced within three years after the cause of action accrues, and not16
thereafter:17
(q) PERMISSIBLE EXTRAORDINARY COLLECTION ACTIONS FOR THE18
COLLECTION OF MEDICAL DEBT, AS DEFINED IN SECTION 6-20-201;19
SECTION 12. In Colorado Revised Statutes, 13-80-103.5,20
amend (1)(a) as follows:21
13-80-103.5. General limitation of actions - six years.22
(1) The following actions shall be commenced within six years23
after the cause of action accrues and not thereafter:24
(a) All actions to recover a liquidated debt or an unliquidated,25
determinable amount of money due to the person bringing the action, all26
actions for the enforcement of rights set forth in any instrument securing27
HB26-1267-23-
the payment of or evidencing any debt, and all actions of replevin to1
recover the possession of personal property encumbered under any2
instrument securing any debt; except that:3
(I) Actions to recover MADE pursuant to section 38-35-124.5 (3)4
C.R.S., shall be commenced within one year; AND5
(II) P ERMISSIBLE EXTRAORDINARY COLLECTION ACTIONS6
INVOLVING MEDICAL DEBT PURSUANT TO PART 2 OF ARTICLE 20 OF TITLE7
6 ARE GOVERNED BY THE LIMITATION DESCRIBED IN SECTION 13-80-1018
(1)(q).9
SECTION 13. Safety clause. The general assembly finds,10
determines, and declares that this act is necessary for the immediate11
preservation of the public peace, health, or safety or for appropriations for12
the support and maintenance of the departments of the state and state13
institutions.14
HB26-1267-24-