DATE: February 23, 2023

CONTACT: Katie Reinisch,, 303-653-1009

Priya Telang,, 313-820-2428

HB23-1215 would limit “facility fees” and bring fairness and transparency to medical billing for hardworking Coloradans

DENVER – A bill introduced yesterday by state Representatives Emily Sirota (D-Denver) and Andrew Boesenecker (D-Fort Collins) and Senators Kyle Mullica (D-Thornton) and Lisa Cutter (D-Littleton), backed by the Health Care without Hidden Costs coalition, would make health care more affordable for Coloradans. House Bill 1215 limits hidden medical costs – sometimes called facility fees – charged by hospitals that often result in an extra out-of-pocket expense for patients simply for walking through the door.

These facility fees are billed to patients on top of what they pay for the cost of medical services through insurance, and can vary widely – from hundreds to thousands of dollars. Patients rarely know when or why these fees are added to a bill, making health care costs next to impossible to predict or plan for. 

HB23-1215 would limit where and when facility fees can be charged, including banning them for telehealth services. It would also strengthen consumer reporting so Coloradans will have access to data that will give them a clear picture of health care costs and charges. 

“I’m proud to sponsor HB23-1215 to reduce health care costs and bring more transparency and fairness to our health system,” said Rep. Emily Sirota. “We have heard from patients across Colorado who are getting bills with unexpected fees of over a thousand dollars with no explanation on top of what they pay through insurance. Facility fees are simply another way that hospital CEOs are lining their pockets at the expense of patients, and we simply can’t let this continue.”  

Families around Colorado have faced egregious facility fee charges.

A recent investigation from FOX31 Problem Solvers found that a Colorado Springs family was charged a facility fee of over $2,500 after taking their 5-year-old son to a pediatric neurologist for a brain scan. After paying $238 out of pocket for the 90-minute visit and scan, the family received a separate bill for “hospital services.”

“We did the right thing, we made sure the specialist was in our network, double checked our co-pay, and they never disclosed that I would be charged an extra fee before any appointment,” said Diane Kruse of Conifer. “The extra fee almost doubled the out-of-pocket cost for each appointment with the specialist. We would have chosen a specialist at a different location and avoided the facility fee if we had been told we were going to be charged an additional $140-$195 every time. Colorado needs to regulate when and where facility fees are being charged, and providers need to notify patients beforehand about any cost changes.”

According to the 2021 Colorado Health Access Survey, 1 in 5 Coloradans received a medical bill they weren’t expecting in the past year. Among those who received a surprise bill, more than a third struggled to pay their bills. The survey also found that among those who struggled to pay medical bills, over half took on credit card debt and 39% were unable to pay for necessities like food, heat, or rent.

“No one should have to make the choice between paying for health care or paying for groceries or heat, especially when these fees are in the fine print during regular health care visits with no explanation of what these fees are for,” Sen. Kyle Mullica said. “Limiting most facility fees is a targeted solution that will save hardworking Colorado families money, and make health care costs more transparent.” 

Corporate hospital chains are merging and buying up clinics across Colorado, then turning around and charging unchecked facility fees because they own most of the facilities in town and consumer have nowhere else to turn. 

“Facility fees are not covered by insurance and are not required to be disclosed to patients beforehand. Coloradans should not be held responsible for paying hidden fees for medical care,” said Rep. Andrew Boesenecker. “These unexplained charges are a barrier to affordable health care that can drain a family’s bank account. It’s time to stand up for patients by demanding more transparency and lower costs.”

“Patients seeking care are receiving medical bills with hidden fees that are hundreds of dollars higher than expected and often exceed the cost of medical care,” said Sen. Lisa Cutter. “Hospitals cannot continue to charge outrageous facility fees unchecked. HB23-1215 will limit when and where facility fees can be charged and help protect the thousands of people in Colorado who have been hit with these charges when they are struggling to recover from an illness or accident.”

HB23-1215 is backed by Health Care without Hidden Costs, a coalition of dozens of organizations and individuals focused on making health care more transparent and affordable. 

“We’ve heard from too many Coloradans who’ve been caught off guard by hospital systems and their hidden costs.” said Austin Blumenfeld, Executive Director of Centennial State Prosperity. “Thank you Representatives Sirota and Boesenecker and Senators Mullica and Cutter for taking action to make health care more transparent and affordable for hardworking Coloradans. This bill will curb these hidden fees saving Coloradans money and putting patients above hospital profits.”  

“As hospital systems consolidate, we’ve noticed an increasing trend of facility fees being tacked onto outpatient visits, putting health care ever more out of reach,” said Isabel Cruz, Policy Manager of the Colorado Consumer Health Initiative. “Too many Colorado families, insured or not, avoid medical care because of the high cost, and these additional charges are just another barrier to getting the care they need. HB23-1215 will limit where hospital systems can charge these hidden fees and further protect consumers.”

“People should be allowed the peace of mind that they can afford and access the care they need – they don’t also need to worry about getting charged exorbitant fees on top of their medical bill.” said Caitlin Westerson, State External Affairs and Partnerships Director at United States of Care. “We’re proud to support HB23-1215, which will protect patients seeking care by prohibiting these fees in certain settings, such as primary care and other outpatient offices, and increase transparency when they are charged. Part of a dependable health system is knowing what you’re going to pay beforehand and this bill builds on the work Colorado has done to create an affordable health care system that is responsive to patient needs.”

“One-third of Colorado small business owners said policymakers should prioritize bringing down the cost of healthcare during the 2022 legislative session. A recent national poll revealed that healthcare costs remain a top priority for small business owners, with 71% ranking it a top concern,” said Lindsey Vigoda, Colorado Director, Small Business Majority. “Surprise hospital facility fees are drivers of high healthcare costs and financial burdens for Colorado small business owners. We are happy to support this legislation that will curb fees, make healthcare more transparent, and give entrepreneurs the relief from rising healthcare costs they’ve been calling for.”

“As a physician, I see everyday how high health care costs, including so-called ‘facility fees’, prevent patients from seeking the care they need, or else saddling them with crushing medical debt,” said Dr. Michael Belmonte, obstetrician-gynecologist in Aurora and member of the Committee to Protect Health Care. “This legislation to help rein in facility fees is a welcome step from lawmakers, and one that will help ensure Coloradans can access health and life-saving care without unfair, burdensome charges from hospitals. Doctors and patients alike look forward to its passage.”

“Patients should not face unexpected, hidden fees just for walking through the door of their doctor’s office,” said Milena Castaneda, Policy Fellow, Colorado Center on Law and Policy.  “Facility fees are another example of hospital systems prioritizing profits over patients. These additional costs increase barriers to accessing health care and this bill is a step towards a more fair, affordable health care system for Colorado patients.”

While Colorado families struggle to afford critical health care needs, a recent report from the Colorado Department on Health Care Policy and Financing found that hospitals are experiencing growing profits and margins overall. Specifically, from 2018 through 2020, Colorado hospitals were ranked in the Top 10 nationally for costs, prices and profits.



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