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

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.
  

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.

Ms. Kaitlyn Tollefson, Young Invincibles, testified in support of the bill.

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.

The bill sponsors provided closing comments on the bill.

Committee members provided closing comments on the bill.

Representative McCluskie, bill co-sponsor, continued introducing SB21-142.

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.

The bill sponsors provided closing comments on the bill.

Committee members provided closing comments on the bill.

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.

The bill sponsors responded to questions from the committee.

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.

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.

The bill sponsors provided closing comments on the bill.

Committee members made closing comments on the bill.