Colorado Code § 25-3-705

Health-care charge transparency - hospital charge report - definitions
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(1) 
The commissioner of insurance shall work with the duly constituted association of hospitals
selected by the executive director for assistance in carrying out the purposes of this section.
(2) (a) On or before August 1, 2009, and on or before each August 1 thereafter, each
hospital licensed pursuant to part 1 of this article shall report annually to the association of
hospitals the information necessary to allow the association to determine the charges for the
twenty-five most common inpatient diagnostic-related groups for which there are at least ten
cases rendered by the hospital during the calendar year immediately preceding the release of the
hospital charge report. If a hospital does not have twenty-five of the most common diagnostic-
related groups with at least ten or more cases rendered, the hospital shall report only on those
most common diagnostic-related groups that have at least ten cases rendered.
(b) A hospital that does not use diagnostic-related groups is exempt from paragraph (a)
of this subsection (2).
(3) (a) The commissioner of insurance shall work with the association of hospitals to
incorporate the information reported pursuant to this section on the website.
(b) The commissioner of insurance shall require the association of hospitals to submit a
plan to the commissioner on or before November 30, 2008, that states the implementation status
of a plan to make the hospital charges reported pursuant to this section available to the public on
the website. The plan shall identify the process and time periods for implementation, any barriers
to implementation, and recommendations of changes in the law that may be enacted by the
general assembly to eliminate the barriers.
(c) When developing the required plan, the association of hospitals shall consider:
(I) The method for hospitals to report charges to the association;
(II) Standards that provide for the validity and comparability of hospital charges; and
(III) The format for making hospital charges available to the public.
(4) (a) The association of hospitals shall make the information reported by the hospitals
pursuant to this section available on the website on or before August 1, 2009, and on or before
August 1 of each year thereafter. The information reported by the hospitals shall include
disclaimers regarding factors including case severity ratings and individual patient variations
that may affect actual charges to a patient for services provided.
(b) The information reported by the hospitals that is published in accordance with this
section shall include:
(I) Volume of cases by diagnostic-related group required to be reported by the hospital;
(II) Rank by volume of the top twenty-five diagnostic-related groups required to be
reported by the hospital;
(III) Mean charge for each of the top twenty-five diagnostic-related groups with more
than ten occurrences by hospital;
(IV) Case severity rating by hospital by diagnostic-related group; and
(V) A general disclaimer statement regarding the hospital variations and patient
variations that affect the actual charges to patients.
(c) Before publication of the information published pursuant to this section on the
website, the commissioner shall ensure that every hospital is allowed thirty days within which to
examine the data and submit comments for consideration and inclusion in the final hospital
charge report.
(5) (a) The commissioner of insurance shall approve the publication of information on
the website consisting of public disclosure of charge data assembled pursuant to this section. At
a minimum, the information shall be made available on the website in a manner that allows
consumers to conduct an interactive search to view and compare the information for specific
hospitals. The website shall include any additional information necessary to ensure that the
website information is available to consumers and health-care purchasers. The information shall
include, at a minimum, appropriate guidance on how to use the data and an explanation of why
the data may vary from hospital to hospital. The report specified in this subsection (5) shall be
released on the website on or before August 1, 2009, and on or before each August 1 thereafter.
(b) The commissioner of insurance shall make the website available by hyperlink on the
division of insurance website.
(c) The division of insurance shall review the information posted on the website to
ensure that the website and information provided by the association is easy to navigate, contains
consumer-friendly language, and fulfills the intent of this section. The division shall also ensure
that the hyperlink from the division's website to the website is easily accessible.
(6) There shall be no liability on the association of hospitals or a cause of action against
the association or its agents, employees, or directors or authorized designees of the
commissioner for actions taken or omitted in the performance of duties pursuant to this section.
(7) Repealed.
(8) As used in this section:
(a) "Charge" means the amount that a hospital expects to charge for an inpatient
diagnostic-related group. A charge that is required to be reported to the public shall be the mean
charge for all cases of the diagnostic-related group occurring in the calendar year prior to the
release of the hospital charge report.
(b) "Diagnostic-related group" means the classification assigned to an inpatient hospital
service claim based on the patient's age and sex, the principal and secondary diagnoses, the
procedures performed, and the discharge status.
(c) "Website" means a website established by the association of hospitals that links to
the website created pursuant to section 25-3-703.

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