Three bills save patients money on health care, improve access to contraception, and improve access to health care services
DENVER, CO - Lieutenant Governor Dianne Primavera today signed three bills into law that prohibit facility fee charges for preventative care to save Colorado patients money, increase health insurance coverage for contraception, and increase annual funding for nursing facilities and prioritize reimbursement for facilities that serve a higher rate of Medicaid patients.
“Surprise bills like hospital facility fees are making it more difficult for Coloradans to seek the care that they need because they can’t afford to be charged hundreds or thousands of dollars in hidden costs on top of the care they received,” said Rep. Emily Sirota, D-Denver, sponsor of HB23-1215. “We need hospital billing and facility fees to be more transparent so patients know what to expect. With this bill becoming law today, we’re better protecting patients and saving Coloradans money on health care.”
“Most Coloradans are unable to afford hundreds or thousands of dollars of surprise hidden fees,” said Senator Kyle Mullica, D-Thornton, sponsor of HB23-1215. “Surprise fees make it difficult for Coloradans to budget for health care services, deterring people from seeking the care they need altogether. Prohibiting certain facility fees will help protect patients and provide much needed relief for Colorado families.”
“When Coloradans put off medical care because they can’t afford to take on more bills, it can become more expensive and life-threatening to address,” said Rep. Andrew Boesenecker, D-Fort Collins, sponsor of HB23-1215. “Increasing access to preventative care reduces costs for everyone by helping patients get the care they need before their conditions become worse and more expensive to treat. By prohibiting facility fees on preventative care, Coloradans will save money on care that keeps them healthy and avoid surprise fees they can’t afford.”
“Medical debt is already a leading cause of bankruptcy in the United States; it is not acceptable that Coloradans are being burdened with unnecessary costs they should not be responsible for,” said Senator Lisa Cutter, D-Jefferson County, sponsor of HB23-1215. “Facility fees can range from hundreds to thousands of dollars and are impossible for families to plan for, since they are often unexpected. Further examining and addressing facility fees, and requiring additional transparency, will help save Coloradans money and allow them to better plan and budget for necessary medical care."
Some health care centers have started to charge patients hidden fees, often called a facility fee, on top of the health care services they are already being charged to cover operating costs. These fees can range from hundreds to thousands of dollars and are impossible for families to budget for, since there is no transparency as to how these fees will be applied. HB23-1215 prohibits health care providers from charging a facility fee for preventative care in an outpatient setting. Under this law, health care providers are required to share information about facility fees to patients and post information on their property. The law makes it a deceptive trade practice to not share facility fee information to patients.
The law also requires a report to be produced by August 1, 2024 that outlines the details of the impact of facility fees to better understand what these fees cover and how these fees impact patient cost and patient health.
"No one should have to ask for permission every month from their insurance company to not get pregnant," said Senator Jeff Bridges, D-Greenwood Village, sponsor of SB23-284. "I spoke with a woman during the election who spends more than an hour on the phone every month just getting her birth control prescription refilled. That's absurd. Today's bill protects the freedom of Coloradans to make health care choices on their own timeline."
“Coloradans should be able to access their entire twelve month prescribed contraceptive medication at once, and this legislation closes loopholes so the law can work as intended,” said Rep. Iman Jodeh, D-Aurora, sponsor of SB23-284. “Allowing access to a twelve month supply of contraceptives ensures that Coloradans don’t face additional barriers to accessing their medication, such as not living close to a pharmacy, lacking reliable transportation, or many other reasons.”
“Whether folks live in rural areas or work odd hours, trips to the pharmacy can be inconvenient and difficult to make,” said Senator Jessie Danielson, D-Lakewood, sponsor of SB23-284. “With SB23-284, we’re tightening up restrictions so insurance companies and PBMs can’t skirt our laws, and ensuring patients can access twelve months of birth control. This bill will expand and improve access to reproductive health care across Colorado.”
SB23-284 requires both insurance plans and Pharmacy Benefit Management firms (PBMs) to cover a year's supply of contraception, which can be dispensed at one time or in smaller amounts if requested. SB23-284 builds off HB17-1186, a bipartisan bill that allowed Coloradans to access 12 months of birth control. However, legal loopholes have allowed insurers and PBMs to not comply with the law. SB23-284 ties up loose ends, and makes sure Colordans can easily access a twelve month supply of contraceptives using their medical insurance.
Research shows that dispensing one to three months of birth control at a time increases the likelihood of contraceptive discontinuation and can make it harder for people to plan their pregnancies. Additionally, access to 12 months of birth control can prevent unplanned pregnancies.
“This new law will provide critical funding to Colorado nursing facilities, helping them keep their doors open and serve older Coloradans across our state, especially in rural areas where many facilities are at risk of closing,” said Speaker Julie McCluskie, D-Dillon, sponsor of HB23-1228. “If we don’t secure funding to prevent nursing facilities from closing, many older Coloradans will lose their homes and access to the daily care they rely on. This new law provides over $60 million in funding so nursing facilities can stay open, hire quality staff, and continue to care for our parents, grandparents, and friends.”
“Due to low financial reimbursement rates, our skilled nursing facilities have struggled to maintain the level of quality care they strive to provide,” said Senator Rachel Zenzinger, D-Arvada, Chair of the Joint Budget Committee and sponsor of HB23-1228. “In addition to increasing funding to our nursing homes, we are taking critical steps toward improving the overall nursing facility reimbursement model to ensure Colorado will have a system that works well into the future. I’m proud to see this critical policy signed into law so that our nursing facilities can keep their doors open, provide quality care to high-need Coloradans, and plan for a sustainable financial future for years to come.”
“Low reimbursement rates have caused many nursing facilities to close their doors, making it more difficult for our loved ones to receive the care they need,” said Rep. Jenny Willford, D-Northglenn, sponsor of HB23-1228. “This law includes stronger financial transparency requirements to ensure nursing facilities and the state are working in tandem to properly allocate funding, allowing nursing facilities to stay in business, accept new residents, and overall provide the critical care, treatment and services residents need.”
HB23-1228 makes several changes to the Medicaid nursing facility reimbursement rates to ensure Colorado’s nursing facilities are getting the proper funding to care for their high-need residents, accept new residents, and maintain their operation.
Specifically, this law repeals the standard core per diem rate of 3-percent annually and increases it to 10-percent next fiscal year, 3-percent in fiscal year 2024-25, 1.5-percent in 2025-2026, and then a rate to be determined by the Department of Health Care Policy and Financing (HCPF) in the following years. Targeted funding will supplement the needs of facilities that serve residents with severe mental health conditions, severe dementia and acquired brain injuries. This law increases the core per diem rate combined with a new supplemental payment for facilities with disproportionately high Medicaid utilization, facilities that are geographically critical to ensuring access to care, and facilities that admit compassion release individuals will result in HCPF receiving more than $62 million this year to support Colorado’s nursing facilities. To ensure financial transparency, nursing facilities will be required to submit audited financial statements to HCPF.
Currently, Colorado’s nursing home facilities can report costs that have already been
reimbursed by Medicare for Medicaid reimbursement, but due to complications from funding sources, nursing facilities are not currently being reimbursed for their full costs. HB23-1228 changes this Medicaid reimbursement structure to create a more sustainable, flexible, and innovative reimbursement structure so nursing facilities are getting the full reimbursement they deserve.