Colorado hospitals must meet the federal machine-readable file (MRF) requirement under 45 CFR 180.50 — and Colorado layers its own rules on top: Colorado's HB 21-1124 (Hospital Transparency Pricing) requires hospitals to report payer-specific negotiated rates to the state — layered on top of the federal 45 CFR 180. With ~96 hospitals in the state, CMS's 2026 AI-enabled audit ramp means non-compliant files in Colorado are more likely than ever to convert a warning letter into a $5,500/day fine.
Colorado hospitals must submit payer-specific negotiated rate files directly to the Colorado Department of Health Care Policy and Financing (HCPF), with state reporting deadlines separate from CMS's federal file requirement.
Federal baseline: 45 CFR Part 180 still applies to every Colorado hospital regardless of state rules. Missing either track is an exposure.
| Hospitals in Colorado | ~96 |
| State law | CO HB 21-1124 — Hospital Transparency Pricing |
| Federal exposure | $5,500/day per violation under 45 CFR 180.50 |
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