About this file:

Title: Patient payment for unreimbursed ambulance and related emergency medical services

Description: The Summit County Fire and EMS Fire Protection District (“Fire District”) is aware that some patients have been confused regarding their obligation to pay for the costs the Fire District incurs in providing ambulance and related emergency medical services to its citizens and visitors to the extent the Fire District is not reimbursed by the patient’s insurance carrier, as applicable. During its 2019 Legislative Session, the Colorado General Assembly passed, and on May 14, 2019 Governor Polis signed into law, HB19-1174. This new law, which took effect on January 1, 2020, prohibits many of Colorado’s “out-of-network” service agencies from charging a patient for the costs the out-of-network service agency incurs in providing medical services that are not reimbursed by the patient’s insurance carrier. As an example, a patient may have surgery at an “in-network” facility that has a contract with the patient’s insurance carrier. In this circumstance, the patient will typically only have to pay any co-pay or deductible. However, if one of the physicians assisting in the surgery, such as the anesthesiologist, does not have a contract with the patient’s insurance carrier (i.e., is “out-of-network”), the insurance carrier often will only pay a portion (or none) of the anesthesiologist’s charges, leaving an “unpaid balance”. The anesthesiologist will then bill the patient for the unpaid balance, this is known as “balance billing”. The new law prohibits the anesthesiologist from “balance billing” the patient for this unpaid balance, but still allows the patient to be billed for co-insurance/co-pay and deductible.