Insights

Surprise Billing Law Effective January 1, 2020


On May 14, 2019, Gov. Polis signed HB19-1174, which aims to limit surprise billing by capping the amount that out-of-network providers can charge persons covered by Colorado state-regulated insurance plans at an in-network facility. The law also applies to out-of-network providers or facilities that provide emergency services to such covered persons. Additionally, the law provides for an arbitration process when a health care provider or facility has a dispute with the amount paid under these circumstances. The law requires health insurance carriers, health care providers, and health care facilities to provide patients covered by health benefit plans with information concerning the provision of services by out-of-network providers and in-network and out-of-network facilities.

The law imposes no new employer compliance obligations, but employers with fully insured plans should be aware of this law. The law is effective as of January 1, 2020.

Surprise Billing Law »
Arbitration Process »
Disclosure Rules »