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8577289B6C5AB2F6872586BE006B3C9E Hearing Summary




PUBLIC
BILL SUMMARY For HB21-1198

HOUSE COMMITTEE ON HEALTH & INSURANCE
Date Apr 21, 2021      
Location HCR 0112



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






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