With strong bipartisan support, the House approved major legislation to stop people from receiving costly "out-of-network" medical bills Thursday.

House Bill 1174 by Rep. Daneya Esgar, D-Pueblo, and Rep. Marc Caitlin, R-Montrose, received a unanimous voice vote Thursday after more debate and additional amendments.

In a session that has been marked by some bitter partisan conflict, the "out of network" bill has been a model of cooperation as Esgar and Caitlin have amended the measure throughout the process to address issues from hospitals, insurance companies and physicians.

"As a legislator, my job is to find a way to ensure Coloradans aren't dealing with these surprise medical bills through no fault of their own," Esgar said after the vote. "I am responding to to the concerns of families, individuals and seniors who have been hit by these surprise and often expensive bills. We think this is a strong bipartisan solution to this problem."

HB 1174 is aimed at the sometimes shocking medical charges that come from a provider outside an insurance company's approved network. That can often happen in emergency room situations and can reach tens of thousands of dollars.

Both Republican and Democratic lawmakers emphasized this was a real problem for their constituents.

Republican Minority Leader Patrick Neville seemed to sum it up best Thursday when he told the full House: "There is more good now in this bill than any other concerns I still have, so I urge a yes vote."

There will be a formal third-reading vote today, though one thing heard loud and clear on the bill is that even state legislators have been hit with unexpected, expensive bills.

Rep. Dominique Jackson, D-Denver, said she was discussing the problem with a constituent when her own phone rang with an unexpected out-of-network claim of $3,000 for her care.

"How would you like being told you need to cough up another three grand?" she asked her colleagues.

There were other horror stories during the House committee hearing earlier this month, like patients being billed $90,000 for emergency room expenses from an out-of-network doctor they didn't know had participated in their care.

"No one disagrees that we need to do something about this problem," said Rep. Betty Ransom, R-Parker, who was still opposed to the bill Thursday and claimed it might force doctors to the leave the state.

Essentially, the bill says consumers won't liable for out-of-network medical bills when they were unaware of them. The bill says those doctors will be paid based on an average reimbursement rate that insurers are paying for the same service.

One issue that was resolved on the floor Thursday was language that said providers might have to accept the Medicare reimbursement rate, plus 25 percent — a fee that doctors in particular opposed.

Esgar agreed to an amendment from Neville eliminating that possible rate.

Esgar has been working on the legislation for more than a year, earning repeated praise from both sides of the aisle for accommodating so many concerns.

Though Caitlin is a co-sponsor, he has credited Esgar for being the primary mover on the bill.

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