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H_HIE_2017A 04/13/2017 Committee Summary

Final

STAFF SUMMARY OF MEETING



HOUSE COMMITTEE ON HEALTH, INSURANCE, & ENVIRONMENT

Date: 04/13/2017
ATTENDANCE
Time: 02:15 PM to 10:36 PM
Beckman
X
Buckner
X
Place: HCR 0107
Covarrubias
X
Humphrey
X
This Meeting was called to order by
Jackson
X
Representative Ginal
Kennedy
X
Landgraf
X
This Report was prepared by
Lontine
*
Vanessa Conway
Ransom
X
Esgar
X
Ginal
X
X = Present, E = Excused, A = Absent, * = Present after roll call
Bills Addressed: Action Taken:
HB17-1237

HB17-1318

HB17-1286

HB17-1247

HB17-1284
Referred to the Committee of the Whole

Amended, Referred to the Committee of the Whole

Referred to the Committee of the Whole

Postponed Indefinitely

Amended, Referred to House Finance





02:15 PM -- HB 17-1237



Representative Hamner presented House Bill 17-1237 to the committee, along with a handout (Attachment A). This bill allows local governments to provide health benefits to their employees through the state employee group benefit plans managed by the Department of Personnel and Administration (DPA). Participation in the state group benefit plans is voluntary for local governments and must be approved by the state personnel director through an intergovernmental agreement. The state personnel director must establish rules for local government participation, and may require that local governments meet certain financial and other conditions in order to participate in the state plan. The bill defines eligible local governments as municipalities, counties, city and counties, special districts, school districts, and any other subdivision of the state.



170413 AttachA.pdf170413 AttachA.pdf



02:20 PM --
Michael Holton, representing Vail Valley Medical Center, testified against the bill and presented a packet of letters (Attachment B).



170413 AttachB.pdf170413 AttachB.pdf







02:24 PM --
Marguerite Tuthill, representing Western Healthcare Alliance, testified against the bill and presented a handout (Attachment C).



170413 AttachC.pdf170413 AttachC.pdf



02:28 PM --
Bonnie Wasli, representing Valley View Hospital, testified against the bill.



02:30 PM --
John Leavitt, representing Colorado Network, testified against the bill.



02:34 PM --
Charlie Sheffield, representing the Colorado Association of Health Plans, testified against the bill.



02:37 PM --
Lieutenant Governor Donna Lynne testified in support of the bill and presented a handout (Attachment D).



170413 AttachD.pdf170413 AttachD.pdf



02:41 PM --
June Taylor, Executive Director of the Colorado Department of Personnel and Administration, testified in support of the bill.



02:57 PM --
Freda Pachter, representing the Bell Policy Center, testified in support of the bill.



03:01 PM --
Kevin Bommer, representing Colorado Municipal League, testified in support of the bill.



03:03 PM --
Gini Pingenot, representing Colorado Counties Incorporated, testified in support of the bill.







03:04 PM --
Sarah Vaine, representing Summit County, testified in support of the bill.

BILL: HB17-1237
TIME: 03:11:59 PM
MOVED: Landgraf
MOTION: Adopt amendment L.001 (Attachment E) to House Bill 17-1237. The chair ruled that the amendment did not fall under the bill's title.
SECONDED:
VOTE
Beckman
Buckner
Covarrubias
Humphrey
Jackson
Kennedy
Landgraf
Lontine
Ransom
Esgar
Ginal
YES: 0 NO: 0 EXC: 0 ABS: 0 FINAL ACTION:



170413 AttachE.pdf170413 AttachE.pdf







03:14 PM



Representative Hamner wrapped up her presentation to the committee.

BILL: HB17-1237
TIME: 03:15:13 PM
MOVED: Esgar
MOTION: Refer House Bill 17-1237 to the Committee of the Whole. The motion passed on a vote of 6-5.
SECONDED: Jackson
VOTE
Beckman
No
Buckner
Yes
Covarrubias
No
Humphrey
No
Jackson
Yes
Kennedy
Yes
Landgraf
No
Lontine
Yes
Ransom
No
Esgar
Yes
Ginal
Yes
Final YES: 6 NO: 5 EXC: 0 ABS: 0 FINAL ACTION: PASS



03:20 PM -- HB 17-1318



Representative Ginal presented House Bill 17-1318, along with amendment L.001 (Attachment F). This bill requires health insurers to submit various information to the Division of Insurance (DOI) in the Department of Regulatory Agencies (DORA) on the cost of pharmaceuticals covered under individual and group health insurance plans. Data must be submitted by March 31, 2018, and each March 31 through 2020. In the first year, carriers must provide cost data for 2015 through 2017, and then in future years for the prior calendar year only. The DOI must aggregate data submitted by insurers and submit a report to the Governor and the Health and Human Services committees of the General Assembly by December 1 each year from 2018 through 2020. Information on pharmaceutical costs must also be presented by DORA during its SMART Government Act hearing.



170413 AttachF.pdf170413 AttachF.pdf



The bill places certain limits on data reporting by the DOI to ensure that prices paid by single carriers are not disclosed and that only aggregated information is presented. The report may not list the names of individual health insurance carriers or pharmaceutical companies, and must identify pharmaceuticals by their drug class rather than individual product names. Information to be reported by carriers and aggregated by the DOI includes:





• the total pharmaceutical costs incurred, including all cost sharing amounts, and the net cost to the carrier after all discounts and rebates;

• the net cost of all pharmaceuticals as a percentage of all medical costs;

• a list of the drug classes of the ten most-dispensed pharmaceuticals, the aggregate cost of each pharmaceutical and the number of unique covered persons receiving the pharmaceutical for brand-named drugs, generic drugs, biological products, and interchangeable biological products; and a list of the drug classes of the ten pharmaceuticals with the highest cost, the number of unique covered persons who received the pharmaceuticals on the list, and the medical condition each pharmaceutical was required to treat.



03:25 PM --
Charlie Sheffield, representing Colorado Association of Health Plans, testified against the bill and presented a packet of handouts (Attachment G).



170413 AttachG.pdf170413 AttachG.pdf



03:34 PM --
Ana English, representing the Center for Improving Value in Health Care, testified in a neutral capacity and presented a handout (Attachment H).



170413 AttachH.pdf170413 AttachH.pdf



03:46 PM --
Lieutenant Governor Donna Lynne testified in support of the bill.



03:56 PM --
Peg Brown, representing DOI, testified in support of the bill and presented a handout (Attachment I).



170413 AttachI.pdf170413 AttachI.pdf



04:00 PM --
Tim Gaudett, representing the Small Business Majority, testified in support of the bill and presented a handout (Attachment J).



170413 AttachJ.pdf170413 AttachJ.pdf



04:03 PM --
Diane Robinson, representing the Senior Lobby, testified in support of the bill.



04:08 PM --
Sandra Payne, representing herself, testified in support of the bill.



04:11 PM --
Caitlin Westerson, representing the Colorado Consumer Health Initiative, testified in support of the bill.







04:14 PM --
Ed Shackelford, representing the Senior Lobby, testified in support of the bill.

BILL: HB17-1318
TIME: 04:19:15 PM
MOVED: Ginal
MOTION: Adopt amendment L.001 (Attachment F) to House Bill 17-1318. The motion passed on a vote of 6-5.
SECONDED: Lontine
VOTE
Beckman
No
Buckner
Yes
Covarrubias
No
Humphrey
No
Jackson
Yes
Kennedy
Yes
Landgraf
No
Lontine
Yes
Ransom
No
Esgar
Yes
Ginal
Yes
YES: 6 NO: 5 EXC: 0 ABS: 0 FINAL ACTION: PASS


BILL: HB17-1318
TIME: 04:29:40 PM
MOVED: Ginal
MOTION: Refer House Bill 17-1318, as amended, to the Committee of the Whole. The motion passed on a vote of 6-5.
SECONDED: Esgar
VOTE
Beckman
No
Buckner
Yes
Covarrubias
No
Humphrey
No
Jackson
Yes
Kennedy
Yes
Landgraf
No
Lontine
Yes
Ransom
No
Esgar
Yes
Ginal
Yes
Final YES: 6 NO: 5 EXC: 0 ABS: 0 FINAL ACTION: PASS



04:45 PM -- HB 17-1286



Representative Esgar presented House Bill 17-1286 to the committee. This bill requires health insurance carriers that contract with the state to provide group benefit plans to state employees to:



• participate in the individual market through the health insurance exchange (Connect for Health Colorado); and

• participate in Medicaid and the Children's Basic Health Plan (CHP+) as specified in rule by the Department of Health Care Policy and Financing (HCPF), including in managed care programs, the accountable care collaborative, and other programs.



In offering plans through the exchange, the carrier must offer a plan in at least two counties in the region of the state with the highest average premiums. The carrier must offer at least three plans, including:



• one plan that has a substantially similar benefit and cost-sharing structure to that offered to state employees;

• one plan that has similar benefits to the state employee plan but a different cost-sharing structure; and

• one plan that is substantially less expensive in terms of monthly premiums as compared to the previous two plans listed above.





04:54 PM --
Nicholas Colglazier, representing Colorado Competitive Council, testified against the bill.



04:57 PM --
Charlie Sheffield, representing Colorado Association of Health Plans, testified against the bill.











05:10 PM --
Lieutenant Governor Donna Lynne testified in support of the bill.



05:18 PM --
June Taylor, Executive Director of the Colorado Department of Personnel and Administration, testified in support of the bill.



05:36 PM --
Debra Judy, representing the Colorado Consumer Health Initiative, testified in support of the bill.



05:38 PM --
Bethany Pray, representing the Colorado Center on Law & Policy, testified in support of the bill.



05:41 PM --
Kate Harris, representing Connect for Health Colorado, testified in a neutral capacity.



05:42 PM



Representative Esgar wrapped up her presentation to the committee.

BILL: HB17-1286
TIME: 05:47:54 PM
MOVED: Esgar
MOTION: Refer House Bill 17-1286 to the Committee of the Whole. The motion passed on a vote of 6-5.
SECONDED: Ginal
VOTE
Beckman
No
Buckner
Yes
Covarrubias
No
Humphrey
No
Jackson
Yes
Kennedy
Yes
Landgraf
No
Lontine
Yes
Ransom
No
Esgar
Yes
Ginal
Yes
Final YES: 6 NO: 5 EXC: 0 ABS: 0 FINAL ACTION: PASS



05:49 PM -- HB 17-1247



Representatives Danielson and J. Becker presented House Bill 17-1247 to the committee. For a health benefit plan or third-party administrator plan covering services provided by a licensed chiropractor, optometrist, or pharmacist, the bill prohibits the carrier or administrator from limiting a patient's ability to choose such a provider in the following ways:





• limiting or restricting a covered persons ability to select the provider of his or her choice, as long as the selected provider has agreed to the terms of the contract of the health benefit plan;

• imposing a copayment, fee, or other cost-sharing requirement on a covered person or health care provider unless the health benefit plan imposes the same copayment, fee, or cost-sharing requirement on all covered persons or health care providers in the state;

• imposing any other conditions on a covered person or provider that limit or restrict a covered person's ability to use the provider or his or her choice; or

• denying a selected provider the right to participate in any of its provider network contracts in this state if the provider agrees to the contractual terms and provides appropriate services under all applicable state and federal laws and regulations.



The bill does not apply to inpatient or emergency health care services provided in a health facility licensed or certified by the Colorado Department of Public Health and Environment. It also does not apply to self-funded health plans that are exempt from state regulation, plans covering state or federal employees, or managed care plans in which the majority of covered services are provided through physicians employed by the carrier.



06:13 PM --
Patrick Boyle, representing Express Scripts, testified against the bill.



06:18 PM --
Rachel Lee, representing CVS Health, testified against the bill.



06:33 PM --
Marc Reece, representing Aetna, testified against the bill.



06:37 PM --
Bridget Flavin, representing Anthem, testified against the bill.



06:40 PM --
Sara Orrange, representing Colorado Association of Health Plans, testified against the bill and presented a handout (Attachment K)



170413 AttachK.pdf170413 AttachK.pdf



06:44 PM --
Virginia Morrison Love, representing America's Health Insurance Plans, testified against the bill.



06:54 PM --
Bill Skewes, representing Colorado Association of Commerce & Industry, testified against the bill.



06:59 PM -- Tom Davis, representing himself, testified in support of the bill.



07:12 PM --
Representative Danielson read the testimony of Marijo Rymer, representing The Arc of Colorado, in support of the bill, and presented a copy of the testimony (Attachment L).



170413 AttachL.pdf170413 AttachL.pdf



07:14 PM --
Ky Davis, representing Rx+ Pharmacies, testified in support of the bill.



07:27 PM --
Trish Leone, representing herself, testified in support of the bill.











07:34 PM --
Peg Brown, representing the Colorado Department of Regulatory Agencies Division of Insurance, answered committee questions.



07:45 PM --
Dr. Zoey Loomis, representing the Colorado Optometric' Association, testified in support of the bill.



07:52 PM --
Terri Newland, representing herself, testified in support of the bill.



08:01 PM --
Dr. John Pederson, representing the Colorado Optometric Association, testified in support of the bill.



08:07 PM --
Dr. Deanna Alexander, representing the Colorado Optometric Association, testified in support of the bill.



08:12 PM --
Barb Cardell, representing Colorado Organizations Responding to AIDS, testified in support of the bill.



08:16 PM --
Dr. Karena Cretan, representing Clinical Pharmacists for Rocky Mountain Cares, testified in support of the bill.



08:18 PM --
Rebecca Cranston, representing the Northern Colorado AIDS Project, testified in support of the bill.



08:22 PM



Representative Danielson distributed a handout (Attachment M).



170413 AttachM.pdf170413 AttachM.pdf







08:31 PM



Representatives Danielson and Becker wrapped up their presentation to the committee.

BILL: HB17-1247
TIME: 09:10:34 PM
MOVED: Esgar
MOTION: Refer House Bill 17-1247 to the Committee of the Whole. The motion failed on a vote of 4-7.
SECONDED: Lontine
VOTE
Beckman
No
Buckner
Yes
Covarrubias
No
Humphrey
No
Jackson
No
Kennedy
Yes
Landgraf
No
Lontine
Yes
Ransom
No
Esgar
Yes
Ginal
No
YES: 4 NO: 7 EXC: 0 ABS: 0 FINAL ACTION: FAIL
BILL: HB17-1247
TIME: 09:08:08 PM
MOVED: Ransom
MOTION: Postpone House Bill 17-1247 indefinitely. The motion passed on a vote of 6-5.
SECONDED: Humphrey
VOTE
Beckman
Yes
Buckner
No
Covarrubias
Yes
Humphrey
Yes
Jackson
No
Kennedy
No
Landgraf
Yes
Lontine
No
Ransom
Yes
Esgar
No
Ginal
Yes
Final YES: 6 NO: 5 EXC: 0 ABS: 0 FINAL ACTION: PASS







09:09 PM -- HB 17-1284



Representative Lontine presented House Bill 17-1284 to the committee, along with a handout (Attachment N) and amendment L.001 (Attachment O). This bill requires the following employers to conduct a records check of the Colorado adult protective services (CAPS) data system for prospective employees to determine if a prospective employee who will work directly with at-risk adults is the subject of a substantiated report of adult abuse or neglect:



170413 AttachO.pdf170413 AttachO.pdf



• county adult protective service departments;

• health facilities licensed by the Colorado Department of Public Health and Environment;

• adult day care facilities;

• community integrated health service agencies;

• community-centered boards and other contracted agencies serving persons on Medicaid home- and community-based service waiver programs;

• area agencies on aging and contracted service providers;

• facilities operated by the Department of Human Services (DHS) that provide care and treatment for persons with developmental disabilities (regional centers);

• facilities operated by DHS that provide care and treatment for persons with mental illness; and

• veterans community living centers.



CAPS records checks must be conducted starting on January 1, 2019. The State Board of Human Services must set a fee schedule for conducting the records checks that covers the cost of administering the program. DHS may charge this fee to requesting employers. In addition, the bill allows a person hiring a caregiver to provide consumer-directed attendant support services under a Medicaid waiver program to voluntarily request a CAPS records check at his or her own expense. DHS must establish rules for conducting records checks.



As soon as feasible following passage of the bill, county departments of human services are required to notify individuals when a report of adult abuse or neglect has been substantiated against them and to inform them of their right to appeal the finding. The DHS must promulgate rules and establish an appeals process for persons to contest the substantiated finding against them. DHS is required to provide training to all current county adult protection employees by July 1, 2018, and to all future employees on an ongoing basis, about the requirements of the bill and other best practices concerning adult protection investigations, assessments, and services.



The bill specifies that information from CAPS records checks is confidential. Employers making a hiring decision based on disqualifying information received from the CAPS records check are immune from civil liability, unless the information in the CAPS system is false and the employer knows it to be false. The bill prohibits an employer from requesting a CAPS records check on someone who is not a current employee or applicant, and prohibits the release of information obtained in a CAPS records check to anyone who is not involved in the hiring process, with certain limited exceptions. A person who is found to have improperly requested a CAPS records check or shared information from a records check commits a class 1 misdemeanor.



09:20 PM



Representative Lontine read the testimony of Marijo Rymer, representing The Arc of Colorado, in support of the bill.













09:34 PM



Brita Darling, representing the Office of Legislative Legal Services, answered committee questions on the bill.



09:37 PM --
David Ervin, representing The Resource Exchange, testified in support of the bill.



09:42 PM --
Jeanette Hensley, representing Colorado Senior Lobby, testified in support of the bill.



09:47 PM --
Doug Farmer, representing Colorado Health Care Association, testified in a neutral capacity.



09:53 PM --
Riley Kitts, representing DHS, testified in support of the bill and presented two handouts (Attachments P and Q).



170413 AttachP.pdf170413 AttachP.pdf170413 AttachQ.pdf170413 AttachQ.pdf



09:57 PM --
Mindy Kemp, representing DHS, testified in support of the bill.



10:01 PM --
Stefanie Norred, representing DHS, testified in support of the bill.



10:08 PM



Bill Zepernick, representing Legislative Council Staff, answered committee questions on the fiscal note.

BILL: HB17-1284
TIME: 10:29:43 PM
MOVED: Lontine
MOTION: Adopt amendment L.001 (Attachment O) to House Bill 17-1284. The motion passed without objection.
SECONDED: Ginal
VOTE
Beckman
Buckner
Covarrubias
Humphrey
Jackson
Kennedy
Landgraf
Lontine
Ransom
Esgar
Ginal
YES: 0 NO: 0 EXC: 0 ABS: 0 FINAL ACTION: Pass Without Objection


BILL: HB17-1284
TIME: 10:32:45 PM
MOVED: Lontine
MOTION: Refer House Bill 17-1284, as amended, to the Committee on Finance. The motion passed on a vote of 7-4.
SECONDED: Buckner
VOTE
Beckman
Yes
Buckner
Yes
Covarrubias
No
Humphrey
No
Jackson
Yes
Kennedy
Yes
Landgraf
No
Lontine
Yes
Ransom
No
Esgar
Yes
Ginal
Yes
Final YES: 7 NO: 4 EXC: 0 ABS: 0 FINAL ACTION: PASS






The House and Senate are temporarily adjourned.  The building is closed to the public.

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