s_blt_2017a_2017-02-15t14:02:50z0 Hearing Summary

Date: 02/15/2017

Location: SCR 352

02:03 PM -- SB 17-151



Senator Crowder introduced Senate Bill 17-151, concerning changes in the requirements for the coverage of health care benefits to allow for increased consumer access to health care services. The bill requires health insurance carriers that conduct credentialing of providers, utilization management, and utilization review to do the following:



1. base health care coverage authorization and medical necessity determination on generally accepted and evidence-based standards and criteria of clinical practice;

2. disclose evidence-based standards and criteria of clinical practice and processes to policyholders and providers that the carrier uses for coverage authorization and medical necessity determinations;

3. ensure that coverage authorizations and medical necessity determinations are performed by a health care provider who is licensed in a similar health field as the requesting provider;

4. categorize a condition as a new episode of care if the same provider has not treated the policyholder for the condition within the previous 30 days; and

5. ensure that tiered prior authorization criteria are based on generally accepted evidence-based standards and criteria.



Senator Crowder provided amendment L.001 (Attachment A) to the committee and discussed the purpose of the amendment.



170215 AttachA.pdf



02:08 PM -- Nicholas Colglazier, Colorado Competitive Council and Colorado Association of Commerce and Industry, spoke in opposition to the bill.



02:10 PM -- Dr. Liz Kah, Kaiser Permanente, spoke in opposition to the bill. She responded to questions from the committee.



02:15 PM -- Dr. Elizabeth Kraft, Anthem, spoke in opposition to the bill.



02:18 PM -- Sara Orrange, Colorado Association of Health Plans, spoke in opposition to the bill.



02:20 PM -- Judith Burke, Health Care for All Colorado, spoke in support of the bill. She responded to questions from the committee.



02:23 PM -- Rachel Wendt, Colorado Chiropractic Association, spoke in support of the bill. She responded to questions from the committee.



02:31 PM -- Nico Brown, American Physical Therapy Association - Colorado, spoke in support of the bill. He responded to questions from the committee.



02:35 PM -- Pamela DiPasquale, Occupational Therapy Association of Colorado, spoke in support of the bill.



02:38 PM -- Ken Summers, representing himself, spoke in support of the bill. He responded to questions from the committee.



02:49 PM -- Ed Shackelford, Colorado Senior Lobby, spoke in support of the bill.



02:51 PM -- Dr. Terry Gebhardt, Colorado In Motion, spoke in support of the bill. He responded to questions from the committee.



02:55 PM -- Ellen Caruso, American Physical Therapy Association, spoke in support of the bill. She discussed a letter from a patient that was provided to the committee (Attachment B). She responded to questions from the committee.



170215 AttachB.pdf





03:02 PM



Senator Crowder made closing comments on the merits of the bill. The committee recessed.



03:13 PM



The committee came back to order.