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H_HI_2021A 05/05/2021 01:44:51 PM Committee Summary

PUBLIC
STAFF SUMMARY OF MEETING
HOUSE COMMITTEE ON HEALTH & INSURANCE
Date 05/05/2021
Attendance
Cutter X
Hanks X
Kennedy X
McCormick X
Mullica X
Ortiz X
Pelton X
Soper *
Titone X
Van Beber X
Williams X
Caraveo X
Lontine X
Time 01:44:51 PM to 06:40:37 PM
Place HCR 0112
This Meeting was called to order by Lontine
This Report was prepared by Julia Group
Hearing Items Action Taken
HB21-1068 Amended, referred to House Appropriations
SB21-142 Referred to the Committee of the Whole
HB21-1276 Amended, referred to House Appropriations

HB21-1068 - Amended, referred to House Appropriations


01:45:00 PM  
Representative Michaelson
Jenet, bill co-sponsor, presented HB21-1068.
 Under
current law, health insurance carriers offering individual or small-group
health benefit plans must ensure that coverage includes behavioral, mental
health, and substance use disorder services, including behavioral health
treatment.  While some level of coverage is required under these plans,
carriers are not required to provide coverage for the total cost of such
services.



The bill requires that health plans issued after January 1, 2022, provide
coverage for the total cost of an annual mental health examination of up
to 60 minutes.  The examination must be performed by a qualified mental
health care provider, which the bill defines as any of the following:

  • physician who has certification
    or training in psychiatry or mental or behavioral health;
  • physician assistant
    who has training in psychiatry or mental health;

  • psychologist;
  • clinical social worker;
  • marriage and family
    therapist;
  • licensed professional
    counselor;
  • addiction counselor;
    or
  • advanced practice registered
    nurse, with specific training in psychiatric nursing.

01:49:23 PM  
Representative Titone,
bill co-sponsor, continued introducing HB21-1068.
01:54:55 PM  
The sponsors responded
to questions from the committee.
02:05:19 PM  
Brian Mason, 17th
Judicial District Attorney's Office (Adams and Broomfield Counties), testified
in support of the bill.  Amy Lyden, Jefferson Center/Mental Health,
testified in support of the bill.  Mr. Steve Tool, representing himself,
testified in support of the bill.  Elsa Cavender, representing herself,
testified in support of the bill.  The panelists responded to questions
from the committee.
02:25:56 PM  
Annelise Grygiel,
Young Invincibles Colorado, testified in support of the bill.  Christopher
Nelson, representing himself, testified in support of the bill.  Ms.
Deb Mahan, Gazette Charities and Anschutz Foundation, testified in support
of the bill.  Elizabeth  Emerson, representing herself, testified
in support of the bill.
02:38:53 PM  
Claire Zhang, representing
herself, testified in support of the bill.  Ms. Dhivahari Vivek, Young
Invincibles, testified in support of the bill.  Mr. Ray Merenstein,
National Alliance on Mental Illness Colorado, testified in support of the
bill.  Ms. Jeanette Hensley, Colorado Senior Lobby, testified in support
of the bill.
02:52:54 PM  
Dr. Jonathan Clapp, representing himself, testified in support of the bill. Karlee Tebbutt, Colorado Association of Health Plans, testified in a neutral position on the bill. Julia Hunt, representing herself, testified in support of the bill.
02:59:22 PM  
Ms. Kaitlyn Tollefson, Young Invincibles, testified in support of the bill.
03:03:55 PM  
Kelly Erb, Colorado
Rural Health Center, testified in support of the bill.  Mr. Kody Simpson,
representing himself, testified in support of the bill.  Ms. Leanne
Rupp, National Association of Social Workers- Colorado Chapter, testified
in support of the bill.  Ms. Marisa Beltran, Young Invincibles, testified
in support of the bill.
03:16:45 PM  
Moe Keller, Mental
Health Colorado, testified in support of the bill.  Ms. Sarah Staron,
Young Invincibles, testified in support of the bill.  Steven Haden,
Envision You, testified in support of the bill.  Ms. Valerie Schlecht,
representing Colorado Cross-Disability Coalition, testified in support
of the bill.




Written public
testimony can be found in Attachment A.
03:31:28 PM  
Representative Titone
introduced and explained amendment L.001 (Attachment B).


03:32:16 PM
Motion Adopt amendment L.001 (Attachment B).
Moved Titone
Seconded Kennedy
Cutter
Hanks
Kennedy
McCormick
Mullica
Ortiz
Pelton
Soper
Titone
Van Beber
Williams
Caraveo
Lontine
YES: 0   NO: 0   EXC: 0   ABS:  0   FINAL ACTION:  Pass Without Objection
03:32:31 PM  
Representative Titone
introduced and explained amendment L.002 (Attachment C).



03:33:04 PM
Motion Adopt amendment L.002 (Attachment C).
Moved Titone
Seconded Kennedy
Cutter
Hanks
Kennedy
McCormick
Mullica
Ortiz
Pelton
Soper
Titone
Van Beber
Williams
Caraveo
Lontine
YES: 0   NO: 0   EXC: 0   ABS:  0   FINAL ACTION:  Pass Without Objection
03:33:23 PM  
The bill sponsors provided closing comments on the bill.
03:38:08 PM  
Committee members provided closing comments on the bill.


03:43:51 PM
Motion Refer House Bill 21-1068, as amended, to the Committee on Appropriations.
Moved Titone
Seconded Ortiz
Cutter Yes
Hanks Yes
Kennedy Yes
McCormick Yes
Mullica Yes
Ortiz Yes
Pelton Yes
Soper Yes
Titone Yes
Van Beber Yes
Williams Excused
Caraveo Yes
Lontine Yes
Final YES: 12   NO: 0   EXC: 1   ABS:  0   FINAL ACTION:  PASS



SB21-142 - Referred to the Committee of the Whole


03:44:55 PM  
Representative Caraveo,
bill co-sponsor, introduced SB21-142.  Colorado’s Medicaid and Indigent
Care programs provide coverage for abortions only in cases of rape or incest,
or when the life of the mother is endangered.  In these instances,
current law restricts abortion procedures to certain facility types and
they can only be performed by a physician.  The bill eliminates these
facility- and provider-type restrictions, allowing reimbursement for these
services when performed in any health facility and by any licensed health
care provider acting within the scope of their license and in accordance
with applicable federal regulations.
03:47:41 PM  
Representative McCluskie, bill co-sponsor, continued introducing SB21-142.
03:50:37 PM  
Mrs. Brittany Vessely,
Colorado Catholic Conference, testified in opposition to the bill.  Dr.
Thomas Perille, Democrats for Life of Colorado, testified in opposition
to the bill.  The witnesses responded to questions from the committee.
04:00:30 PM  
Jack Teter, Planned Parenthood of the Rocky Mountains, testified in support of the bill. Miss Lorenne Gavish, representing herself, testified in support of the bill. Karla Gonzales Garcia, Colorado Organization for Latina Opportunity and Reproductive Rights, testified in support of the bill.
04:11:59 PM  
Ms. Susanna Snyder,
Department of Health Care Policy and Financing, testified in support of
the bill.



Submitted public testimony can be found in Attachment D.
04:14:07 PM  
The bill sponsors provided closing comments on the bill.
04:16:07 PM  
Committee members provided closing comments on the bill.


04:18:19 PM
Motion Refer Senate Bill 21-142 to the Committee of the Whole.
Moved Caraveo
Seconded Kennedy
Cutter Yes
Hanks No
Kennedy Yes
McCormick Yes
Mullica Yes
Ortiz Yes
Pelton No
Soper No
Titone Yes
Van Beber No
Williams Excused
Caraveo Yes
Lontine Yes
Final YES: 8   NO: 4   EXC: 1   ABS:  0   FINAL ACTION:  PASS



HB21-1276 - Amended, referred to House Appropriations

04:18:27 PM  
The committee took
a brief recess.
04:18:35 PM  
Representative Herod,
bill co-sponsor, introduced HB21-1276.  The bill makes several changes
to state law concerning the prevention of opioid and other substance use
disorders, as described below.



Health insurance provisions.
 The bill places several restrictions
and requirements on insurance carriers and health benefit plans relating
to opioids and alternative treatments for certain plans issued or renewed
beginning January 1, 2023.
  • Physical therapists,
    occupational therapists, chiropractors, or acupuncturists.
     The
    bill prevents an insurance carrier that has a contract with a physical
    therapist, occupational therapist, chiropractor, or acupuncturist from
    prohibiting or penalizing these practitioners for providing a covered person
    with information on their financial responsibility for such services.  When
    the covered person starts treatment, the provider must notify the person's
    insurance carrier.  In addition, an insurance carrier cannot require
    such a practitioner to charge or collect a co-payment that exceeds the
    total charges submitted.  If the Commissioner of Insurance in the
    Department of Regulatory Agencies (DORA) determines that an insurance carrier
    has engaged in these practices, then the commissioner is required to institute
    a corrective action plan for the insurance carrier to follow.
  • Atypical opioid
    or non-opioid medication.
     The bill requires insurance carriers
    to provide coverage for an atypical opioid or non-opioid medication that
    is approved by the federal Food and Drug Administration (FDA) and prohibits
    carriers from mandating a covered person undergo step therapy or requiring
    pre-authorization.  The insurance carrier is required to make the
    atypical opioid or non-opioid medication available at the lowest cost-sharing
    tier under the health benefit plan applicable to a covered opioid with
    the same indication.
  • Mandatory coverage
    provisions.
     The bill requires each health benefit plan to provide
    coverage for a minimum number of physical therapy visits, occupational
    therapy visits, chiropractic visits, and acupuncture visits, at a cost-sharing
    amount not to exceed the cost-sharing amount for a primary care visit for
    non-preventive services.



    Prescribing limitations.
     Under current law, an opioid prescriber
    is prevented from prescribing more than a seven-day supply of an opioid
    to a patient that has not had an opioid prescription in the last 12 months
    unless certain conditions apply.  The executive director of DORA is
    required to, by rule, limit the supply of a benzodiazepine that a prescriber
    may prescribe to a patient who has not been prescribed benzodiazepine in
    the last 12 months by that prescriber.  Benzodiazepines may be prescribed
    electronically.  The current opioid prescribing limit is set to repeal
    on September 1, 2021. The bill continues the prescribing limitation indefinitely.




    Prescription drug monitoring program (PDMP).
     Under current law,
    health care providers are required to query the PDMP before prescribing
    a second fill for an opioid.  This requirement, which is set to repeal
    on September 1, 2021, is continued indefinitely by the bill.  In addition,
    the bill requires health care providers to query the PDMP before prescribing
    or refilling a benzodiazepine.  Lastly, the bill allows health information
    organization networks to access to the program if the State Medical Board
    can accomplish this with existing program funds.



    Education for providers.
     The bill authorizes the Center for Research
    into Substance Use Disorder Prevention, Treatment, and Recovery Support
    Strategies (center) at the Colorado Health Sciences Center to include in
    its educational activities the best practices for prescribing benzodiazepines
    and the potential harm of inappropriately limiting prescriptions to chronic
    pain patients.  The bill adds an emphasis for these educational activities
    to be directed to physicians, physician assistants, nurses, and dentists
    serving underserved populations and communities.  In addition, the
    bill directs the executive director of DORA to consult with the center
    and the State Medical Board to promulgate rules establishing competency-based
    continuing education requirements for physicians and physician’s assistants
    concerning prescribing practices for opioids.



    Colorado Substance Use Disorders Prevention Collaborative.  
    The
    bill directs the Office of Behavioral Health in the Department of Human
    Services to convene a collaborative with institutions of higher education,
    nonprofit agencies, and state agencies to gather feedback on evidence-based
    prevention practices and other functions related to preventative health,
    to be funded from the Marijuana Tax Cash Fund.  The office is required
    to report its progress to the General Assembly each September from 2022
    to 2025, when the collaborative repeals.
  • 04:34:09 PM  
    Representative Kennedy,
    bill co-sponsor, continued introducing the bill.
    04:40:49 PM  
    The bill sponsors responded to questions from the committee.
    04:46:24 PM  
    Dr. Robert Valuck, Colorado Consortium for Prescription Drug Abuse Prevention, testified in support of the bill. Ms. Lauren Snyder, Mental Health Colorado, testified in support of the bill. Dr. Jonathan Clapp, Colorado Medical Society and Colorado Pain Society, testified to amend the bill. The witnesses responded to questions from the committee.
    05:03:23 PM  
    Dr. Karl Hill, CU
    Boulder / Institute of Behavioral Science, testified in support of the
    bill.  Dr. Nathaniel Riggs, representing himself, testified in support
    of the bill.  Dr. Jeff Jenson, University of Denver, testified in
    support of the bill.  Dr. Mario Perez, Colorado Society of Addiction
    Medicine, testified in support of the bill.  Dr. Stephanie Stewart,
    Colorado Society of Addiction Medicine, testified in support of the bill.
    05:18:41 PM  
    Mr. Butch Lewis,
    Colorado Providers Association, testified in support of the bill.  Ms.
    Jeanette Hensley, Colorado Senior Lobby, testified to amend the bill.  Dr.
    Alexis Ritvo, representing herself, testified in support of the bill.  Ms.
    Terri Schreiber, Benzo Action Work Group of the Colorado Consortium, The
    Schreiber Research Group and person with lived experience of the challenges
    of long-term benzo prescribing, testified in support of the bill.  Mr.
    D Foster, representing himself, testified in support of the bill.

    05:34:24 PM  
    Cameron McDonald, American Physical Therapy Association - Colorado Chapter, testified in support of the bill. Tim Flynn, American Physical Therapy Association - Colorado Chapter, testified in support of the bill. Fran Maes, representing herself, testified to amend the bill.
    05:46:05 PM  
    Dr. Michael Neil,
    Colorado Cross-Disability Coalition, testified to amend the bill.  JoyAnn
    Ruscha, representing herself, testified to amend the bill.  Mr. Kenneth
    Maestas, Colorado Cross-Disability Coalition, testified to amend the bill.
     Ms. Valerie Schlecht, Colorado Cross-Disability Coalition, testified
    to amend the bill.  Ms. Sarah Klein, Epilepsy Foundation of Colorado,
    testified to amend the bill.
    06:05:16 PM  
    Karlee Tebbutt, representing
    herself, testified in opposition to the bill.  Mr. Chris Gassen, Department
    of Regulatory Agencies, answered committee questions.  Ms. Tebbutt
    answered committee questions.



    Submitted public testimony can be found in Attachment E.
    06:19:48 PM  
    Representative Kennedy
    introduced amendment L.005 (Attachment F).


    06:23:35 PM
    Motion Adopt amendment L.005 (Attachment F).
    Moved Kennedy
    Seconded Caraveo
    Cutter
    Hanks
    Kennedy
    McCormick
    Mullica
    Ortiz
    Pelton
    Soper
    Titone
    Van Beber
    Williams Excused
    Caraveo
    Lontine
    YES: 0   NO: 0   EXC: 1   ABS:  0   FINAL ACTION:  Pass Without Objection
    06:24:05 PM  
    Representative Kennedy
    introduced amendment L.007 (Attachment G).


    06:25:37 PM
    Motion Adopt amendment L.007 (Attachment G).
    Moved Kennedy
    Seconded Ortiz
    Cutter
    Hanks
    Kennedy
    McCormick
    Mullica
    Ortiz
    Pelton
    Soper
    Titone
    Van Beber
    Williams
    Caraveo
    Lontine
    YES: 0   NO: 0   EXC: 0   ABS:  0   FINAL ACTION:  Pass Without Objection
    06:26:14 PM  
    Representative Kennedy
    introduced and explained L.004 (Attachment H).
    06:26:38 PM  
    The bill sponsors
    responded to questions about the amendment.


    06:27:43 PM
    Motion Adopt amendment L.004 (Attachment H).
    Moved Kennedy
    Seconded Titone
    Cutter
    Hanks
    Kennedy
    McCormick
    Mullica
    Ortiz
    Pelton
    Soper
    Titone
    Van Beber
    Williams
    Caraveo
    Lontine
    YES: 0   NO: 0   EXC: 0   ABS:  0   FINAL ACTION:  Pass Without Objection
    06:28:17 PM  
    Representative Kennedy
    introduced amendment L.003 (Attachment I).


    06:28:45 PM
    Motion Adopt amendment L.003 (Attachment I).
    Moved Kennedy
    Seconded Ortiz
    Cutter
    Hanks
    Kennedy
    McCormick
    Mullica
    Ortiz
    Pelton
    Soper
    Titone
    Van Beber
    Williams
    Caraveo
    Lontine
    YES: 0   NO: 0   EXC: 0   ABS:  0   FINAL ACTION:  Pass Without Objection
    06:29:17 PM  
    Representative Kennedy
    introduced amendment L.008 (Attachment J).


    06:29:33 PM
    Motion Adopt amendment L.008 (Attachment J).
    Moved Kennedy
    Seconded Titone
    Cutter
    Hanks
    Kennedy
    McCormick
    Mullica
    Ortiz
    Pelton
    Soper
    Titone
    Van Beber
    Williams
    Caraveo
    Lontine
    YES: 0   NO: 0   EXC: 0   ABS:  0   FINAL ACTION:  Pass Without Objection
    06:30:01 PM  
    Representative Kennedy
    introduced amendment L.009 (Attachment K).


    06:30:47 PM
    Motion Adopt amendment L.009 (Attachment K).
    Moved Kennedy
    Seconded Ortiz
    Cutter
    Hanks
    Kennedy
    McCormick
    Mullica
    Ortiz
    Pelton
    Soper
    Titone
    Van Beber
    Williams
    Caraveo
    Lontine
    YES: 0   NO: 0   EXC: 0   ABS:  0   FINAL ACTION:  Pass Without Objection
    06:31:05 PM  
    The bill sponsors provided closing comments on the bill.
    06:36:54 PM  
    Committee members made closing comments on the bill.


    06:40:31 PM
    Motion Refer House Bill 21-1276, as amended, to the Committee on Appropriations.
    Moved Kennedy
    Seconded Ortiz
    Cutter Yes
    Hanks No
    Kennedy Yes
    McCormick Yes
    Mullica Excused
    Ortiz Yes
    Pelton No
    Soper No
    Titone Yes
    Van Beber No
    Williams No
    Caraveo Yes
    Lontine Yes
    Final YES: 7   NO: 5   EXC: 1   ABS:  0   FINAL ACTION:  PASS


    06:40:37 PM   The committee adjourned.






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