The impact of HB19-1174 on Direct Entry Midwives in Colorado - Consumer Protection for "surprise billing."

What is HB19-1174?

HB19-1174 is designed to protect consumers from “surprise billing,” as a result of healthcare encounters, especially with out-of-network providers.  You can find HB19-1174 here, and a good explanation of the bill here.  This legislation goes into effect January 1, 2020, and applies to all providers regulated by DORA, including Direct Entry Midwives (DEMs). 

What does DORA have to do with this legislation?

The legislation empowers the Department of Regulatory Agencies (DORA) to create rules and the disclosure documentation required of all out-of-network providers and facilities.  Elephant Circle attended DORA’s stakeholder meeting and the emergency rule-making hearing about the rules that pertain to DEMs.  You can view a copy of the rules that passed the emergency hearing here.  Final rules will be implemented 120 days after Jan 1 2020.

How does this affect Colorado DEMs?

The bottom line is that this legislation applies to providers who take insurance regulated by the Department of Insurance, so it rarely applies to DEMs.  I talked with the Deputy Director running the rulemaking hearing and she agreed this legislation will not affect DEMs much (if at all).  Her advice for best practice was twofold:

  1. If you have an office, hanging the documentation provided by the rulemaking process in a visible location would suffice generally.

  2. If you are ever an out-of-network provider, provide the documentation directly to the client.

As always, reach out with questions, comments, or concerns!