Hospital Discounted Care

Page Updated: May 16, 2024

CHA Advocacy Principle: Reforms should support affordability through transparency, accountability, and shared responsibility, including from state agencies implementing legislation.

What Has Been Completed:

Origin: House Bill 21-1198, which went into effect Sept. 1, 2022, codifies charity care laws and establishes requirements for how hospitals screen, bill, and collect payments from low-income patients.

Background: The rules govern the process for how hospitals screen, bill, and collect payments from low-income patients. They cover any medically necessary services provided in acute care and critical access hospitals, as well as freestanding emergency departments.

Outstanding Items:

CHA continues to work with members to identify and address operational barriers to success through both the regulatory and legislative process.

CHA led passage of SB 24-116 to make five key changes to Hospital Discounted Care:

  1. Medicaid: The bill allows all hospitals to serve as presumptive eligibility sites to get patients temporary coverage. Currently, patients who are eligible for Medicaid, but not enrolled, do not have an expedited pathway to gain access to coverage or a requirement to apply. HCPF will conduct training for hospitals that wish to become presumptive eligibility sites starting in fiscal year 2026-27.
  2. Physician Reporting: The bill removes hospitals from an inappropriate middleman role aligning reporting requirements for physicians.
  3. Inconsistent Billing Caps: The bill allows hospitals to bill up to 6% of a patient’s gross monthly income when the hospital is billing on behalf of physicians. Current law allows hospitals to bill up to 4% and physicians up to 2%, consistent with the HDC fee schedule. However, this structure doesn’t effectively recognize instances where the hospital bills on behalf of an employed physician.
  4. Scope of Hospital Services: The bill excludes primary care provided in rural health clinics from HDC. Current law applies to all services under the hospital’s license, which inappropriately includes many services outside of the scope of HDC.
  5. Colorado Residency: The bill clarifies that an individual must attest to residing in Colorado to be eligible for HDC. This change codifies current practice.

These changes will be effective Aug. 1, 2024. CHA will help support with implementing these changes.


Hospital Discounted Care HCPF Contact Information: [email protected]

Meetings/Dates of Note:

CHA Staff Contact: CHA Staff Contact: Adeline Ewing, CHA manager of public policy, [email protected]