HB 18-1358: Comprehensive Health Care Billing Transparency Act

• Health care facilities, providers, and pharmacies must publish fee schedules and chargemasters starting January 1, 2019, in accessible online formats and in printed form upon request, showing charges before any discounts or adjustments.

• Facilities and providers must include itemized details in patient bills showing each service provided, its charge, and how insurance payments were applied to each line item; hospitals must separately itemize healthcare affordability and sustainability fees.

• Facilities and providers must disclose to patients providing insurance information whether they participate in the patient's plan, whether services are covered as in-network or out-of-network benefits, and whether out-of-network providers at in-network facilities can balance bill.

• Health insurers must publish contract terms, cost-sharing arrangements, and prescription drug prices on their websites starting January 1, 2019, and annually disclose rebates and other remunerations received from drugs or medical devices.

• Facilities and providers cannot bill patients or payers more than the lower of established self-pay rates or lowest third-party rates if they fail to publish fee schedules; pharmacies must publish retail drug prices or face state board discipline.