Statutes, codes, and regulations
Colorado Administrative Code
Department 700 - Department of Regulatory AgenciesDivision 719 - Division of Professions and Occupations - State Board of Pharmacy
Rule 3 CCR 719-1 - STATE BOARD OF PHARMACY RULES AND REGULATIONS
Section 3 CCR 719-1-32.00.00 - CONCERNING HEALTH CARE PROVIDER DISCLOSURES TO CONSUMERS ABOUT THE POTENTIAL EFFECTS OF RECEIVING EMERGENCY OR NONEMERGENCY SERVICES FROM AN OUT-OF-NETWORK PROVIDER

3 Colo. Code Regs. § 719-1-32.00.00

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Current through Register Vol. 47, No. 20, October 25, 2024
Section 3 CCR 719-1-32.00.00 - CONCERNING HEALTH CARE PROVIDER DISCLOSURES TO CONSUMERS ABOUT THE POTENTIAL EFFECTS OF RECEIVING EMERGENCY OR NONEMERGENCY SERVICES FROM AN OUT-OF-NETWORK PROVIDER
A. Basis: The basis for this rule is to implement the requirements of section 12-30-112, C.R.S., in consultation with the Commissioner of Insurance and the State Board of Health.
B. Purpose: The purpose of these rules and regulations is to establish the requirements for healthcare providers to provide disclosures to consumers about the potential effects of receiving emergency or non-emergency services from an out-of-network provider as required by section 12-30-112, C.R.S.
C. Definitions, for purposes of this Rule, are as follows:
1. "Publicly available" means, for the purposes of this regulation, searchable on the healthcare provider's public website, displayed in a manner that is easily accessible, without barriers, and that ensures that the information is accessible to the general public, including that it is findable through public search engines. The health care provider's public website must be accessible free of charge, without having to establish a user account, password, or other credentials, accept any terms or conditions, and without having to submit any personal identifying information.
D. Disclosure requirements.
1. An out of network provider may balance bill a covered person for post-stabilization services in accordance with section 10-16-704, C.R.S., and covered nonemergency services in an in-network facility that are not ancillary services if the provider meets the requirements set forth in section 12-30-112 (3.5), C.R.S. If a consumer has incurred a claim for emergency or nonemergency health care services from an out-of-network provider, the health care provider shall provide the disclosures contained in Appendix F in compliance with section 12-30-112 (3.5), C.R.S.
2. The health care provider shall provide the disclosure contained in Appendix F as set forth in section 12-30-112 (3.5), C.R.S.:
E.Noncompliance with this Rule may result in the imposition of any of discipline made available by section 12-280-126(1)(c), C.R.S. Appendix A

3 CCR 719-1-32.00.00

37 CR 18, September 25, 2014, effective 10/15/2014
38 CR 16, August 25, 2015, effective 9/14/2015
39 CR 04, February 25, 2016, effective 3/16/2016
39 CR 19, October 10, 2016, effective 11/14/2016
40 CR 04, February 25, 2017, effective 3/17/2017
40 CR 20, October 25, 2017, effective 11/14/2017
41 CR 16, August 25, 2018, effective 9/17/2018
42 CR 21, November 10, 2019, effective 11/30/2019
43 CR 10, May 25, 2020, effective 5/1/2020
43 CR 08, April 25, 2020, effective 5/15/2020
43 CR 15, August 10, 2020, effective 8/30/2020
43 CR 20, October 25, 2020, effective 11/14/2020
44 CR 04, February 25, 2021, effective 3/17/2021
44 CR 08, April 25, 2021, effective 5/15/2021
44 CR 21, November 10, 2021, effective 11/30/2021
45 CR 20, October 25, 2022, effective 9/29/2022
45 CR 21, November 10, 2022, effective 11/30/2022
46 CR 21, November 10, 2023, effective 11/30/2023