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On April 15, 2019 HB 19-174 was amended and referred to the CO Senate Finance Committee. The bill would do the following: 1) Require physicians to provide patients with informaiton regarding out of network (OON) services provided at in-network facilities, 2) Establishes an OON reimbursement method for OON providers generally and OON emergency services in particular; 3) Creates a penalty of OON physicians who fail to comply with notice and billing requirements.

The bill is an unfair rate-setting tool, promoted and funded by the insurance industry.  The House bill sets OON rates for OON providers at in network hospitals and emergency physicians to “median in network rates” which the health plans alone will control.  The rate setting will likely impact existing and future participation agreements and ignores more patient protective, market-based solutions that are proposed in SB 19-134.  While Zotec and our industry partners support removing patients from the middle and physicians support transparency, we cannot support HB 19-1174. If passed, HB 19-1174 could have a negative impact on all hospital-based physicians, especially those who work directly with emergency departments and hospitals. Hospitalists, radiologists and other specialties would be affected, and emergency medicine physicians would likely see the greatest impact. In fact, a recent ACEP report cites Colorado as already having the worst compensated emergency physicians in the entire country.

Luckily, SB19-134 would solve the out-of-network issue by saving patients and insurers money in a fair and balanced manner, but that bill is currently moving its way up through the senate.

Call to Action:

We need your help TODAY! Please contact members of the Colorado Senate and urge them to support passage of SB 19-134 to halt the progress of HB 19-1174. Our ZPAC campaign will allow you to get this message in front of your state senators in the click of a button.


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