h_hie_2016a_2016-05-05t13:36:07z0 Hearing Summary

Date: 05/05/2016

01:37 PM -- SB 16-199



Representative DelGrosso and Representative Ginal, co-prime bill sponsors, presented Senate Bill 16-199. The bill, as amended by the Senate Health and Human Services Committee, requires that contracts between the Department of Health Care Policy and Financing (HCPF) and organizations providing a program of all-inclusive care for the elderly (PACE organizations) include the negotiated monthly capitated rate for services. The rate must be less than the amount that would have been paid for services to the PACE participant under the regular Medicaid state plan if the person were not enrolled in PACE. In addition, the bill requires HCPF, with the participation of PACE organizations, to develop an actuarially sound upper payment limit methodology that meets federal requirements and other standards. HCPF must contract with an actuary with relevant experience concerning Medicaid and PACE. Until the upper payment limit methodology is developed, the bill requires that the percentage of the upper payment limit used to determine the monthly capitated rate not be less than the percentage negotiated with providers for FY 2016-17. HCPF is not required to develop the new methodology if sufficient gifts, grants, or donations are not received for this purpose.



The bill also creates the state PACE ombudsman in the Office of the Long-term Care Ombudsman in the Department of Human Services (DHS). PACE organizations are required to post information in their facilities and provide written notice to PACE participants about contacting the PACE ombudsman. The bill sets forth procedures for the state PACE ombudsman, including duties, access to PACE organization records, and penalties for retaliating against PACE participants or employees who communicate or share information with the state PACE ombudsman. For FY 2016-17 through FY 2020-21, the state PACE ombudsman will not operate if sufficient gifts, grants, and donations are not received to cover the costs of the ombudsman. The PACE Ombudsman Fund is created in the DHS to receive these gifts, grants, and donations. Lastly, the bill establishes a stakeholder group to develop legislation for introduction during the 2017 legislative session concerning the creation of a system of local PACE ombudsmen to work in conjunction with the state PACE ombudsman.



01:46 PM



Representative DelGrosso and Representative Ginal answered questions from the committee. Representative DelGrosso referenced amendment L.012 (Attachment A). Representative Lontine distributed amendment L.013 (Attachment B).



160505 AttachA.pdf160505 AttachB.pdf



01:58 PM -- Jennifer Anderson, Attorney General's Office, testified in support of the bill. Ms. Anderson answered questions from the committee.



02:04 PM -- Mike Feeley, InnovAge, testified in support of the bill. Mr. Feeley answered questions from the committee



02:21 PM



Committee discussion with Representative DelGrosso, Representative Ginal, and Mr. Feeley ensued.



02:29 PM -- Elisabeth Arenales, Colorado Center on Law and Policy, testified in support of the bill, if amended.



02:33 PM -- Adela Flores-Brennan, Colorado Consumer Health Initiative, testified in support of the bill.



02:35 PM



Ms. Arenales answered questions from the committee.



02:41 PM -- Zach Lynkiewicz, HCPF, testified in a neutral capacity on the bill.



02:45 PM -- Shane Mofford, HCPF, testified in a neutral capacity on the bill. Mr. Mofford answered questions from the committee.



02:57 PM



Mr. Lynkiewicz and Mr. Mofford answered questions from the committee.



03:03 PM -- Bev Dahan, InnovAge, testified on the bill. Ms. Dahan answered questions from the committee.



03:07 PM -- Anne Meier, State Long-term Care Ombudsman, answered questions from the committee.

03:10 PM



Representative DelGrosso commented on amendment L.013 (Attachment B). Representative Lontine discussed amendment L.013. Committee discussion about amendment L.013 with Representative DelGrosso and Representative Ginal ensued.

03:17 PM



Representative Ginal made concluding remarks about the bill.