Colorado panel advances bill to streamline out‑of‑network emergency payment disputes

Senate Bill 17, legislation aimed at reducing administrative burden for physicians who receive out‑of‑network emergency claims, was advanced from the Senate Health and Human Services Committee to the Committee on Appropriations after sponsor amendments were adopted.

Senator Doherty, one of the bill sponsors, told the committee the measure is intended to stop the “claim‑by‑claim arbitration” process that often costs more than disputed amounts and to provide a lower‑cost, efficient pathway for providers. “This bill aims to address the problem by seeking to batch similar out‑of‑network claims to, efficiently determine if reimbursement was appropriate,” Doherty said during opening remarks.

The bill’s three core changes, as summarized by co‑sponsor Andrew Bridal, are to codify the Division of Insurance (DOI) rule that offers an alternative dispute process; to extend Colorado’s prompt‑payment statute when DOI finds that a provider was underpaid; and to require health plans to include remittance details so providers can determine whether claims fall under state law or the federal No Surprises Act. Bridal said the bill “does not change the statutory defined reimbursement formula nor does it remove or compromise any patient protections.”

Witnesses from multiple perspectives testified. Kevin McFatridge of the Colorado Association of Health Plans said his organization was in an “amend” position and requested edits to remittance‑advice language and other technical fixes but expressed appreciation for stakeholder engagement. Emergency physicians described clinical scenarios in which immediate care is provided without inquiry about insurance status and said SB 17 would not change reimbursement rates but would make dispute resolution more accessible. “When the division of insurance determines that a physician was underpaid, the bill ensures that those funds are paid promptly,” said Dr. Jasmeet Dhaliwal of the Colorado chapter of the American College of Emergency Physicians.

During the amendment phase the sponsors offered and the committee adopted a package of technical and stakeholder‑driven changes (amendments L2–L7). Key changes included striking reporting requirements tied to a fiscal note (L2), clarifying proprietary treatment of shared information (L3), removing certain references to federal law (L5 and others) and extending the enactment timeline to give insurers time to update programming; one amendment (L6) also removed an explicit reference to the commissioner’s authority to issue fines and substituted language from the DOI.

After closing remarks emphasizing stakeholder compromise, Senator Bright moved SB 17 as amended to the Committee on Appropriations with a favorable recommendation; the committee adopted the motion and advanced the bill.

Next steps: SB 17 will be considered by the Committee on Appropriations; no final enactment date was set in committee.