Colorado has enacted a law requiring out-of-network doctors to notify patients in advance and obtain signed consent before holding them responsible for the costs of care. The measure addresses billing practices for medical services delivered by providers outside a patient's insurance network.

The law applies to situations in which patients may be charged at out-of-network rates, which are typically higher than in-network charges. Under the statute, providers must secure documented patient acknowledgment of financial responsibility prior to delivering services.

Billing data compiled by FAIR Health shows a substantial gap between in-network and out-of-network charges for childbirth in the United States. The national median in-network charge for a vaginal delivery is $15,178, while the median in-network charge for a caesarean section is $19,292. The national median out-of-network charge for a vaginal delivery is $31,117, and the median out-of-network charge for a caesarean section is $44,432.

Out-of-network charges vary widely by state. In Nevada, the out-of-network charge for a vaginal birth is $49,699 and for a caesarean section is $72,604, according to FAIR Health. In California, the figures are $42,078 and $66,662. In Florida, the charges are $39,256 and $57,072. In New Jersey, they are $42,712 and $55,730. In Alaska, the figures are $38,800 and $55,997.

Childbirth represents a large share of medical billing in the United States. Medicaid financed 40.2 percent of all deliveries nationwide in 2024. Pregnant women typically qualify for Medicaid if their household income is around or below 200 percent of the federal poverty level, which is about $50,000 a year for a family of three.

According to the U.S. Census Bureau, about 92 percent of Americans had health insurance coverage through public programs or private insurance in 2023, and roughly 8 percent were uninsured. The Colorado consent requirement is intended to ensure that insured patients who receive care from providers outside their network are aware of the financial implications before incurring charges.