s_hhs_2018a_2018-02-14t10:02:43z3 Hearing Summary

Senators Kefalas and Smallwood, co-prime sponsors, presented Senate Bill 18-146.  The bill requires freestanding emergency departments (FSED) to provide certain written and oral disclosures to a patient before and after screening for an emergency condition.  The State Board of Health may promulgate rules to implement and enforce these disclosure requirements.



      Prior to screening a patient, the FSED must provide a written statement to patients that lists the patient's rights, which  FSED staff must also explain orally to the patient.  This written statement must indicate that:

• the FSED will screen and treat the individual regardless of their ability to pay;
• the individual has a right to ask questions about treatment options and costs and to receive a prompt and reasonable response;
• the individual has a right to reject treatment;
• the FSED encourages the individual to defer questions until after being screened for an emergency medical condition; and
• the facility is an emergency medical facility that treats emergency conditions and that it is not an urgent care center or primary care provider.

      In addition, the FSED must post a sign that states the public and private health plans that it accepts, indicates the insurance networks in which it participates, and lists the prices for the 25 most common health services it provides.  If an FSED determines that a patient does not have an emergency condition after the initial screening, it must provide an additional written disclosure that:

• lists its prices and indicates that the prices are the maximum charge that any patient will be billed and that the actual charge may be lower based on health insurance benefits, discounts, and financial assistance;
• includes a statement urging a person covered by a health insurance plan to contact his or her insurer about his or her financial responsibility and for a person without health insurance to contact the FSED's financial services office to discuss payment options and availability of assistance before receiving treatment; and
• provides information on facility fees that the FSED charges.

      The written disclosure must also be posted on the FSED website and updated at least once every six months.  The disclosure must be available in languages appropriate to the communities served by the FSED.

Dr. Nate Hibbs, American College of Emergency Physicians, testified against the bill. Dr. Hibbs responded to questions.

Dr. Adrian Miranda, National Association of Freestanding Emergency Centers, testified against the bill. Dr. Miranda responded to questions from the committee. Committee comments followed.

Joshua Ewing, Colorado Hospital Association, provided a handout (Attachment A) to the committee and testified against the bill.  Mr. Ewing responded to questions from the committee.  

Committee members dialogued with Mr. Ewing.

Amendments L.002 (Attachment B), L,003 (Attachment C), L.004 (Attachment D), and L.005 (Attachment E) were distributed to the committee.

Committee members dialouged with Mr. Ewing.

Dr. Hibbs responded to committee concerns.

Caitlin Westerson, Colorado Consumer Health Initiative (CCHI), provided a handout to the committee and testified in support of the bill (Attachment F).

Jim Mullin, representing himself, testified in support of the bill.

Peter Severson, representing himself, testified in support of the bill.

Bethany Pray, Colorado Center on Law and Policy, testified in support of the bill.

Randy Kuykendall, Colorado Department of Public Health and Environment, responded to questions from the committee.

Senator Smallwood made closing comments.

Senator Smallwood discussed amendments L.002, L.003, and L.004. He commented on L.005. Committee members discussed the amendments.

Committee members discussed amendment L.005. Senator Martinez Humenik withdrew amendment L.005 (Attachment E).

Senator Kefalas made closing comments.