Hospital Discounted Care

​​​​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.   

2022-23 Hospital Discounted Care Operations Manual

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 11:00 a.m. through September. Additional dates in October and beyond may be added if requested.

Hospital Discounted Care Office Hours, Wednesdays at 9:00 a.m.

Call in number: +1 720 707 2699

Meeting ID: 869 6160 7891
Passcode: 581600

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.

Hospital Discounted Care - Patient Information Page

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 Frequently Asked Questions

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. 

Hospital Discounted Care Rates

Implementation

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:  The meeting on January 20, 2022 was geared toward providers: 

An additional stakeholder meeting was held on February 16, 2022.

Training
Hospital Discounted Care Policies and Procedures

Recording

Training Handouts

Uniform Application for Hospital Discounted Care and CICP

Recording

Training Handouts

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

Screening Application Processes Recording

Training Handouts

Screening and Application Processes Training Slides

Screening and Application Processes for Note Taking

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

Payment Plans and Collections Recording

Training Handouts

Payment Plans and Collections Training Slides

Payment Plans and Collections for Note Taking

Uniform Application

Training on the Uniform Application, including updates made to the application since the training sessions in May.

Register:

Tuesday Aug. 23, 10 a.m.-1 p.m.

Thursday Aug. 25, 1-4 p.m.

Question and Answer Session

Uniform Application Training Slides

Rules

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. 

Updates and Communications
Contact Information

Email:  HCPF_HospDiscountCare@state.co.us