My decision to work at a public county hospital was driven by my desire to serve the most vulnerable. As such, I have witnessed firsthand the financial strain and negative health consequences caused by unexpected medical debt — the leading cause of bankruptcy in the United States. For too long, Coloradans have faced the daunting reality of not being able to predict or plan for astronomically high health care costs, expenses that for many families mean not being able to cover essentials, such as housing or groceries.

One particular kind of hidden fee, often referred to as a “facility fee,” is popping up more frequently on Coloradans’ medical bills, resulting in hundreds or even thousands in unexpected expenses. These charges are imposed by hospitals for services provided at any facility they own or operate, often unbeknownst to patients until they receive a bill. These fees, ostensibly justified as covering hospital operational costs, undermine Coloradans’ ability to access essential health care services without fear of financial ruin.

Thankfully, as of July 1, a new Colorado law is in effect that protects patients from facility fees. House Bill 23-1215, passed by Colorado lawmakers last year, limits when facility fees can be charged and puts transparency requirements in place to protect patients from unwelcome surprises on their medical bills. The implementation of this legislation represents a crucial step toward ensuring fairness and transparency in medical billing.

Under this new law, facility fees cannot be imposed for preventive care services — a critical provision to allow families to stay healthy without fear of financial repercussions. It also requires health care providers to inform patients about potential facility fees — and how much those fees are — both at the time of appointment scheduling and during care delivery. All patients must be provided with an itemized bill that identifies the facility fee and how much of the total cost, if any, was covered by their insurance. 

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Finally, the new law requires any health care provider that is acquired by a hospital or health system to notify patients who have recently received care at that location before they start charging facility fees. This protects patients from increasingly common hospital mergers where large hospital systems buy up smaller providers, leaving consumers with fewer choices on where to receive care and increasing their risk of being charged a facility fee. 

For patients who have faced sky-high medical costs, this legislation offers much-needed relief. By creating strict transparency requirements, patients are empowered to make more informed decisions about their medical care. As a health care provider, I believe this legislative victory is crucial to improving health outcomes. When patients are burdened with unexpected financial strains, they may delay or forego necessary medical care — a choice that can have serious long-term consequences for their health and well-being. By removing financial barriers and promoting transparency, this law paves the way for a health care system that is more accessible for all Colorado families. 

Every Coloradan deserves to be able to access quality health care without fear of unexpected medical bills and financial hardship. Though there is much more work to be done to create a health care system that is affordable and accessible for all patients, implementing common sense limits on facility fees is a crucial step toward prioritizing patients over profits.

Dr. Nicholos “Nicky” Joseph is a resident physician in emergency medicine in Denver. He is originally from Houston and he received his medical degree from Harvard. His passions lie in equitable care delivery and health policy. The views expressed are his own and do not represent the opinions of any entity with which he is affiliated.