j_hce_2016a_2016-08-24t09:03:13z2 Hearing Summary
Date: 08/24/2016
Final
Discussion with DOI of Previously Raised Questions
COMMITTEE ON HEALTH CARE EXCHANGE
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09:25 AM -- Discussion with Division of Insurance of Previously Raised Questions
Commissioner Marguerite Salazar, Division of Insurance (DOI), told the committee that she and her staff will be discussing two issues: the inclusion of free standing independent birthing centers staffed by nurse midwives in provider networks, and the idea of allowing pregnancy to be a triggering event for an SEP. Commission Salazar explained that New York is the only state that allows pregnancy to trigger an SEP. She explained that since New York implemented this provision in January 2016 there is no data yet to show how allowing pregnancy to trigger an SEP will affect insurance rates.
09:28 AM
Matt Mortier, DOI, told the committee that all Colorado health insurance providers cover certified midwife services, but not all insurers include nurse midwives who are providing services in a free standing independent birthing center in their networks. Mr. Mortier explained that the issue that was raised at the previous meeting by a representative of Mountain Midwifery Center was that certain insurers were not contracting with this specific business. The representative stated that the center should be included in plans for network adequacy purposes. Mr. Mortier explained that network adequacy rules do not require insurers to contract with any willing provider nor with every type of provider. Mr. Mortier responded to questions from the committee about the number of nurse midwives that are covered by insurance providers. Discussion about direct-entry midwives and certified nurse midwives followed. Senator Lundberg discussed insurance coverage for direct-entry midwives.
09:35 AM
Senator Aguilar asked that DOI provide information about the areas of the state where residents have only one insurance provider offering health plans.