House Bill (HB) 21-1198, otherwise known as Health Care Billing Requirements for Indigent Patients, establishes requirements for hospital discounted care for low income patients. They will be given the opportunity to apply for financial assistance or charity care programs at the health care facility where they receive care. Service charges will be the greater of either the Medicare rate or Medicaid base rate. Payment plans that are established to pay the bills may not exceed four (4) percent of the patient's monthly household income. For bills from health care professionals, the limit is two (2) percent of the monthly household income. Once 36 payments have been made, the remainder of the bill is forgiven. HB 21-1198 will also set rules for hospitals that limit collections against a patient.
- CICP Provider Directory
- Hospital Discounted Care - Patient Information Page
- Hospital Discounted Care Frequently Asked Questions
- Hospital Discounted Care Rates
- Sign up for the Hospital Discounted Care Newsletter
- Uniform Application - PDF version for Providers to post on website to meet posting requirements, Updated July 2023
- Uniform Application - Version 1.5, Effective July 24, 2023
- Hospital Discounted Care Maximum Payment Calculator (Excel) - Effective April 1, 2023
- Federal Poverty Guidelines, April 2023 - March 2024
- 2022-23 Hospital Discounted Care Operations Manual
- 2022-23 Hospital Discounted Care Manual - Updated January 2023
- Hospital Discounted Care and Licensed Health Care Professionals FAQs
- Federal Poverty Guidelines April 2022 - March 2023
- Screening, Application, and Screening Best Efforts Flowcharts
- CICP Patients Flowchart
Questions about the policies and procedures contained in the Operations Manual can be sent to hcpf_HospDiscountCare@state.co.us. In your email, please include the article and/or section number your question stems from.
- Office Hours
The Department will be holding Office Hours for Hospital Discounted Care providers to attend as needed to ask questions about the rules, policies, implementation, integration with CICP, etc. No advance registration is required. Office Hours will be every Wednesday from 9:00 to 10:00 a.m.
Office Hours will not be held November 22, 2023 or December 27, 2023.
Call in number: +1 720 707 2699
Meeting ID: 960 6539 2091
Office Hours Discussion Topics
- November 29- Screening
- December 6- Determination Letters
- December 13- Application Timeframe
- December 20- Patient Rights
- Patient Rights
Per HB 21-1198, The Department of Health Care Policy and Financing (the Department) developed a Patient's Rights form using feedback from numerous stakeholders. The form is provided below in both English and Spanish and has been updated to reflect the September 1 effective date.
Effective September 1, 2022, Health Care Facilities, which include general acute care or critical access hospitals or free standing emergency departments must have this patient's rights form available to the public and to each patient. This includes:
- Posting the Spanish and English patient's rights form conspicuously on the Health Care Facilities website, including a link to the information on the Health Care Facilities main landing page;
- Make the form available in patient waiting areas;
- Make the information available to each patient, or the patient's legal guardian, verbally, which may include using a professional interpretation service, or in writing in the patient's or legal guardian's preferred language before the patient is discharged from the Health Care Facility; and
- Inform each patient or the patient's legal guardian on the billing statement of the patient's rights. Including the right to apply for discounted care, and provide the website, email address, and telephone number where the information may be obtained in the patient's preferred language.
- Decline Screening Forms
Patients may decline the screening for public health care coverage and/or discounted health care. The decision to decline screening is not final.
Generally, a decline screening form only covers one episode of care and any services provided related to the original episode of care. A decline screening form may cover additional past dates of service if the patient or their guardian signs a decline screening form that notes those specific past dates of service or a past date range that includes those specific past dates of service. A decline screening form cannot be collected for dates of service that have not occurred yet and are not related to a previous episode of care.
A patient’s decision to decline the screening that is documented and complies with Colorado Department of Health Care Policy and Financing CCR Rule is a complete defense to a claim brought by a patient under CSR Section 25.5-3-506 (2) for a violation of CSR Section 25.5-3-506 (1)(a) OR (1)(b).
- What Services are Covered?
Health care services covered include any services received in a general acute care or critical access hospital or free standing emergency department. Services provided by health care professionals in these settings are also covered. HB 21-1198 requires that all uninsured patients be screened for eligibility for Health First Colorado, CHP+, Medicare, Emergency Medicaid, the CICP, and discounted health care. Uninsured patients must be screened or formally waive their screening. Insured patients may request to be screened.
- Hospital Discounted Care Rates
Rates for Hospital Discounted Care and the Maximum Payment Calculator are now available online. Hospital Discounted Care limits the cost of hospital care for low income, uninsured Coloradans receiving services through hospitals’ financial assistance. Rates approximate 100% of Medicare or 100% of Medicaid, whichever is greater. These rates are the maximum that can be charged for hospital services under Hospital Discounted Care.
Hospital Discounted Care directs the Department to set outpatient/inpatient/professional base rates for all CPT codes or facilities based on the greater of either Medicaid rates or Medicare rates. Any CPT code that is assigned a $0 rate has neither a Medicaid or Medicare set rate.
Rates are effective September 1, 2022 and will be updated annually by July 1. Contact us by email at the Hospital Discounted Care inbox hcpf_HospDiscountCare@state.co.us with any questions regarding these rates.
The Department is working on the implementation of this Bill, which will begin on September 1, 2022. On this date, hospitals will be expected to screen patients to determine whether they are eligible for the discounted care. Health care professionals will also be subject to a maximum they can bill a qualified patient. Also, certain limitations to collection actions will begin for hospitals and health care professionals.
If you would like to stay up to date with the implementation process and receive information on how you can participate, you can sign up to receive the Hospital Discounted Care newsletter.
- Stakeholder Meetings
The Department held three Stakeholder meetings in January. They were held on January 18, 19 and 20, 2022.
The meetings on January 18 and 19, 2022 were for stakeholders and advocates:
- Meeting Agenda and Presentation
- Spanish Presentation
- Draft Patients Rights
- Draft Opt-Out Form
- Jan. 19, 2022 Meeting Recording
- Jan. 19, 2022 Spanish Meeting Recording
The meeting on January 20, 2022 was geared toward providers:
An additional stakeholder meeting was held on February 16, 2022.
- Spring Training 2023
Screening and Applications
- Screening and Applications Recording
- Screening and Applications Slides
- Screening and Applications Slides - Notes
Payment Plans and Collections
- Payment Plans and Collections Recording
- Payment Plans and Collections Slides
- Payment Plans and Collections Slides - Notes
Data Reporting Template
Hospital Discounted Care Policies and Procedures
Uniform Application for Hospital Discounted Care and CICP
- Uniform Application for Hospital Discounted Care and CICP Training Slides
- Uniform Application for Hospital Discounted Care and CICP for Note Taking
Screening and Application Process
Reviewing the Screening and Application processes for patients, including but not limited to timelines, screening best efforts, and decline screening form.
Screening Application Process Training
Payment Plans and Collections
Covering payment plans and collections processes, including but not limited to guidance on starting, adjusting, combining and/or ending payment plans, collections timeline for uninsured vs insured patients, and collections for patients who were approved for HDC vs those who opted out.
Payment Plans and Collections Training
Question and Answer Session
Uniform Application Training Slides
The rules for Hospital Discounted Care were finalized at the May Medical Services Board meeting. The current version of the Hospital Discounted Care rules can be accessed here and on the Secretary of State website. The rules begin at section 8.920.
- Inzata - Data Reporting
- Data Reporting
The first data reporting for Hospital Discounted Care will be due to HCPF by September 1, 2023. It will cover September 1, 2022 through June 30, 2023. Data will be submitted to Inzata through their portal. HCPF has created an Excel template for the data submission, linked below. There is also a file that shows which data elements are required and which are optional. Please note that any elements not included in the data reporting may be subject to a more thorough audit in order for HCPF to meet statutory requirements.
HDC Hospital Data Template - Blue columns indicate required data, grey columns indicate optional data. Required data fields also have a star in the column headings.
- Updates and Communications
- October 24, 2023 - Contact Reminder and Office Hours
- October 5, 2023 - Data Reporting and Office Hours
- September 28, 2023 - Updated Rates
- September 15, 2023 - Data Reporting
- August 28, 2023 - Data Reporting and Licensed Health Care Professionals
- August 7, 2023 - Settings Subject to HDC
- July 25, 2023 - Updated Uniform Application
- June 30, 2023 - Data Template, Rates, and Physicians Renting Space
- June 2, 2023 - Data Submission Portal Webinar
- March 31, 2023 - Updated Application and Calculator
- February 24, 2023 - Spring Training and Decline Screening Forms
- January 17, 2023 - Manual and Application Update, Training
- November 28, 2022 - Office Hours Extension and Patients Rights
- October 17, 2022 - Application and Manual updates, Clinic Determinations, and Office Hours
- September 12, 2022 - Required Information for Websites and Rates Update
- August 25, 2022 - Updated Materials and Flowcharts
- July 27, 2022 - Additional Training and Registration Links