Colo. Rev. Stat. § 25.5-1-902, Definitions

As used in this part 9, unless the context otherwise requires:

(1) Collection action means any of the following actions taken with respect to a debt for items and services that were purchased from or provided to a patient by a hospital on a date during which the hospital was not in material compliance with hospital price transparency laws:

(a) Attempting to collect a debt from a patient or patient guarantor by referring the debt, directly or indirectly, to a debt collector, a collection agency, or other third party retained by or on behalf of the hospital;

(b) Suing the patient or patient guarantor or enforcing an arbitration or mediation clause in any hospital documents, including contracts, agreements, statements, or bills; or

(2) (a) Collection agency means any:

(I) Person who engages in a business, the principal purpose of which is the collection of debts; or

(II) Person who:

(A) Regularly collects or attempts to collect, directly or indirectly, debts owed or due or asserted to be owed or due to another;

(B) Takes assignment of debts for collection purposes;

(D) Collects debt for the department of personnel.

(b) Collection agency does not include:

(I) Any officer or employee of a creditor while, in the name of the creditor, collecting debts for such creditor;

(II) Any person while acting as a collection agency for another person, both of whom are related by common ownership or affiliated by corporate control, if the person acting as a collection agency does so only for creditors to whom it is so related or affiliated and if the principal business of the person is not the collection of debts;

(III) Any officer or employee of the United States or any state to the extent that collecting or attempting to collect any debt is in the performance of the officer's or employee's official duties;

(IV) Any person while serving or attempting to serve legal process on any other person in connection with the judicial enforcement of any debt;

(V) Any debt-management services provider operating in compliance with or exempt from the Uniform Debt-Management Services Act, part 2 of article 19 of title 5;

(VI) Any person collecting or attempting to collect any debt owed or due or asserted to be owed or due another to the extent that:

(A) The activity is incidental to a bona fide fiduciary obligation or a bona fide escrow arrangement;

(B) The activity concerns a debt that was extended by the person;

(D) The activity concerns a debt obtained by the person as a secured party in a commercial credit transaction involving the creditor;

(VII) Any person whose principal business is the making of loans or the servicing of debt not in default and who acts as a loan correspondent, seller and servicer for the owner, or holder of a debt that is secured by a deed of trust on real property, whether or not the debt is also secured by an interest in personal property; or

(VIII) A limited gaming or racing licensee acting pursuant to article 33 of title 44.

(c) Notwithstanding the provisions of subsection (2)(b) of this section, collection agency includes any person who, in the process of collecting the person's own debts, uses another name that would indicate that a third person is collecting or attempting to collect such debts.

(3) (a) Consumer reporting agency means any person that, for monetary fees or dues or on a cooperative nonprofit basis, regularly engages, in whole or in part, in the practice of assembling or evaluating consumer credit information or other information on consumers for the purpose of furnishing consumer reports to third parties. Consumer reporting agency includes any person defined in 15 U.S.C. sec. 1681a (f) or section 5-18-103 (4).

(b) Consumer reporting agency does not include any business entity that provides check verification or check guarantee services only.

(4) (a) Debt means any obligation or alleged obligation of a consumer to pay money arising out of a transaction, whether or not the obligation has been reduced to judgment.

(b) Debt does not include a debt for business, investment, commercial, or agricultural purposes or a debt incurred by a business.

(5) Debt collector means any person employed or engaged by a collection agency to perform the collection of debts owed or due or asserted to be owed or due to another.

(6) Federal centers for medicare and medicaid services or CMS means the centers for medicare and medicaid services in the United States department of health and human services.

(7) Hospital means, consistent with 45 CFR 180.20, a hospital:

(a) Licensed or certified by the department of public health and environment pursuant to section 25-1.5-103 (1)(a); or

(b) Approved by the department of public health and environment as meeting the standards established for licensing a hospital.

(8) Hospital price transparency laws means section 2718 (e) of the Public Health Service Act, Pub.L. 78-410, as amended, and rules adopted by the United States department of health and human services implementing section 2718 (e).

(9) Items and services or items or services means items and services as defined in 45 CFR 180.20.

Source: L. 2023: Entire part added with relocations, (SB 23-252), ch. 305, p. 1866, � 3, effective August 7.

Editor's note: This section is similar to former � 25-3-802 as it existed prior to 2023.

25.5-1-903. Failure to comply with hospital price transparency laws - prohibiting collection of debt - penalty. (1) A hospital that is not in material compliance with hospital price transparency laws on the date that items or services are purchased from or provided to a patient by the hospital shall not initiate or pursue a collection action against the patient or patient guarantor for a debt owed for the items or services.

(2) If a patient believes that a hospital was not in material compliance with hospital price transparency laws on the date that items or services were purchased by or provided to the patient, and the hospital takes a collection action against the patient or patient guarantor, the patient or patient guarantor may file suit to determine if:

(a) The hospital was materially out of compliance with hospital price transparency laws, rules, or regulations on the date the items or services were provided; and

(b) The noncompliance is related to the items or services. The hospital shall not take a collection action against the patient or patient guarantor while the lawsuit is pending.

(3) If a judge or jury, considering compliance standards issued by the federal centers for medicare and medicaid services, finds a hospital to be materially out of compliance with hospital price transparency laws, rules, or regulations, the hospital shall:

(a) Refund the payer any amount of the debt the payer has paid and shall pay a penalty to the patient or patient guarantor in an amount equal to the total amount of the debt;

(b) Dismiss or cause to be dismissed any court action with prejudice and pay any attorney fees and costs incurred by the patient or patient guarantor relating to the action;

(c) Remove or cause to be removed from the patient's or patient guarantor's credit report any report made to a consumer reporting agency relating to the debt; and

(d) Notify the state department of the material noncompliance with hospital price transparency laws, rules, or regulations.

(4) Nothing in this part 9:

(a) Prohibits a hospital from billing a patient, patient guarantor, or third-party payer, including a health insurer, for items or services provided to the patient; or

(b) Requires a hospital to refund any payment made to the hospital for items or services provided to the patient, so long as no collection action is taken in violation of this part 9.

Source: L. 2023: Entire part added with relocations, (SB 23-252), ch. 305, p. 1868, � 3, effective August 7.

Editor's note: This section is similar to former � 25-3-803 as it existed prior to 2023.

25.5-1-904. Transparency - hospitals - standard charges - shoppable services - enforcement. (1) On or before October 1, 2023, each hospital shall make public and post the hospital's medicare reimbursement rates, if applicable.

(2) (a) The state department shall conduct performance assessments for adherence to federal transparency rules by:

(I) Reviewing relevant information provided to the state department concerning a hospital's performance assessment in connection with this section;

(II) Auditing hospital websites for performance relative to federal price transparency rules, and in evaluating performance, the state department shall follow rules, standards, and guidance published by the federal centers for medicare and medicaid; and

(III) Confirming that each hospital submitted the lists required by this section.

(b) If the state department determines that a hospital has performed poorly in its performance assessment, the state department may:

(I) Issue a written notice to the hospital that clearly explains the manner in which the state department determined that the hospital performed poorly on the adherence to price transparency; and

(II) Provide technical assistance to the hospital to improve performance.

(3) On or before February 1, 2024, the state department shall create and maintain a publicly available list on its website of hospitals that perform poorly on the state department's performance assessment. Such notices and communications are subject to public disclosure under 5 U.S.C. sec. 552, as amended, notwithstanding any exemptions or exclusions to the contrary, in full without redaction. The state department shall update the list at least annually.

(4) A person that violates subsection (1) of this section commits a deceptive trade practice under section 6-1-105.

Source: L. 2023: Entire part added with relocations, (SB 23-252), ch. 305, p. 1869, � 3, effective August 7. L. 2024: (2)(a)(II), (2)(b)(I), and (3) amended, (HB 24-1450), ch. 490, p. 3419, � 59, effective August 7.