HomeMy WebLinkAbout09015
ORDINANCE NO. 9015
AN ORDINANCE AMENDING TITLE XI OF THE PUEBLO MUNICIPAL CODE
BY THE ADDITION OF A NEW CHAPTER 12
BE IT ORDAINED BY THE PEOPLE OF THE CITY OF PUEBLO, that (brackets indicate
matter being deleted; underscoring indicates new matter being added):
SECTION 1.
The Pueblo Municipal Code is hereby amended by the addition of a new Chapter 12 of
Title XI to read as follows:
CHAPTER 12
LIMITATIONS ON HOSPITAL FEES AND CHARGES
Section 11-12-1. Findings and Purpose.
The electors of the City of Pueblo find that the health care costs in the City of Pueblo are
higher than in the City and County of Denver. The health insurance cost for the consumer and
employers are 30% to 48% higher when the cost of a 41-year-old person is compared. This is
despite the difference in cost-of-living which is 11% higher in Denver than in Pueblo. The electors
of the City of Pueblo find that the main cause for this difference is the hospital health care costs
which are directly related to poor patient care, especially in the area of patient safety. Another
cause of increased costs is acquisition of private physicians’ practices with the addition of
unnecessary facility fees. The electors of the City of Pueblo find that the inflated health care costs
have discouraged the influx of new businesses to the City, resulting in severe adverse economic
impact.
Section 11-12-2. Definitions.
The following words, terms and phrases, when used in this Chapter, shall have the
meanings ascribed to them in this Section:
(1) “Emergency services” means a medical screening examination that is within the
capability of a hospital emergency department, including ancillary services routinely
available to such department to evaluate such condition, and such further medical
examinations and treatment required to stabilize such individual.
(2) “Facility fee” means any fee charged or billed by a hospital
a. Intended to compensate the hospital for either the operational expenses of the
hospital or for providing data for hospital services; and
b. Separate and distinct from a professional fee.
(3) “Hospital” means a not-for-profit establishment under the Internal Revenue Code that
is licensed by the appropriate City, County, or State authority or accredited by the Joint
Commission on Accreditation of Hospitals to be primarily engaged in providing
diagnostic services, extensive medical treatment, including surgical services, and
other hospital services, as well as continuous nursing services. Hospitals have an
organized medical staff, inpatient beds and equipment and facilities to provide
complete health care. The Colorado Mental Health Institute at Pueblo and for-profit
nursing homes are excluded from this definition.
(4) “Outpatient” means a patient who receives medical treatment that does not involve
hospitalization of the patient.
(5) “Patient” means any consumer of medical treatment from a physician or hospital
including seeking advice or professional guidance in regards to the consumer’s health
care status or plan.
(6) “Patient Safety” means the averting of potentially preventable errors and adverse
effects to patients associated with health care. Such errors include but are not limited
to those described by the Agency for Healthcare Research and Quality, including
Accidental Puncture or Laceration, Complications of Anesthesia, Deaths in Low-
Mortality Diagnosis Related Groups, Decubitus Ulcers (Bed Sores), Failure to Rescue,
Foreign Body Left During Procedure, Iatrogenic Pneumothorax (Puncturing of the
Lungs), Postoperative Hip Fracture, Postoperative Hemorrhage or Hematoma,
Postoperative Physiologic and Metabolic Derangements, Postoperative Respiratory
Failure, Postoperative Pulmonary Embolism or Deep Vein Thrombosis, Postoperative
Sepsis, Postoperative Wound Dehiscence (Wound Reopening After Surgery),
Selected Infections Due to Medical Care, and Transfusion Reaction.
(7) “Professional fee” means any fee charged or billed by a physician for professional
medical services provided in a hospital-based or hospital-contracted facility.
Section 11-12-3. Facility Fees Prohibited.
It shall be unlawful:
(a) For any hospital to charge, bill, or request payment from a patient or insurer for a
facility fee for outpatient visits to a physician.
(b) The prohibition contained in subsection (a) of this section shall be inapplicable to
hospital outpatient surgery, radiology, pathology, anesthesiology and emergency
services.
Section 11-12-4. Limitations on Hospital Fees and Charges.
It shall be unlawful for a hospital to charge or bill any insurance or patient fee for services
or treatment in excess of the Medicare A and B program allowable charges. This limitation shall
be applicable to both inpatient and outpatient services.
Section 11-12-5. Offset.
Every hospital subject to the prohibition on facilities fees outlined in Sec. 11-12-3 and the
limitations on hospital fees and charges outlined in Sec. 11-12-4 above is prohibited from reducing
the number of hospital staff from the current level of staffing to adjust to the change in revenue
and is hereby mandated to improve the quality of care and Patient Safety to the optimal level so
as to qualify for reimbursements associated with CMS Value-based Reimbursement.
FOR THE ORDINANCE __________
AGAINST THE ORDINANCE ___________