Skip to main content
Colorado General AssemblyToggle Main Menu
Agency NameToggle Agency Menu

H_HI_2021A 04/21/2021 01:31:04 PM Committee Summary

PUBLIC
STAFF SUMMARY OF MEETING
HOUSE COMMITTEE ON HEALTH & INSURANCE
Date 04/21/2021
Attendance
Baisley X
Hanks X
Jackson X
Kennedy *
McCormick X
Mullica X
Ortiz X
Pelton X
Soper X
Titone X
Van Beber X
Caraveo X
Lontine X
Time 01:31:04 PM to 08:02:38 PM
Place HCR 0112
This Meeting was called to order by Lontine
This Report was prepared by Julia Group
Hearing Items Action Taken
HB21-1198 Amended, referred to House Appropriations
HB21-1172 Postponed Indefinitely
HB21-1237 Amended, referred to the Committee of the Whole
HB21-1256 Referred to the Committee of the Whole

HB21-1198 - Amended, referred to House Appropriations

01:31:21 PM  
Representative Jodeh,
bill sponsor, introduced HB21-1198.

The bill repeals, reenacts, and expands hospital requirements around providing
discount care to uninsured patients (discount program) and moves regulatory
authority over the program from the Colorado Department of Public Health
and Environment (CDPHE) to the Department of Health Care Policy and Financing
(HCPF).  Changes to the program include:


Applying regulations
to health care facilities, instead of just hospitals;
  • requiring HCPF
    to develop a standard application for health care facilities to screen
    uninsured patients for eligibility for public health insurance programs,
    the Colorado Indigent Care Program (CICP), or discounted care;
  • creating an appeals
    process if a patient is found to be ineligible;
  • limiting the amount
    a health care facility can charge for eligible patients for emergency and
    other non-CICP services to 80 percent of the Medicare rate, instead of
    the lowest negotiated rate from a private health plan;
  • limiting collection
    amounts to monthly payments of no more than 5.0 percent of the patient’s
    monthly household income;
  • considering a
    patient’s bill paid in full after  36 months of payments;
  • requiring health
    care facilities to post information on patient’s rights under the discount
    program, as developed by HCPF;
  • requiring health
    care facilities to collect and report certain information to HCPF to determine
    compliance across demographics;
  • requiring HCPF
    to periodically review health care facilities to ensure compliance; and
  • requiring HCPF
    to promulgate rules prohibiting hospitals from considering assets when
    determining if a patient’s income eligibility and to ensure the method
    used to determine eligibility is uniform across hospitals. By April 1,
    2022, the State Board of Health in the CDPHE must promulgate rules to implement
    the program and HCPF must develop information on patient’s rights, establish
    a process for patients to appeal a determination of ineligibility, and
    begin to periodically review health-care facilities for compliance.  By
    June 1, 2023, and each June 1 after, each health care facility must collect
    and report data to HCPF on compliance.

Collection
of medical debt.  
The bill updates regulations around the collection
of medical debt.  Specifically, before a health care facility can
assign or sell patient debt to a collection agency or before pursing permissible
extraordinary collection action the facility must:  screen the patient
for eligibility for programs listed above; provide discounted care or offer
a payment plan that does not exceed 5.0 percent of the patient’s monthly
household income, and provide an explanation of the services and fees being
billed.  A health care facility that does not follow these steps is
liable to the patient for damages, as specified in the bill.  A medical
creditor or medical debt collector cannot engage in any permissible extraordinary
collection actions until 180 days after the first bill for a medical debt
is sent.  In addition, 30 days before taking an action, a creditor
must provide the patient with a notice developed by HCPF.  If a creditor
fails to follow these steps, the creditor must reverse any collection actions.




Representative Jodeh distributed a handout to the committee (Attachment
A).

01:48:56 PM  
The bill sponsor responded to questions from the committee.
01:49:32 PM  
Allison Neswood,
Colorado Center on Law and Policy, testified in support of the bill.  Mr.
Daniel Vedra, representing himself, testified in support of the bill.  Mrs.
Nancy Dolson, Department of Health Care Policy and Financing, testified
in support of the bill.  The witnesses responded to questions from
the committee.
02:04:14 PM  
Joshua Ewing, Colorado
Hospital Association, testified to amend the bill.  Ms. Jackie Zheleznyak,
Denver Health, testified to amend the bill.  Dr. Karen Foster, Colorado
Dental Association, testified to amend the bill.  Dr. Steven Nelson,
Colorado Dental Association, testified to amend the bill.  The panel
of witnesses responded to questions from the committee.
02:33:24 PM  
Alex Witteveld, Colorado
Legal Services, testified in support of the bill.  Regina Stjernholm,
representing herself, testified in support of the bill.
02:41:13 PM  
Jill Schneider, Clinica
Colorado, testified in support of the bill.  Mr. Kerry Gleason, representing
himself, testified in support of the bill.  Ms. Leslie Kalechman,
AARP Colorado, testified in support of the bill.  Ms. Elissa Jane
Mastel, representing herself, testified in support of the bill.  Perla
Rodriguez, Center for Health Progress, testified in support of the bill.
 Adela Flores-Brennan, Colorado Consumer Health Initiative, testified
in support of the bill and distributed a handout to the committee (Attachment
B).  The witnesses responded to questions from the committee.

03:06:31 PM  
Ms. Neswood responded
to questions from the committee.




Submitted written
testimony can be found in Attachment F.
03:09:14 PM  
Representative Jodeh
introduced and explained amendments L.002 (Attachment C), L.001 (Attachment
 D), and L.004 (Attachment E).


03:12:35 PM
Motion Adopt amendment L.002 (Attachment C)
Moved Caraveo
Seconded Kennedy
Baisley
Hanks
Jackson
Kennedy
McCormick
Mullica
Ortiz
Pelton
Soper
Titone
Van Beber
Caraveo
Lontine
YES: 0   NO: 0   EXC: 0   ABS:  0   FINAL ACTION:  Pass Without Objection


03:13:45 PM
Motion Adopt amendment L.001 (Attachment D)
Moved Caraveo
Seconded Kennedy
Baisley
Hanks
Jackson
Kennedy
McCormick
Mullica
Ortiz
Pelton
Soper
Titone
Van Beber
Caraveo
Lontine
YES: 0   NO: 0   EXC: 0   ABS:  0   FINAL ACTION:  Pass Without Objection


03:14:26 PM
Motion Adopt amendment L.004 (Attachment E)
Moved Caraveo
Seconded Titone
Baisley
Hanks
Jackson
Kennedy
McCormick
Mullica
Ortiz
Pelton
Soper
Titone
Van Beber
Caraveo
Lontine
YES: 0   NO: 0   EXC: 0   ABS:  0   FINAL ACTION:  Pass Without Objection
03:14:45 PM  
Representative Jodeh provided closing comments on the bill.
03:16:53 PM  
Committee members made closing comments on the bill.


03:18:15 PM
Motion Refer House Bill 21-1198, as amended, to the Committee on Appropriations.
Moved Caraveo
Seconded Ortiz
Baisley No
Hanks No
Jackson Yes
Kennedy Yes
McCormick Yes
Mullica Yes
Ortiz Yes
Pelton No
Soper No
Titone Yes
Van Beber No
Caraveo Yes
Lontine Yes
Final YES: 8   NO: 5   EXC: 0   ABS:  0   FINAL ACTION:  PASS



HB21-1172 - Postponed Indefinitely


03:21:06 PM  
Representative Geitner,
bill sponsor, presented HB21-1172.  The bill requires health care
facilities, including hospitals, nursing care facilities and assisted living
residences, to allow their patients and residents to have at least one
visitor of their choosing.  The bill also requires these health care
facilities to have written policies and procedures concerning visitation,
including any restrictions or limitations that are placed on visitation
and the reasons for these restrictions or limitations.  



The bill prohibits health care facilities from disallowing visitation if
the sole reason is to reduce the risk of transmission of a pandemic disease,
but allows health care facilities to impose requirements and limitations
on visitors to reduce the risk of transmission of a pandemic disease as
follows:
  • during a period
    of heightened pandemic disease transmission risk, health care facilities
    may designate entry points, deny visitors with known symptoms of the pandemic
    disease, require visitors to wear face coverings or other protective equipment,
    and require them to sign a waiver acknowledging the risks of visitation;
  • during a period
    of known community transmission of a pandemic disease, health care facilities
    may require all visitors to be screened for symptoms of the disease before
    visitation, and deny entrance to any visitor who has symptoms of the disease;
    and
  • during widespread
    community transmission of the disease, facilities may limit visitation
    to essential caregivers or for compassionate care visits from a friend
    or family member to alleviate physical or emotional distress.
  • 03:33:28 PM  
    The bill sponsor responded to questions from the committee.
    04:04:58 PM  
    Representative Lontine proceeded with witness testimony.
    04:05:22 PM  
    Ms. Judith Burke,
    Colorado Nurses Association, testified in opposition to the bill.  Arlene
    Miles, Colorado Health Care Association, testified to amend the bill.  Joshua
    Ewing, Colorado Hospital Association, testified to amend the bill.  Mr.
    Ewing responded to questions.
    04:33:32 PM  
    Andrea Waitley, representing
    herself, testified in support of the bill.  Stephen Reiter, the NEVER
    Alone Project, testified in support of the bill.  The panel responded
    to questions from the committee.
    04:43:53 PM  
    Mr. Todd Workman, representing himself, testified in support of the bill. Jennifer Crow, representing herself, testified in support of the bill. Ms. Kelly Huenink, representing herself, testified in support of the bill.
    04:55:39 PM  
    Mrs. Brandee Gillham, representing herself, testified in support of the bill. Mr. Roy Gillham, representing himself, testified in support of the bill. Mr. Matt Gillham, representing himself, testified in support of the bill. The witnesses responded to questions from the committee.
    05:18:53 PM  
    Mr. Jake Gillham, representing himself, testified in support of the bill. Mrs. Nita Gillham, representing herself, testified in support of the bill.
    05:28:24 PM  
    Ms. Huenink responded to questions from the committee.
    05:29:01 PM  
    Mr. Daniel Gillham,
    representing himself, testified in support of the bill.  Mrs. Sarah
    Gillham, representing herself, testified in support of the bill.  The
    witnesses responded to questions from the committee.




    Submitted written
    testimony can be found in Attachment G.
    05:38:38 PM  
    Representative Geitner provided closing comments on the bill.
    05:49:41 PM  
    Committee members made closing comments on the bill.
    06:00:11 PM  
    Committee comments on the bill continued.


    06:18:45 PM
    Motion Refer House Bill 21-1172 to the Committee on Appropriations.
    Moved Baisley
    Seconded Van Beber
    Baisley Yes
    Hanks Yes
    Jackson No
    Kennedy No
    McCormick No
    Mullica No
    Ortiz No
    Pelton Yes
    Soper Yes
    Titone No
    Van Beber Yes
    Caraveo No
    Lontine No
    YES: 5   NO: 8   EXC: 0   ABS:  0   FINAL ACTION:  FAIL


    06:19:04 PM
    Motion Postpone House Bill 21-1172 indefinitely using a reversal of the previous roll call. There was no objection to the use of the reverse roll call, therefore, the bill was postponed indefinitely.
    Moved Kennedy
    Seconded Caraveo
    Baisley No
    Hanks No
    Jackson Yes
    Kennedy Yes
    McCormick Yes
    Mullica Yes
    Ortiz Yes
    Pelton No
    Soper No
    Titone Yes
    Van Beber No
    Caraveo Yes
    Lontine Yes
    Final YES: 8   NO: 5   EXC: 0   ABS:  0   FINAL ACTION:  PASS



    HB21-1237 - Amended, referred to the Committee of the Whole


    06:19:20 PM  
    The committee took
    a brief recess.
    06:30:40 PM  
    Representative Lontine,
    bill co-sponsor, presented HB21-1237.  The bill directs the Department
    of Personnel and Administration (DPA) to enter into a contract with a pharmacy
    benefit manager (PBM) for the administration of state employee health insurance
    through a reverse-auction process prescribed by the bill, and then use
    that platform to audit claims.  State employee insurance offered through
    Kaiser Permanente is exempt from this requirement.  It creates avenues
    for other public and private health insurance plans to participate jointly
    with the state.




    Technology platform.
     By November 1, 2021, DPA must obtain a technology
    platform, and associated services from the platform operator, capable of
    conducting a reverse-auction for a PBM.  The platform must be equipped
    with certain automation and price comparison capabilities specified in
    the bill.  In addition, the platform must be able to perform automated
    line-by-line review of all invoiced PBM drug claims to identify any deviations
    from the terms of the PBM contract.  DPA may perform a market check
    during the term of the PBM contract to evaluate the incumbent PBM’s drug
    pricing for continuing competitiveness.




    Fee.
     The platform, operator services, claim review, and market
    checks will be paid for by a per-prescription fee paid by the winning PBM
    directly to the platform operator.




    Joint participation.
     Any other self-funded public sector health
    plan may use the processes and procedures established in the bill individually,
    collectively, or as a joint purchasing group with a state employee health
    insurance plan.  After completion of the first PBM reverse auction,
    self-funded private sector health plans with substantial participation
    by Colorado employees may also participate in a joint purchasing pool with
    state employees for subsequent PBM reverse auctions.  Any health plans
    participating in a purchasing pool retain autonomy over their drug formularies
    and benefit designs.



    She distributed a handout to the committee (Attachment H).
    06:33:23 PM  
    Representative Rich, bill co-sponsor, continued introducing the bill.
    06:35:57 PM  
    The sponsors responded to questions from the committee.
    06:38:57 PM  
    The testimony of
    Mr. Drew Cline, Josiah Bartlett Center for Public Policy, was read into
    the record.  The testimony was in a neutral position on the bill.
    06:42:34 PM  
    Mr. Ky Davis, RxPlus
    Pharmacies, testified to amend the bill.
    06:46:15 PM  
    Mrs. Hilary Glasgow,
    Colorado WINS, testified in support of the bill.
    06:50:37 PM  
    The sponsors responded
    to questions from the committee.
    06:54:31 PM  
    Mr. Dudley Burdge,
    Communications Workers of America/New Jersey State Health Benefits Commission,
    testified in support of the bill.
    07:00:24 PM  
    Mr. Mark Blum, America's
    Agenda, answered committee questions.
    07:10:46 PM  
    The sponsors responded to questions from the committee.
    07:11:42 PM  
    Mr. Blum and Mr.
    Burdge continued to respond to committee questions.




    Submitted written
    testimony can be found in Attachment I.
    07:15:23 PM  
    Representative Rich
    introduced amendment L.006 (Attachment J).
    07:16:45 PM  
    Committee members
    made comments on amendment L.006.


    07:18:51 PM
    Motion Adopt amendment L.006 (Attachment J)
    Moved Lontine
    Seconded Kennedy
    Baisley
    Hanks
    Jackson
    Kennedy
    McCormick
    Mullica
    Ortiz
    Pelton
    Soper
    Titone
    Van Beber
    Lontine
    Caraveo
    YES: 0   NO: 0   EXC: 0   ABS:  0   FINAL ACTION:  Pass Without Objection
    07:19:13 PM  
    The bill sponsors made closing comments on the bill.
    07:22:21 PM  
    Committee members made closing comments on the bill.


    07:24:47 PM
    Motion Refer House Bill 21-1237, as amended, to the Committee of the Whole.
    Moved Lontine
    Seconded Ortiz
    Baisley Yes
    Hanks No
    Jackson Yes
    Kennedy Yes
    McCormick Yes
    Mullica Yes
    Ortiz Yes
    Pelton Yes
    Soper No
    Titone Yes
    Van Beber Yes
    Lontine Yes
    Caraveo Yes
    Final YES: 11   NO: 2   EXC: 0   ABS:  0   FINAL ACTION:  PASS



    HB21-1256 - Referred to the Committee of the Whole


    07:24:54 PM  
    The committee took
    a brief recess.
    07:25:16 PM  
    Representative Lontine,
    bill sponsor, introduced HB21-1256.  The bill directs the Department
    of Health Care Policy and Financing, which administers the state’s Medicaid
    program, to promulgate rules specifically relating to health care providers
    that deliver health care or mental health services exclusively or primarily
    through telemedicine.  She distributed a packet of info to the committee
    (Attachment K).
    07:32:57 PM  
    Ms. Aubrey Hill,
    Colorado Association for School-Based Health Care, testified in support
    of the bill.  Dr. Deborah Archer, American Academy of Pediatrics -
    Colorado, testified in support of the bill.  Ms. Phyllis Albritton,
    Colorado Safety Net Collaborative, testified in support of the bill.  Commissioner
    Wendy Buxton-Andrade, Prowers County, testified in support of the bill.
    07:46:28 PM  
    Jackie Zheleznyak,
    Denver Health, testified in support of the bill.  Dr. Tracy Johnson,
    Department of Health Care Policy and Financing, testified in support of
    the bill.  The witnesses responded to questions from the committee.





    Submitted written testimony can be found in Attachment L.

    07:55:12 PM  
    Representative Soper
    introduced and described amendment L.001 (Attachment M).


    07:57:02 PM
    Motion Adopt amendment L.001 (Attachment M)
    Moved Soper
    Seconded Baisley
    Baisley Yes
    Hanks Yes
    Jackson No
    Kennedy No
    McCormick No
    Mullica No
    Ortiz No
    Pelton Yes
    Soper Yes
    Titone No
    Van Beber Yes
    Lontine No
    Caraveo No
    YES: 5   NO: 8   EXC: 0   ABS:  0   FINAL ACTION:  FAIL
    07:57:17 PM  
    Representative Lontine provided closing comments on the bill.
    07:59:34 PM  
    Committee members provided closing comments on the bill.


    08:02:30 PM
    Motion Refer House Bill 21-1256 to the Committee of the Whole.
    Moved Lontine
    Seconded Mullica
    Baisley No
    Hanks Yes
    Jackson Yes
    Kennedy Yes
    McCormick Yes
    Mullica Yes
    Ortiz Yes
    Pelton Yes
    Soper No
    Titone Yes
    Van Beber Yes
    Lontine Yes
    Caraveo Yes
    Final YES: 11   NO: 2   EXC: 0   ABS:  0   FINAL ACTION:  PASS


    08:02:38 PM   The committee adjourned.






    COVID-19 Resources
    NORTH ENTRANCE IS CURRENTLY CLOSED.  TO ENTER THE CAPITOL, USE THE SOUTH ENTRANCE, UNDER THE STAIRS, AT 14th AVENUE AND SHERMAN STREET.