HB 25-1317

House Bill 25-1317, which has been signed into law, corrects a mistake in Colorado’s existing health-care billing rules. The original rule allowed for a final bill to be no more than $400 or 15% higher than the initial estimate provided to patients, whichever was smaller. This bill clarifies that the $400 limit is an additional amount on top of the 15% increase, not a standalone maximum cost. Additionally, it removes confusing language about emergencies allowing bills to exceed these limits by more than $400 or 15%, making the exception clearer for unexpected situations. This change affects patients seeking health-care services and ensures they receive accurate billing estimates.

Official Summary

Existing law permits an individual to request a self-pay estimate of the total cost of an anticipated health-care service (self-pay estimate) from the designated billing or patient services personnel representing the health-care provider or health-care facility providing the service. Unless the patient suffers a medical emergency or other unforeseen circumstance that affects the services provided, statute states that the final cost of the health-care service must be no more than 15% higher than the self-pay estimate or $400, whichever is less. The act corrects the mistake in the statutory language by clarifying that the $400 qualifier relates to the permissible dollar amount above the cost estimated in the self-pay estimate rather than the qualifier itself reflecting the maximum allowable cost of the health-care service, regardless of the service provided. Further, when referencing the exception in statute that, due to an emergency or unforeseen circumstance, the total cost of services may exceed the self-pay estimate by more than 15% or $400, the act removes the erroneous qualifier, "whichever is less", as that language is inapplicable when the exception applies. (Note: This summary applies to this bill as enacted.)

Votes