PROMO 64J1 Health - Healthcare Money Stethescope Cash - iStock - Sensay

Surprise medical billing protections clear legislature

© iStock - Sensay
Eric Galatas

(Colorado News Network) Coloradans will have more protections against so-called surprise medical bills after the General Assembly passed House Bill 1284

Adam Fox, interim executive director for the Colorado Consumer Health Initiative, said patients were being billed even after their insurance company had paid for services

In many cases they were being charged, often for thousands of dollars, for procedures performed by team members who were working at an in-network hospital, but were not in-network providers.

"Providers can be out-of-network at an in-network facility," said Fox. "And that's what creates this mess that consumers were running into, before these bills were passed."

Patients have often been billed for the difference, or balance, between what the insurer covered and the total bill, which can include costly services performed by out-of-network providers such as radiologists or other specialists. 

HB 1284 aligns Colorado state law with the recently passed federal "No Surprises Act." 

Fox said most Coloradans should have protections against surprise billing after the measure is signed by Governor Jared Polis.

Under the new law, if a health provider wants to ask a patient to consent to out-of-network care, at a higher cost, they must provide paperwork at least 72 hours in advance. Fox added that you don't have to sign a waiver to receive the care you've already scheduled. 

"If you are presented paperwork that is trying to get you to consent to out-of-network care," said Fox, "you are not obligated to sign that."

Fox said Coloradans also will have more robust protections in place against being charged for out-of-network services if they ever must visit an emergency room.

"Unless somebody is truly stabilized after an emergency, and able to be transferred with non-medical transit and able to also consent to out-of-network care," said Fox, "then they can't be balanced billed, period."