The Colorado Senate approved a bill Wednesday to allow the state to enforce federal laws requiring hospitals to publicly post prices online. 

Under Senate Bill 252, hospitals must maintain a public list of at least 300 shoppable services and regularly report to the Colorado Department of Health Care Policy and Financing, which will monitor compliance. Violations of the bill would qualify as a deceptive trade practice. 

The Senate passed the bill in a 22-11 vote on Wednesday, advancing it to the House for further consideration. 

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“Coloradans deserve to know what their medical bills will look like before going into treatment or surgery,” said bill sponsor Sen. Julie Gonzales, D-Denver. “It’s time to take the next step and increase medical price transparency so Coloradans aren’t blindsided with big bills after receiving care.”

This bill comes more than two years after federal laws went into effect in January 2021, mandating that hospitals provide clear and easily accessible online pricing information so the public can know in advance how much a treatment costs and compare costs between hospitals. 

In Colorado, not one of 32 of the state’s largest hospitals’ websites analyzed by an advocacy group has fully complied with the federal laws, according to the nonprofit PatientsRightsAdvocate.org.

The Colorado Hospital Association earlier said SB 252 could confuse consumers as it “creates the potential for conflict between state and federal law,” said Cara Welch, senior director of communications for the association in an email on Friday.

Skeptical of the PatientRightsAdvocate.org findings, she said Colorado hospitals “have a long history of supporting meaningful price transparency that helps patients understand their financial responsibility in advance of receiving care.”

Welch added that compliance with the federal law falls under the Centers for Medicare & Medicaid Services, and that agency recently published a blog that looked at 600 hospitals in late 2022 and found “substantial progress” in transparency.

SB 252 builds off of previous state efforts to get hospitals to comply, including House Bill 22-1285 passed last year, which prohibits hospitals from pursuing debt collection action against a patient if the hospital failed to comply with the federal hospital price transparency laws. 

Though it has bipartisan sponsorship, SB 252 received support from most Democrats and opposition from most Republicans on Wednesday. Three Republicans and two Democrats switched sides. 

Critics of the bill argued that it would put too much of a burden on hospitals, particularly small, rural hospitals. 

“We know rural hospitals are struggling,” said Sen. Kyle Mullica, D-Thornton, one of only two Democrats who voted against the bill. “Now, we’re going to come in and say, ‘If you don’t (make prices transparent), we’re going to fine you $10,000 a day per instance,’ when these hospitals are struggling just to make ends meet.” 

Proponents of the bill pointed out that noncompliant hospitals have been violating federal laws for more than two years, and they will be given ample notice. 

Under SB 252, hospitals not complying with federal price transparency laws would receive a warning and be given information and support from the state on how to get in compliance. If noncompliance continues after a few months, the hospital could be referred to the state attorney general as a violation of the state’s deceptive trade practices law. 

“All a hospital has to do with this bill is follow the rules that have been in effect for more than two years,” said bill sponsor Sen. Kevin Van Winkle, R-Highlands Ranch. “This bill is the key to unlocking clear, accessible and upfront pricing in health care.” 

The House is expected to vote on SB 252 in the coming weeks.