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385ED40FF9ADAE50872586CC007A8939 Hearing Summary




PUBLIC
BILL SUMMARY For HB21-1276

HOUSE COMMITTEE ON HEALTH & INSURANCE
Date May 5, 2021      
Location HCR 0112



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






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