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Second Regular Session
Seventy-fifth General Assembly
STATE OF COLORADO
INTRODUCED
LLS NO. 26-0721.01 Josh Schultz x5486 SENATE BILL 26-138
Senate Committees House Committees
Health & Human Services
A BILL FOR AN ACT
CONCERNING MEASURES TO REDUCE THE ADMINISTRATIVE BURDEN ON101
THE HEALTH-CARE SYSTEM.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.)
Section 2 of the bill requires the commissioner of insurance
(commissioner) to conduct a performance audit of all division of
insurance (division) rules related to health care on or before January 1,
2029, and at least once every 5 years thereafter. Commencing January
2029, and every 5 years thereafter, the division shall report on the
findings of the audit during its "SMART Act" hearing.
SENATE SPONSORSHIP
Daugherty and Mullica,
HOUSE SPONSORSHIP
Stewart K.,
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.
Section 3 repeals provisions that require health insurance carriers
(carriers) to comply with federal price transparency laws and to make
available an internet-based self-service tool that provides real-time
responses to a covered person's questions concerning carrier prices that
are based on cost-sharing information.
Section 3 also repeals a requirement that carriers submit
information required by federal pharmacy benefit and drug cost reporting
laws to the commissioner and make certain information regarding price
transparency publicly available.
Section 4 repeals a requirement that health-care profession
regulators adopt rules that require each licensed health-care provider, as
a condition of renewing, reactivating, or reinstating a license, to complete
up to 4 credit hours of training per licensing cycle in order to demonstrate
competency regarding topics related to prescribing drugs and treatment.
Section 5 changes the frequency that specific health-care facilities
are required to apply for a license issued by the department of public
health and environment from annually to every 2 years.
Section 6 requires the department of health care policy and
financing (state department) to conduct a performance audit of all state
department rules related to health care on or before January 1, 2029, and
at least once every 5 years thereafter. Commencing January 2029, and
every 5 years thereafter, the state department shall report on the findings
of the audit during its "SMART Act" hearing.
Under current law, a health-care facility is required to screen each
uninsured patient for eligibility for public health insurance programs and
discounted care (screening) utilizing a single uniform application
developed by the state department. Sections 7 through 12 change these
requirements in the following ways:
! Changing the method used to conduct the screening from
a uniform application to use of a third-party resource, such
as a major credit bureau, or use of a uniform screening
questionnaire (questionnaire) developed by the state
department;
! Allowing a health-care facility the option of screening a
patient for eligibility for the health-care facility's financial
assistance program;
! Requiring a health-care facility to provide specified
notifications upon completion of the screening;
! Creating an application for discounted care (application)
for use by a health-care facility upon completion of the
screening through which additional information is
requested from a patient to enable the health-care facility
to determine whether the patient has qualified or is likely
to qualify for public health-care coverage or discounted
care;
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! Requiring a health-care facility to provide specified notice
and appeal rights to a patient upon completion and review
of the application; and
! Requiring the state department to adopt rules regarding the
questionnaire and application.
Section 12 also narrows state department review requirements of
health-care facilities' and licensed health-care professionals' billing for
patients who are indigent. The bill prohibits the state department from
making changes to regulatory documents or imposing new requirements
unless the changes or new requirements are adopted by rule by specified
dates and are subject to stakeholder engagement.
Section 13 requires the state department to establish the content
and format of the information each hospital must provide to the state
department for a hospital transparency report by rule at least 30 days prior
to the hospital's fiscal year. Current law requires that each hospital has a
minimum of 15 days to review the hospital transparency report; the bill
requires that a statewide hospital association must also have a minimum
of 15 days to review the report.
Sections 14 through 17 make conforming amendments.
Be it enacted by the General Assembly of the State of Colorado:1
SECTION 1. Legislative declaration. (1) The general assembly2
finds and declares that:3
(a) Every Colorado family deserves a fair, dignified, and4
understandable path to financial assistance when seeking health care.5
Patients benefit from hospitals' discounted care programs and these6
programs increase access to affordable care. Reducing duplication and7
confusion in navigating the process for both patients and health-care8
providers is essential to ensure the process does not create barriers for the9
very people the law was intended to help.10
(b) Rising insurance premiums and the impacts of H.R. 1 of the11
119th congress (2025-2026), Pub.L. 119-21, are likely to increase the12
number of uninsured and underinsured Coloradans seeking discounted13
care. At a time when more families are struggling to afford basic health14
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services, Colorado must ensure that access to financial relief is simple,1
timely, and centered on the needs of patients.2
(c) It is the intent of the general assembly to reduce unnecessary3
paperwork, eliminate avoidable burdens, and create a process that4
respects people's time, circumstances, and dignity. Streamlining and5
clarifying these pathways will allow health-care providers to focus more6
resources on helping families instead of on navigating shifting rules or7
administrative obstacles.8
(d) The general assembly affirms that all patient rights, including9
the right to appeal and to provide information demonstrating eligibility10
for public health-care coverage or discounted care, must remain fully11
protected; and12
(e) This act strengthens the promise that discounted care in our13
state will be accessible and rooted in compassion.14
SECTION 2. In Colorado Revised Statutes, 10-1-109, add (3) as15
follows:16
10-1-109. Rules of commissioner - performance audit - report.17
(3) (a) O N OR BEFORE JANUARY 1, 2029, AND AT LEAST ONCE18
EVERY FIVE YEARS THEREAFTER, THE COMMISSIONER SHALL COMPLETE A19
PERFORMANCE AUDIT OF ALL DIVISION RULES RELATED TO HEALTH CARE20
TO:21
(I) ASSESS WHETHER EACH RULE COMPLIES WITH ITS STATUTORY22
PURPOSE;23
(II) U NDERSTAND THE IMPACT OF EACH RULE , INCLUDING24
ECONOMIC AND COMPLIANCE COSTS;25
(III) ASSESS THE RULE -MAKING OUTREACH PROCESS TO ENSURE26
STAKEHOLDERS ARE ENGAGED IN ANY RULE-MAKING PROCEEDINGS AND27
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PERFORMANCE EVALUATIONS;1
(IV) DETERMINE APPROPRIATE STAFFING; AND2
(V) P ERFORM A COST -BENEFIT ANALYSIS , UNLESS THE3
COMMISSIONER OR DIVISION HAS ALREADY PERFORMED A COST-BENEFIT4
ANALYSIS PURSUANT TO SECTION 24-4-103 (2.5).5
(b) BEGINNING IN JANUARY 2029, AND IN JANUARY EVERY FIVE6
YEARS THEREAFTER , THE DIVISION SHALL INCLUDE , AS PART OF ITS7
PRESENTATION DURING ITS "SMART ACT" HEARING REQUIRED BY8
SECTION 2-7-203, INFORMATION CONCERNING THE RESULTS OF THE9
PERFORMANCE AUDIT CONDUCTED PURSUANT TO SUBSECTION (3)(a) OF10
THIS SECTION.11
SECTION 3. In Colorado Revised Statutes, repeal 10-16-16812
and 10-16-169.13
SECTION 4. In Colorado Revised Statutes, amend 12-30-114 as14
follows:15
12-30-114. Demonstrated competency - repeal.16
(1) (a) The regulator for each licensed health-care provider, in17
consultation with the center for research into substance use disorder18
prevention, treatment, and recovery support strategies created in section19
27-80-118, shall promulgate rules that require each licensed health-care20
provider, as a condition of renewing, reactivating, or reinstating a license21
on or after October 1, 2022, to complete up to four credit hours of22
training per licensing cycle in order to demonstrate competency23
regarding:24
(I) Best practices for opioid prescribing, according to the most25
recent version of the division's guidelines for the safe prescribing and26
dispensing of opioids;27
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(II) The potential harm of inappropriately limiting prescriptions1
to chronic pain patients;2
(III) Best practices for prescribing benzodiazepines;3
(IV) Recognition of substance use disorders;4
(V) Referral of patients with substance use disorders for5
treatment; and6
(VI) The use of the electronic prescription drug monitoring7
program created in part 4 of article 280 of this title 12.8
(b) The rules promulgated by each regulator shall exempt a9
licensed health-care provider who:10
(I) Maintains a national board certification that requires equivalent11
substance use prevention training; or12
(II) Attests to the regulator that the health-care provider does not13
prescribe opioids.14
(2) For the purposes of this section, "licensed health-care15
provider" includes any of the following providers who are licensed16
pursuant to this title 12:17
(a) A physician;18
(b) A physician assistant;19
(c) A podiatrist;20
(d) A dentist;21
(e) An advanced practice registered nurse or certified midwife22
with prescriptive authority;23
(f) An optometrist; and24
(g) A veterinarian.25
(3) EACH REGULATOR THAT HAS ADOPTED RULES PURSUANT TO26
THIS SECTION BEFORE THE EFFECTIVE DATE OF THIS SUBSECTION (3) THAT27
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REQUIRE A LICENSED HEALTH -CARE PROVIDER , AS A CONDITION OF1
RENEWING, REACTIVATING, OR REINSTATING A LICENSE, TO COMPLETE UP2
TO FOUR CREDIT HOURS OF TRAINING PER LICENSING CYCLE IN ORDER TO3
DEMONSTRATE COMPETENCY SHALL REPEAL THE RULES ON OR BEFORE4
JANUARY 1, 2027.5
(4) THIS SECTION IS REPEALED, EFFECTIVE SEPTEMBER 1, 2029.6
SECTION 5. In Colorado Revised Statutes, 25-3-102, amend7
(1)(a); and add (1)(f) as follows:8
25-3-102. License - application - issuance - waiver - certificate9
of compliance required - rules.10
(1) (a) An applicant for a license described in section 25-3-10111
shall apply to the department of public health and environment annually12
EVERY TWO YEARS upon such form and in such manner as prescribed by13
the department; except that a community residential home shall make14
application for a license pursuant to section 25.5-10-214. C.R.S.15
(f) (I) I F THE DEPARTMENT GRANTS A WAIVER OF REGULATIONS16
FOR FACILITIES AND AGENCIES TO A LICENSED HEALTH -CARE FACILITY17
PURSUANT TO THE DEPARTMENT 'S RULES REGARDING STANDARDS FOR18
HOSPITALS AND HEALTH FACILITIES, THE WAIVER IS VALID AS LONG AS THE19
LICENSED HEALTH -CARE FACILITY DOES NOT PERFORM SUBSTANTIAL20
MODIFICATIONS.21
(II) I F A HEALTH -CARE FACILITY MODIFIES THE SCOPE OF THE22
APPROVED WAIVER GRANTED PURSUANT TO SUBSECTION (1)(f)(I) OF THIS23
SECTION OR INITIATES ANY CONSTRUCTION OR RENOVATION ACTIVITY, THE24
WAIVER IS SURRENDERED . UPON SURRENDER OF THE WAIVER , THE25
HEALTH-CARE FACILITY SHALL COMPLY WITH ALL APPLICABLE STATE26
REGULATORY REQUIREMENTS AND ALL RELEVANT FACILITY GUIDELINES27
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INSTITUTE GUIDELINES IN EFFECT AT THE TIME THE CONSTRUCTION OR1
RENOVATION IS INITIATED.2
SECTION 6. In Colorado Revised Statutes, 25.5-1-108, add (3)3
as follows:4
25.5-1-108. Executive director - performance audit - report -5
rules.6
(3) (a) O N OR BEFORE JANUARY 1, 2029, AND AT LEAST ONCE7
EVERY FIVE YEARS THEREAFTER , THE STATE DEPARTMENT SHALL8
COMPLETE A PERFORMANCE AUDIT OF ALL STATE DEPARTMENT RULES9
RELATED TO HEALTH CARE TO:10
(I) ASSESS WHETHER EACH RULE COMPLIES WITH ITS STATUTORY11
PURPOSE;12
(II) U NDERSTAND THE IMPACT OF EACH RULE , INCLUDING13
ECONOMIC AND COMPLIANCE COSTS;14
(III) ASSESS THE RULE-MAKING OUTREACH PROCESS TO ENSURE15
STAKEHOLDERS ARE ENGAGED IN ANY RULE-MAKING PROCEEDINGS AND16
PERFORMANCE EVALUATIONS;17
(IV) DETERMINE APPROPRIATE STAFFING; AND18
(V) P ERFORM A COST -BENEFIT ANALYSIS , UNLESS THE STATE19
DEPARTMENT HAS ALREADY PERFORMED A COST -BENEFIT ANALYSIS20
PURSUANT TO SECTION 24-4-103 (2.5).21
(b) BEGINNING IN JANUARY 2029, AND IN JANUARY EVERY FIVE22
YEARS THEREAFTER, THE STATE DEPARTMENT SHALL INCLUDE, AS PART OF23
ITS PRESENTATION DURING ITS "SMART ACT" HEARING REQUIRED BY24
SECTION 2-7-203, INFORMATION CONCERNING THE RESULTS OF THE25
PERFORMANCE AUDIT CONDUCTED PURSUANT TO SUBSECTION (3)(a) OF26
THIS SECTION.27
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SECTION 7. In Colorado Revised Statutes, 25.5-3-501, amend1
(6); and add (6.7) as follows:2
25.5-3-501. Definitions.3
As used in this part 5, unless the context otherwise requires:4
(6) "Screen" or "screening" means a process identified in rule by5
the state department DESCRIBED IN SECTION 25.5-3-502 whereby6
health-care facilities assess a patient's circumstances related to eligibility7
criteria and determine whether the patient HAS QUALIFIED OR is likely to8
qualify for public health-care coverage or discounted care AND, AT THE9
OPTION OF THE HEALTH -CARE FACILITY , IS ELIGIBLE FOR THE10
HEALTH-CARE FACILITY'S FINANCIAL ASSISTANCE PROGRAM; inform the11
patient of the health-care facility's determination; and provide information12
to the patient about how the patient can enroll in public health-care13
coverage OR THE HEALTH -CARE FACILITY 'S FINANCIAL ASSISTANCE14
PROGRAM.15
(6.7) "U NIFORM APPLICATION " OR "APPLICATION" MEANS A16
UNIFORM FORM THAT IS DEVELOPED BY THE STATE DEPARTMENT TO17
DETERMINE WHETHER A PATIENT IS A QUALIFIED PATIENT AND IS18
COMPLETED FOLLOWING A SCREENING OR WHEN REQUIRED BY SECTION19
25.5-3-502.5.20
SECTION 8. In Colorado Revised Statutes, amend 25.5-3-50221
as follows:22
25.5-3-502. Requirement to screen patients for eligibility for23
financial assistance - questionnaire - rules.24
(1) Beginning September 1, 2022, a health-care facility shall25
screen, unless a patient declines, each uninsured patient for eligibility for:26
(a) Public health insurance programs, including but not limited to27
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medicare; the state medical assistance program, articles 4, 5, and 6 of this1
title 25.5; emergency medicaid; and the children's basic health plan,2
article 8 of this title 25.5; and3
(b) Repealed.4
(c) (b) Discounted care, as described in section 25.5-3-503; AND5
(c) A T THE OPTION OF THE HEALTH -CARE FACILITY , THE6
HEALTH-CARE FACILITY'S FINANCIAL ASSISTANCE PROGRAM, WHICH OFTEN7
OFFERS BROADER ELIGIBILITY THAN PUBLIC HEALTH INSURANCE8
PROGRAMS.9
(2) Health-care facilities shall use a single uniform application10
developed by the state department when screening a patient pursuant to11
subsection (1) of this section. A HEALTH-CARE FACILITY MAY CONDUCT12
SCREENINGS PURSUANT TO SUBSECTION (1) OF THIS SECTION THROUGH:13
(a) A CCESSING ELIGIBILITY INFORMATION THROUGH AN14
INDUSTRY-STANDARD THIRD-PARTY RESOURCE, SUCH AS A MAJOR CREDIT15
BUREAU;16
(b) REQUESTING THE PATIENT COMPLETE A UNIFORM SCREENING17
QUESTIONNAIRE DEVELOPED BY THE STATE DEPARTMENT; OR18
(c) A COMBINATION OF INFORMATION OBTAINED THROUGH19
SUBSECTIONS (2)(a) AND (2)(b) OF THIS SECTION.20
(3) If a health-care facility determines that a patient is ineligible21
for discounted care, the facility shall provide the patient notice of the22
determination and an opportunity for the patient to appeal the23
determination in accordance with state department rules I F A24
HEALTH-CARE FACILITY DETERMINES IT HAS OBTAINED SUFFICIENT25
INFORMATION IN THE SCREENING CONDUCTED PURSUANT TO SUBSECTION26
(1) OF THIS SECTION , THE HEALTH -CARE FACILITY MAY MAKE A27
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DETERMINATION OF WHETHER THE PATIENT IS A QUALIFIED PATIENT OR IS1
LIKELY ELIGIBLE FOR PUBLIC HEALTH -CARE COVERAGE WITHOUT2
REQUIRING THE PATIENT TO PROVIDE FURTHER INFORMATION THROUGH A3
UNIFORM APPLICATION PURSUANT TO SECTION 25.5-3-502.5.4
(3.5) U PON COMPLETION OF THE SCREENING CONDUCTED5
PURSUANT TO SUBSECTION (1) OF THIS SECTION, A HEALTH-CARE FACILITY6
SHALL:7
(a) IF THE HEALTH-CARE FACILITY DETERMINES THAT A PATIENT8
IS A QUALIFIED PATIENT , PROVIDE THE PATIENT NOTICE OF THE9
DETERMINATION AND THE AMOUNT OF THE DISCOUNT;10
(b) IF THE HEALTH-CARE FACILITY DETERMINES THAT A PATIENT11
IS NOT A QUALIFIED PATIENT , PROVIDE THE PATIENT NOTICE OF THE12
DETERMINATION, WHICH, IF APPLICABLE, MAY ALSO INCLUDE NOTICE THAT13
THE PATIENT IS ELIGIBLE FOR THE HEALTH -CARE FACILITY'S FINANCIAL14
ASSISTANCE PROGRAM AND THE AMOUNT OF ANY DISCOUNT OFFERED15
THROUGH THAT PROGRAM, AND SHALL PROVIDE EITHER:16
(I) AN OPPORTUNITY FOR THE PATIENT TO PROVIDE ADDITIONAL17
INFORMATION TO DETERMINE THE PATIENT 'S ELIGIBILITY FOR THE18
FINANCIAL ASSISTANCE PROGRAM AND THE AMOUNT OF THE DISCOUNT19
THROUGH AN APPLICATION COMPLETED PURSUANT TO SECTION20
25.5-3-502.5; OR21
(II) A STATEMENT THAT THE PATIENT HAS NO BALANCE DUE AFTER22
APPLYING ANY DISCOUNTS FROM THE HEALTH-CARE FACILITY'S FINANCIAL23
ASSISTANCE PROGRAM;24
(c) IF THE HEALTH-CARE FACILITY DETERMINES THAT THE PATIENT25
IS PRESUMPTIVELY ELIGIBLE FOR MEDICAL ASSISTANCE , PROVIDE THE26
PATIENT NOTICE OF THE DETERMINATION AND INFORMATION ON HOW THE27
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PATIENT CAN ENROLL IN PUBLIC HEALTH-CARE COVERAGE; AND1
(d) IF THE HEALTH-CARE FACILITY NEEDS MORE INFORMATION TO2
MAKE A DETERMINATION OF WHETHER THE PATIENT HAS QUALIFIED OR IS3
LIKELY TO QUALIFY FOR PUBLIC HEALTH-CARE COVERAGE, DISCOUNTED4
CARE, OR A FINANCIAL ASSISTANCE PROGRAM, NOTIFY THE PATIENT THAT5
THE PATIENT MUST PROVIDE ADDITIONAL INFORMATION TO ENABLE THE6
HEALTH-CARE FACILITY TO COMPLETE AN APPLICATION PURSUANT TO7
SECTION 25.5-3-502.5.8
(4) If the patient declines the screening described in subsection (1)9
of this section, the health-care facility shall document the patient's10
decision in accordance with state department rules. A patient's decision11
to decline the screening that is documented and complies with state12
department rules is a complete defense to a claim brought by a patient13
under section 25.5-3-506 (2) for a violation of section 25.5-3-506 (1)(a)14
or (1)(b).15
(5) If requested by the AN INSURED patient, a health-care facility16
shall screen an insured patient for discounted care pursuant to subsections17
(1)(b) and (1)(c) of this section PERFORM THE SCREENING DESCRIBED IN18
THIS SECTION AND, IF APPLICABLE, COMPLETE THE APPLICATION PURSUANT19
TO SECTION 25.5-3-502.5 TO DETERMINE IF THE INSURED PATIENT IS A20
QUALIFIED PATIENT.21
SECTION 9. In Colorado Revised Statutes, add 25.5-3-502.5 as22
follows:23
25.5-3-502.5. Uniform application for discounted care.24
(1) AFTER COMPLETION OF THE SCREENING CONDUCTED PURSUANT25
TO SECTION 25.5-3-502, A HEALTH -CARE FACILITY SHALL REQUEST26
INFORMATION FROM A PATIENT TO ENABLE THE HEALTH-CARE FACILITY TO27
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COMPLETE A UNIFORM APPLICATION FOR DISCOUNTED CARE IF:1
(a) T HE HEALTH-CARE FACILITY NEEDS MORE INFORMATION TO2
MAKE A DETERMINATION OF WHETHER THE PATIENT HAS QUALIFIED OR IS3
LIKELY TO QUALIFY FOR PUBLIC HEALTH-CARE COVERAGE, DISCOUNTED4
CARE, OR THE HEALTH-CARE FACILITY'S FINANCIAL ASSISTANCE PROGRAM,5
INCLUDING IF THE HEALTH -CARE FACILITY'S POLICY IS TO REQUIRE AN6
APPLICATION PRIOR TO MAKING A FINAL DETERMINATION; OR7
(b) THE PATIENT REQUESTS AN APPLICATION, UNLESS THE PATIENT8
HAS NO BALANCE REMAINING AFTER APPLYING ANY DISCOUNTS PURSUANT9
TO SECTION 25.5-3-503 OR THE HEALTH -CARE FACILITY 'S FINANCIAL10
ASSISTANCE PROGRAM.11
(2) A HEALTH -CARE FACILITY SHALL USE THE UNIFORM12
APPLICATION DEVELOPED BY THE STATE DEPARTMENT TO COMPLETE THE13
APPLICATION REQUIRED BY THIS SECTION.14
(3) U PON COMPLETION AND REVIEW OF THE APPLICATION , A15
HEALTH-CARE FACILITY SHALL:16
(a) IF THE HEALTH-CARE FACILITY DETERMINES THAT A PATIENT17
IS A QUALIFIED PATIENT , PROVIDE THE PATIENT NOTICE OF THE18
DETERMINATION AND THE AMOUNT OF THE DISCOUNT;19
(b) IF THE HEALTH-CARE FACILITY DETERMINES THAT A PATIENT20
IS NOT A QUALIFIED PATIENT , PROVIDE THE PATIENT NOTICE OF THE21
DETERMINATION, WHICH, IF APPLICABLE, MAY ALSO INCLUDE NOTICE THAT22
THE PATIENT IS ELIGIBLE FOR THE HEALTH -CARE FACILITY'S FINANCIAL23
ASSISTANCE PROGRAM AND THE AMOUNT OF ANY DISCOUNT OFFERED24
THROUGH THAT PROGRAM, AND SHALL PROVIDE EITHER:25
(I) A N OPPORTUNITY FOR THE PATIENT TO APPEAL THE26
DETERMINATION IN ACCORDANCE WITH STATE DEPARTMENT RULES; OR27
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(II) A STATEMENT THAT THE PATIENT HAS NO BALANCE DUE AFTER1
APPLYING ANY DISCOUNTS FROM THE HEALTH-CARE FACILITY'S FINANCIAL2
ASSISTANCE PROGRAM; AND3
(c) IF THE HEALTH-CARE FACILITY DETERMINES THAT THE PATIENT4
IS PRESUMPTIVELY ELIGIBLE FOR MEDICAL ASSISTANCE , PROVIDE THE5
PATIENT NOTICE OF THE DETERMINATION AND INFORMATION ON HOW THE6
PATIENT CAN ENROLL IN PUBLIC HEALTH-CARE COVERAGE.7
SECTION 10. In Colorado Revised Statutes, 25.5-3-503, amend8
(1) introductory portion and (2)(a) as follows:9
25.5-3-503. Health-care discounts on services not eligible for10
Colorado indigent care program reimbursement - definition.11
(1) Beginning September 1, 2022, if a patient is screened pursuant12
to section 25.5-3-502 OR HAS COMPLETED A UNIFORM APPLICATION13
PURSUANT TO SECTION 25.5-3-502.5 and is determined to be a qualified14
patient, a health-care facility and a licensed health-care professional shall,15
for emergency hospital and other health-care services:16
(2) A health-care facility shall not:17
(a) Deny discounted care on the basis that the patient has not18
applied for any public benefits program, unless during the initial19
screening OR APPLICATION PROCESS the patient is determined to be20
presumptively eligible for the state medical assistance program; or21
SECTION 11. In Colorado Revised Statutes, 25.5-3-504, amend22
(1) introductory portion; and add (2) as follows:23
25.5-3-504. Notification of patients' rights - website link.24
(1) Beginning September 1, 2022, a health-care facility shall make25
information developed by the state department about patients' rights under26
this part 5 and the uniform application A LINK ON THE STATE DEPARTMENT27
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WEBSITE TO ACCESS THE UNIFORM APPLICATION developed by the state1
department pursuant to section 25.5-3-505 (2)(i) available to the public2
and to each patient. At a minimum, the health-care facility shall:3
(2) T HE STATE DEPARTMENT SHALL POST THE UNIFORM4
APPLICATION DEVELOPED PURSUANT TO SECTION 25.5-3-505 (2)(i) IN ALL5
REQUIRED LANGUAGES ON A PUBLICLY ACCESSIBLE WEBSITE.6
SECTION 12. In Colorado Revised Statutes, 25.5-3-505, amend7
(2) introductory portion, (2)(c)(II), (2)(d), (2)(e), (2)(f), (2)(g), (2)(i), (5)8
introductory portion, (5)(b)(I), and (5)(b)(II); and add (2)(d.5) and (7) as9
follows:10
25.5-3-505. Health-care facility reporting requirements -11
agency enforcement - report - rules.12
(2) No later than April 1, 2022 SEPTEMBER 1, 2026, the state13
board shall promulgate ADOPT rules necessary for the administration and14
implementation of this part 5. At a minimum, the rules must:15
(c) Establish the process for and the maximum number of days16
that a health-care facility has to:17
(II) Request information from the A patient needed for the18
screening process IF THE HEALTH-CARE FACILITY CONDUCTS A SCREENING19
USING THE UNIFORM SCREENING QUESTIONNAIRE AS DESCRIBED IN20
SECTION 25.5-3-502 (2); and21
(d) Outline the requirements for notifying the patient of the results22
of the screening, including:23
(I) An explanation of the basis for a denial of discounted care; and24
(II) The process for appealing a denial COMPLETING AN25
APPLICATION TO PROVIDE MORE INFORMATION TO DETERMINE WHETHER26
THE PATIENT IS A QUALIFIED PATIENT;27
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(d.5) ESTABLISH A PROCESS FOR AND THE MAXIMUM NUMBER OF1
DAYS THAT A HEALTH-CARE FACILITY HAS TO:2
(I) REQUEST INFORMATION FROM THE PATIENT TO COMPLETE AN3
APPLICATION, IF THE APPLICATION IS REQUIRED PURSUANT TO SECTION4
25.5-3-502.5; AND5
(II) C OMPLETE THE APPLICATION PROCESS AS DESCRIBED IN6
SECTION 25.5-3-502.5;7
(e) Establish guidelines for patient appeals regarding eligibility for8
discounted care pursuant to section 25.5-3-503 25.5-3-502.5;9
(f) Establish a methodology that all ACCEPTABLE METHODOLOGIES10
FOR health-care facilities must use to determine monthly household11
income. F OR PURPOSES OF THE SCREENING , THE USE OF AN12
INDUSTRY-STANDARD THIRD-PARTY RESOURCE, INCLUDING MAJOR CREDIT13
BUREAUS, IS AN ACCEPTABLE METHODOLOGY . The methodology14
METHODOLOGIES must not consider a patient's assets.15
(g) FOR PURPOSES OF THE APPLICATION , identify the documents16
that may be required to establish income eligibility for discounted care17
using the minimum amount of information needed to determine18
eligibility;19
(i) Create a uniform application that a health-care facility must use20
when AN APPLICATION IS REQUIRED AFTER screening a patient for21
eligibility for discounted care, as described in section 25.5-3-50222
SECTIONS 25.5-3-502 AND 25.5-3-502.5; AND23
(5) No later than April 1, 2022, The state department: shall:24
(b) (I) S HALL establish a process for patients to submit a25
complaint relating to noncompliance with this part 5 to the state26
department by phone, BY mail, or online. The state department shall27
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conduct a review OF A PATIENT 'S COMPLAINT within thirty days after1
receiving a complaint.2
(II) (A) The state department Shall periodically review health-care3
facilities and licensed health-care professionals to ensure compliance with4
this section QUALIFIED PATIENTS ARE IDENTIFIED IN COMPLIANCE WITH5
THIS PART 5 AND ARE NOT CHARGED MORE THAN THE DISCOUNTED RATE6
ESTABLISHED IN STATE BOARD RULE PURSUANT TO SUBSECTION (2)(j) OF7
THIS SECTION. THE REVIEW SHALL BE CONDUCTED IN ACCORDANCE WITH8
STATE DEPARTMENT RULES , AND THE FREQUENCY , SAMPLE SIZE , AND9
TIMELINE OF THE REVIEW MUST BE REASONABLE CONSIDERING THE SIZE10
AND RESOURCES OF THE HEALTH-CARE FACILITY.11
(B) If the state department finds that a health-care facility or12
licensed health-care professional is not in compliance with this section13
AND THE NONCOMPLIANCE HAS RESULTED IN A DETRIMENTAL IMPACT TO14
A PATIENT, the state department shall notify the health-care facility or15
licensed health-care professional and the facility or professional has16
ninety days to file a corrective action plan with the state department. that17
IF THE NONCOMPLIANCE RESULTED IN EXCESS CHARGES TO THE PATIENT,18
THE CORRECTIVE ACTION PLAN must include measures to inform the19
patient about the noncompliance and provide a financial correction20
consistent with this part 5. A health-care facility or licensed health-care21
professional may request up to one hundred twenty days to submit a22
corrective action plan. The state department may require a health-care23
facility or licensed health-care professional that is not in compliance with24
this part 5 or any state board rules adopted pursuant to this part 5 to25
develop and operate under a corrective action plan until the state26
department determines the health-care facility or licensed health-care27
SB26-138-17-
professional is in compliance.1
(C) I F A HEALTH -CARE FACILITY 'S OR LICENSED HEALTH -CARE2
PROFESSIONAL'S NONCOMPLIANCE WITH THIS PART 5 DID NOT RESULT IN3
DETRIMENTAL IMPACT TO A PATIENT , THE STATE DEPARTMENT MAY4
NOTIFY THE HEALTH -CARE FACILITY OR LICENSED HEALTH -CARE5
PROFESSIONAL OF THE NONCOMPLIANCE FOR PURPOSES OF QUALITY6
IMPROVEMENT.7
(7) (a) THE STATE DEPARTMENT SHALL NOT IMPOSE CHANGES TO8
THE UNIFORM SCREENING QUESTIONNAIRE, CHANGES TO THE APPLICATION,9
NEW REQUIREMENTS , NEW REPORTING OBLIGATIONS , NEW10
DOCUMENTATION STANDARDS, NEW DATA ELEMENTS, OR NEW PROGRAM11
CRITERIA THROUGH MANUALS , POLICY , OR OTHER SUBREGULATORY12
ISSUANCES UNLESS THE CHANGES OR NEW REQUIREMENTS HAVE BEEN:13
(I) ADOPTED BY RULE PURSUANT TO THE "STATE ADMINISTRATIVE14
PROCEDURE ACT", ARTICLE 4 OF TITLE 24, BY SEPTEMBER 1, 2026, FOR A15
RULE THAT WILL GO INTO EFFECT DURING TO THE 2026-27 STATE FISCAL16
YEAR AND EVERY YEAR THEREAFTER BY JUNE 1 PRIOR TO THE STATE17
FISCAL YEAR FOR WHICH THE RULE WILL GO INTO EFFECT; AND18
(II) S UBJECT TO STAKEHOLDER ENGAGEMENT PURSUANT TO19
SUBSECTION (4) OF THIS SECTION.20
(b) A NY REVISION DESCRIBED IN SUBSECTION (7)(a) OF THIS21
SECTION THAT WAS NOT ADOPTED THROUGH RULE-MAKING IS ADVISORY22
ONLY AND DOES NOT SERVE AS THE BASIS FOR ENFORCEMENT.23
(c) THE STATE DEPARTMENT SHALL MAINTAIN AN UPDATED PUBLIC24
ARCHIVE OF ALL MANUALS AND SUBREGULATORY ISSUANCES, INCLUDING25
THE RATIONALE FOR CHANGES AND CITATIONS TO STATUTORY OR26
REGULATORY AUTHORITY FOR EACH REVISION.27
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(d) T HIS SUBSECTION (7) DOES NOT APPLY IF THE STATE1
DEPARTMENT ADOPTS RULES IN RESPONSE TO EMERGENT AND IMMEDIATE2
TRENDS THAT ARE IDENTIFIED BY CONSUMERS OR HOSPITALS AS LIMITING3
THE PROGRAM 'S EFFECTIVENESS AND ARE DEMONSTRATED BY DATA4
SUBMITTED TO THE STATE DEPARTMENT.5
SECTION 13. In Colorado Revised Statutes, 25.5-4-402.8,6
amend (2)(b) introductory portion and (2)(e) as follows:7
25.5-4-402.8. Hospital transparency report and requirements8
- definitions - rules.9
(2) (b) Except as provided in subsection (2)(c) of this section,10
each hospital licensed pursuant to part 1 of article 3 of title 25, or certified11
pursuant to section 25-1.5-103 (1)(a)(II), shall make information available12
to the state department for purposes of preparing the annual hospital13
transparency report. The state board shall establish the CONTENT AND14
format of the information provided by each hospital on an annual basis BY15
RULE. Each hospital shall provide the following information to the state16
department ON AN ANNUAL BASIS USING THE MOST RECENT CONTENT AND17
FORMAT REQUIREMENTS THAT WERE ADOPTED BY THE STATE BOARD AT18
LEAST THIRTY DAYS PRIOR TO THE BEGINNING OF THE HOSPITAL'S FISCAL19
YEAR:20
(e) Prior to issuing the hospital transparency report, the state21
department shall provide any hospital referenced in the hospital22
transparency report a copy of the report BY DECEMBER 1 OF EACH YEAR.23
Each hospital AND A STATEWIDE HOSPITAL ASSOCIATION must have a24
minimum of fifteen days to review the hospital transparency report and25
any underlying data and submit corrections or clarifications to the state26
department.27
SB26-138-19-
SECTION 14. In Colorado Revised Statutes, 6-20-203, amend1
(5)(b) and (5)(c) as follows:2
6-20-203. Limitations on collection actions - definition.3
(5) Beginning September 1, 2022, a medical creditor collecting on4
a debt for hospital services shall not sell a medical debt to another party5
unless, prior to the sale, the medical debt seller has entered into a legally6
binding written agreement with the medical debt buyer of the debt7
pursuant to which:8
(b) The debt is returnable to or recallable by the medical debt9
seller upon a determination that the patient should have been screened10
pursuant to section 25.5-3-502 SECTIONS 25.5-3-502 AND 25.5-3-502.511
and is eligible for discounted care pursuant to section 25.5-3-503 or that12
the bill underlying the medical debt is eligible for reimbursement through13
a public health-care coverage program; and14
(c) If it is determined that the patient should have been screened15
pursuant to section 25.5-3-502 SECTIONS 25.5-3-502 AND 25.5-3-502.516
and is eligible for discounted care pursuant to section 25.5-3-503 or that17
the bill underlying the medical debt is eligible for reimbursement through18
a public health-care coverage program and the debt is not returned to or19
recalled by the medical debt seller, the medical debt buyer shall adhere to20
procedures that must be specified in the agreement that ensures the21
patient will not pay, and has no obligation to pay, the medical debt buyer22
and the medical creditor together more than the patient is personally23
responsible for paying.24
SECTION 15. In Colorado Revised Statutes, 12-220-306, amend25
(4) as follows:26
12-220-306. Dentists may prescribe drugs - surgical operations27
SB26-138-20-
- anesthesia - limits on prescriptions - rules.1
(4) A licensed dentist is strongly encouraged to purchase or utilize2
an electronic health product that includes integration of a tool that3
facilitates dentists' compliance with prescription drug monitoring4
standards. required by section 12-30-114 (1)(a)(IV).5
SECTION 16. In Colorado Revised Statutes, 12-240-130, amend6
(2)(a)(II); and repeal (2)(a)(III) and (5) as follows:7
12-240-130. Renewal, reinstatement, reactivation -8
delinquency - fees - questionnaire.9
(2) (a) The board shall design a questionnaire to accompany the10
renewal form for the purpose of determining whether a licensee has acted11
in violation of this article 240 or has been disciplined for any action that12
might be considered a violation of this article 240 or that might make the13
licensee unfit to practice medicine with reasonable care and safety. The14
board shall include on the questionnaire a question regarding whether:15
(II) The licensee is in compliance with section 12-280-403 (2)(a)16
and is aware of the penalties for failing to comply with that section; AND17
(III) The licensee is in compliance with section 12-30-114; and18
(5) On and after October 1, 2022, as a condition of renewal,19
reinstatement, or reactivation of a license, each licensee or applicant shall20
attest that the licensee or applicant is in compliance with section21
12-30-114 and that the licensee or applicant is aware of the penalties for22
noncompliance with that section.23
SECTION 17. In Colorado Revised Statutes, 12-240-130.5,24
amend (6) as follows:25
12-240-130.5. Continuing medical education - requirement -26
compliance - legislative declaration - rules - definitions.27
SB26-138-21-
(6) As part of the CME requirement established pursuant to this1
section, in addition to CME programs covering topics selected by the2
physician, a physician's CME credit hours must include3
(a) CME credit hours that comply with section 12-30-114 and4
related board rules; and5
(b) CME credit hours covering a topic specified by the board by6
rule pursuant to subsection (7)(b) of this section.7
SECTION 18. Act subject to petition - effective date. This act8
takes effect at 12:01 a.m. on the day following the expiration of the9
ninety-day period after final adjournment of the general assembly (August10
12, 2026, if adjournment sine die is on May 13, 2026); except that, if a11
referendum petition is filed pursuant to section 1 (3) of article V of the12
state constitution against this act or an item, section, or part of this act13
within such period, then the act, item, section, or part will not take effect14
unless approved by the people at the general election to be held in15
November 2026 and, in such case, will take effect on the date of the16
official declaration of the vote thereon by the governor.17
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