Out-of-network bills can be more than 30 times the average in-network rate

(Mar. 6) – A bipartisan bill to address the out of control practice of sending consumers out-of-network bills, sponsored by Rep. Daneya Esgar, D-Pueblo, and Rep. Marc Catlin, R-Montrose, was just passed by the House Health and Insurance committee.

“In Colorado, there is no limit to what out-of-network providers or facilities can charge consumers,” said Rep. Esgar. “The average consumer has paid $622 in out-of-network bills; some of these bills can be up to 30 times the average in network rate for the same service. My constituents in Pueblo are struggling to keep up with out of control health care costs and deserve the relief and peace of mind that this bill can help bring.”

HB19-1174 prohibits out-of-network billing by providers when the patient unknowingly received the care from an out-of-network provider or facility. It also requires providers to inform consumers of their rights regarding bills sent to them by out-of-network providers. The bill does not prohibit patients from incurring out of network costs when they intentionally go out of network for their care but puts safeguards in place to prevent unexpected medical bills in these situations.

Fifty-seven percent of patients who encountered out-of-network bills paid the bills in full because they didn’t know of their right to fight these bills.

“These are not one-off stories or things that affect only rural Coloradans, but rather a situation that many Coloradans face — too many,” Esgar continued. “We need to finally successfully address this issue here at the legislature, and I am hopeful that this is the year to do it.”

This legislation is meant to help control costs in out-of-network billing situations by setting a reasonable rate of payment for these providers and facilities.

The bipartisan bill was approved unanimously by a vote of 9-0 and now goes to House Appropriations committee.

The bill also has bipartisan sponsorship in the Senate by Sen. Brittany Pettersen, D-Lakewood, and Sen. Bob Gardner, R-Colorado Springs.

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