American Society of Plastic Surgeons
For Consumers

Colorado: Stop Ban on Balance Billing

Colorado state Representative Daneya Esgar introduced out-of-network legislation that would unfairly reimburse physicians in the state, and ASPS quickly activated efforts to thwart advancement of the measure. Over the past few years, the Colorado legislature has worked to provide patients with a legislative solution to address concerns over balance billing, and lawmakers were determined to pass a measure in the 2019 legislative session to uphold their promises to constituents.

Unfortunately, H.B. 1174 was not the comprehensive solution that Coloradoans deserved and was fast-tracked through the legislature without careful deliberation about the negative implications the measure would have on patients in the state. ASPS had serious concerns with H.B. 1174 because it would set out-of-network reimbursement for emergency care at 105 percent of the median in-network rate and would force out-of-network providers to accept an even more discounted reimbursement rate for elective, out-of-network care.

ASPS submitted comments in opposition to the bill to the Senate Finance and Judiciary Committee requesting that the bill be amended to establish a fair physician fee schedule that cannot be manipulated by the state's insurance carriers. Additionally, the Society requested that the Committees include more robust notification requirements for both insurers and facilities so patients are fully informed and can make informed health care decisions. The Society also reiterated those concerns in comments to members of the Senate and legislative leadership in advance of a floor vote on the measure.

Unfortunately, ASPS's efforts to work with the legislature to amend the bill were ignored throughout the process. Despite ASPS's concerted efforts to amend this measure, the legislation passed the Colorado state Legislature and was signed into law by newly-elected Governor Jared Polis on May 14, 2019.