Out-of-Network Health Care Provider Reimbursement

House Bill 19-1174 was passed by the Colorado Legislature to help protect patients from surprise out-of-network bills 

The bill includes provisions for how health insurance carriers will reimburse providers (doctors, hospitals and other health care providers) for out-of-network emergency and non-emergency care. 

Legislation and FAQ

HB19-1174 - Out-of-Network Health Care Services

FAQ from Center for Improving Value in Health Care (CIVHC) - CIVHC's Colorado All Payer Claims Database (CO APCD) is specifically identified in the bill as a data source for the implementation of HB19-1174.
 

Division of Insurance Implementation and Timeline 

Five tracks for implemenation

  1. Emergency ambulance services reimbursement methodology regulation
  2. Consumer disclosures regulation
  3. Arbitration program process and arbitrator selection regulation
  4. Regulation establishing payment methodologies for out-of-network providers that utilize CIVHC / health insurance carrier data 
  5. Out-of-network utilization reporting and terminology regulation  

Regulations Timeline

 


Contact Information
Division of Insurance, Colorado Department of Regulatory Agencies
1560 Broadway, Suite 850
Denver, CO 80202