House Committee on Business Affairs and Labor (02/03/2010)

Final
STAFF SUMMARY OF MEETING

HOUSE COMMITTEE ON BUSINESS AFFAIRS AND LABOR

Date:	02/03/2010	ATTENDANCE

Time:	11:12 AM to 04:23 PM	Balmer	X
		Bradford	X
Place:	HCR 0112	Casso	*
		Kerr A.	*
This Meeting was called to order by		Liston	X
	Representative Rice	Middleton	*
		Priola	*
This Report was prepared by		Soper	X
	Christie Lee	Stephens	X
		Gagliardi	X
		Rice	X
		X = Present, E = Excused, A = Absent, * = Present after roll call

Bills Addressed:		Action Taken:
HB10-1175 HB10-1180 HB10-1038 HB10-1021 HB10-1202		Amended, Referred to the Committee of the Whole Referred to the Committee of the Whole Amended, Referred to Appropriations Amended, Referred to the Committee of the Whole Amended, Referred to the Committee of the Whole

11:13 AM -- House Bill 10-1175

Representative Looper, prime sponsor, presented House Bill 10-1175 concerning the demonstration of competency by an out-of-state applicant in a field regulated by the Department of Regulatory Agencies. Currently, certain health care professionals who are licensed in other states may be licensed in Colorado if they meet competency requirements demonstrated by time spent "in the field." This bill permits either the director of the Division of Registrations, in the Department of Regulatory Agencies, or the appropriate board to identify by rule an alternate set of criteria to demonstrate competency. Representative Looper explained that this bill is another bill intended to help military spouses.

11:16 AM -- Jacline Harriman, representing the Department of Defense, testified in support of the bill. She talked about her experience as a miliary spouse and the differences in pay between miliary personnel and the private sector due to the mobility of their lifestyle. Ms. Harriman read a story from a registered nurse stationed in Japan who is in the process of relocating to Oklahoma and her difficulty reinstating her nursing license.

11:24 AM -- Rachelle Chapman, a spouse whose husband is in the Navy, representing Adecco, testified in support of the bill. She said she has spoken to many military spouses through Adecco and would like to share their experiences. Ms. Chapman talked about the difficulty military spouses have finding a job when they relocate.

11:29 AM -- Arlene Miles, representing Colorado Health Care Association, testified in support of the bill. She talked about the limited number of nursing care licensed administrators and how the bill would positively impact the industry.

11:32 AM -- Rose McCool, representing the Division of Registrations, testified in support of the bill. Ms. McCool explained Amendment L.001 (Attachment A) relating to physical therapists.


BILL:	HB10-1175
TIME:	11:35:08 AM
MOVED:	Soper
MOTION:	Moved amendment L.001 (Attachment A). The motion passed without objection.
SECONDED:	Casso
		VOTE
	Balmer
	Bradford
	Casso
	Kerr A.	Excused
	Liston
	Middleton
	Priola
	Soper
	Stephens
	Gagliardi
	Rice
Not Final YES: 0 NO: 0 EXC: 1 ABS: 0 FINAL ACTION: Pass Without Objection


BILL:	HB10-1175
TIME:	11:36:02 AM
MOVED:	Soper
MOTION:	Moved to refer House Bill 10-1175, as amended, to the Committee of the Whole. The motion passed 10-0.
SECONDED:	Gagliardi
		VOTE
	Balmer	Yes
	Bradford	Yes
	Casso	Yes
	Kerr A.	Excused
	Liston	Yes
	Middleton	Yes
	Priola	Yes
	Soper	Yes
	Stephens	Yes
	Gagliardi	Yes
	Rice	Yes
Final YES: 10 NO: 0 EXC: 1 ABS: 0 FINAL ACTION: PASS

11:36 AM -- House Bill 10-1180

Representative Massey, prime sponsor, presented House Bill 10-1180 concerning the criteria to qualify for a performance-based incentive for film production activities in Colorado. HB 10-1180 loosens the criteria required of a film production company to qualify for a performance-based incentive for film production activities in Colorado. Specifically, the bill:

allows an incentive for a television commercial;
incorporates the definition of "qualified payroll expenditure" into the definition of "qualified local expenditure";
removes the requirement that the production company must spend at least 75 percent of its production expenditures on qualified local expenditures and qualified local payroll expenditures;
reduces the minimum total qualified local expenditures for a production company that does not originate its film production activities in Colorado from $1 million to $250,000; and
lowers the actual qualified local expenditures necessary to receive an incentive.

11:40 AM -- Kevin Shand, representing the Colorado Film Office, testified in support of the bill. He said they have been struggling to get production to Colorado and talked about the impact the bill would have on the commercial industry.


BILL:	HB10-1180
TIME:	11:42:49 AM
MOVED:	Balmer
MOTION:	Moved to refer House Bill 10-1180 to the Committee of the Whole. The motion passed 10-0.
SECONDED:	Middleton
		VOTE
	Balmer	Yes
	Bradford	Yes
	Casso	Yes
	Kerr A.	Excused
	Liston	Yes
	Middleton	Yes
	Priola	Yes
	Soper	Yes
	Stephens	Yes
	Gagliardi	Yes
	Rice	Yes
Final YES: 10 NO: 0 EXC: 1 ABS: 0 FINAL ACTION: PASS

11:43 AM -- House Bill 10-1038

Representative Miklosi, prime sponsor, presented House Bill 10-1038 concerning a brochure to describe the process for workers' compensation claims. This bill, recommended by the Interim Committee to Study Issues Related to Pinnacol Assurance, requires an employer or the employer's insurance carrier to provide a brochure, approved by the Director of the Division of Workers' Compensation, to each workers' compensation claimant. The brochure will include contact information, a description of the claims process, and a claimant's rights to medical treatment and benefit payments under workers' compensation law. Representative Miklosi explained that the bill came out of the Interim Committee to Study Issues Related to Pinnacol Assurance and mentioned that Pinnacol Assurance supports the bill.

11:46 AM

Representative Liston talked about the amount of information that would be required to be included in the brochure under the bill and asked whether Representative Miklosi thinks it may be too much information for a brochure. Representative Miklosi responded.

11:48 AM -- Shelley Dodge, a Workers' Compensation Claimant Attorney, testified in support of the bill. She said that although the Department of Labor and Employment has a proficient website, the bill will help her older clients and clients who do not have access to a computer. Ms. Dodge also talked about the complexity of workers' compensation. Representative Liston talked about the amount of information that would be required to be included in the brochure under the bill. He also asked how many times the information is required to be given to the worker. Ms. Dodge explained that the brochure would be distributed at the beginning of the claim once, per worker, per injury. She also commented on the amount of information included stating it speaks to the complexity of workers' compensation law.

11:53 AM -- Bob Summers, representing the Colorado Division of Workers' Compensation, testified on the bill. He gave some background on the current workers' compensation process and how the bill would change it. Mr. Summers talked about the provision in the bill regarding claimant's rights that an amendment will be addressing.

11:55 AM -- Phil Hayes, representing the Colorado AFL-CIO, testified in support of the bill. He said the bill provides transparency to those who need it. Mr. Hayes talked about the number of calls the AFL-CIO receives concerning workers' compensation and the benefits the brochure would provide when fielding those calls.

11:57 AM -- David Levy, representing the Workers' Compensation Education Association, testified in support of the bill. He said he is all for as much information as possible.

12:00 PM

Representative Miklosi discussed and distributed Amendment L.004 (Attachment B) and L.005 (Attachment C).


BILL:	HB10-1038
TIME:	12:01:10 PM
MOVED:	Gagliardi
MOTION:	Moved amendment L.004 (Attachment B). The motion passed without objection.
SECONDED:	Liston
		VOTE
	Balmer
	Bradford
	Casso
	Kerr A.
	Liston
	Middleton
	Priola
	Soper
	Stephens
	Gagliardi
	Rice
Not Final YES: 0 NO: 0 EXC: 0 ABS: 0 FINAL ACTION: Pass Without Objection


BILL:	HB10-1038
TIME:	12:01:51 PM
MOVED:	Gagliardi
MOTION:	Moved amendment L.005 (Attachment C). The motion passed without objection.
SECONDED:	Bradford
		VOTE
	Balmer
	Bradford
	Casso
	Kerr A.
	Liston
	Middleton
	Priola
	Soper
	Stephens
	Gagliardi
	Rice
Not Final YES: 0 NO: 0 EXC: 0 ABS: 0 FINAL ACTION: Pass Without Objection

12:02 PM

Representative Miklosi gave some closing comments about the bill.


BILL:	HB10-1038
TIME:	12:02:42 PM
MOVED:	Soper
MOTION:	Moved to refer House Bill 10-1038, as amended, to the Committee on Appropriations. The motion passed 10-0.
SECONDED:	Gagliardi
		VOTE
	Balmer	Yes
	Bradford	Yes
	Casso	Yes
	Kerr A.	Yes
	Liston	Yes
	Middleton	Yes
	Priola	Yes
	Soper	Yes
	Stephens	Excused
	Gagliardi	Yes
	Rice	Yes
Final YES: 10 NO: 0 EXC: 1 ABS: 0 FINAL ACTION: PASS

01:31 PM -- House Bill 10-1021

Representative Frangas and Representative McCann, co-prime sponsors, presented House Bill 10-1021 concerning required coverages for reproductive services for health insurance policies. This bill, recommended by the Health Care Task Force, requires that individual sickness and accident insurance policies provide the same coverage for maternity care as is currently mandated for all group sickness and accident policies regulated by the state. It also requires all individual and group policies to provide coverage for pregnancy management including, but not limited to, contraceptive counseling, drugs, and devices. The bill does not mandate coverage for abortion procedures or services.

01:36 PM

Representative Frangas offered some statistics on the number of women who have maternity care and the various costs involved to those who do not. He also distributed Amendment L.003 (Attachment D). Representative McCann talked about the importance of maternity care and the types of people that would benefit from coverage.

01:42 PM

Representative Soper asked whether the bill requires maternity coverage on all policies. Representative Frangas said the bill would require insurance companies to offer a policy that includes maternity care. Representative Middleton talked about unplanned pregnancies and at what point a woman can obtain coverage under the bill. Representative McCann explained that under the bill, unplanned pregnancies could not be included. Representative Middleton suggested a possible opt out type of coverage.

01:47 PM -- Toni Panette, representing the National Abortion and Reproductive Rights Action League (NARAL) Pro-Choice, testified in support of the bill. She talked about the importance of birth control and its effect on unintended pregnancies. Ms. Panette also talked about the impacts prenatal care has on pregnancies. She also talked about the costs involved when the baby is premature. Ms. Panette talked about the history of maternity coverage. She listed some statistics on the number of women who have maternity coverage and individual health insurance. Ms. Panette listed the insurers in the state that offer maternity coverage and the stipulations involved. Ms. Panette explained that four of ten pregnancies are covered under Medicaid in Colorado. Representative Stephens asked whether women could wait to buy maternity coverage until the last minute under the bill. Ms. Panette responded.

01:57 PM -- Rachel Klein, representing the National Abortion and Reproductive Rights Action League (NARAL) Pro-Choice, testified in support of the bill. Ms. Klein talked about her experience obtaining coverage in the individual market that includes contraceptives. She also talked about the costs involved in pregnancy riders.

01:59 PM -- Scott Matthews, representing the March of Dimes, testified in support of the bill. He talked about the number of premature births in Colorado and the costs involved, not including ongoing costs. Mr. Matthews talked about the number of unplanned pregnancies. Representative Middleton asked Mr. Matthews to talk about the number of insured and uninsured he deals with at the March of Dimes. Mr. Matthews said he cannot answer that question.

02:04 PM -- Eliza Buyers, representing the American Congress of Obstetricians and Gynecologists, testified in support of the bill and distributed a handout of her talking points (Attachment E). She talked about the importance of maternity coverage and prenatal care. Ms. Buyers also stated that maternity coverage saves money by improving maternal and child health outcomes.

02:12 PM -- Andrew Ross, M.D., representing the Colorado American Congress of Obstetricians and Gynecologists, testified in support of the bill. He talked about policies that do not cover certain contraceptives, such as intrauterine devices, but do cover permanent contraceptive, such as women getting their tubes tied. He also distributed a handout (Attachment F). Dr. Ross also talked about certain conditions that are treated by contraceptives.

02:19 PM -- Rochelle Dworet Cohen, representing Health Care for All Colorado (HCAC) and herself as a physician, testified in support of the bill. She talked about the importance of affordable health insurance.

02:22 PM -- Dr. Tracy Hofeditz, M.D., representing the Colorado Academy of Family Physicians, testified in support of the bill.

02:23 PM -- Sharlene Yabe, representing the Colorado State Association of Health Underwriters, was originally going to testify against the bill, but said the amendments have addressed most of her concerns. However, she said she would like to see a time frame included in the bill for when the coverage can be purchased so women cannot just wait until the last minute to buy pregnancy coverage. She also responded to earlier testimony regarding the types of coverage that are offered in Colorado. Ms. Yabe talked about contraceptive coverage and the reasons some insurers do not offer it. Ms. Yabe also talked about other types of contraceptives that are offered over the counter and as generics.

02:30 PM

Representative Gagliardi asked Ms. Yabe to explain who she was representing. Representative Liston asked about the number of insurance companies that offer individual coverage in Colorado. He also asked what would happen to insurance coverage and the number of companies in Colorado with the additional mandates. Ms. Yabe talked about the number of group insurers that have dropped out of the group market and the increase in costs in the individual market.

02:35 PM -- Marc Reece, representing the Colorado Association of Health Plans, testified against the bill as introduced. He said now with the amendment they will have to re-evaluate their position. Representative McCann asked Mr. Reece if he knew the number of insurers that offer these types of plans. Mr. Reece did not comment.


BILL:	HB10-1021
TIME:	02:37:38 PM
MOVED:	Gagliardi
MOTION:	Moved amendment L.003 (Attachment D), as amended (see next vote sheet). The motion passed 10-1.
SECONDED:	Balmer
		VOTE
	Balmer	Yes
	Bradford	Yes
	Casso	No
	Kerr A.	Yes
	Liston	Yes
	Middleton	Yes
	Priola	Yes
	Soper	Yes
	Stephens	Yes
	Gagliardi	Yes
	Rice	Yes
Not Final YES: 10 NO: 1 EXC: 0 ABS: 0 FINAL ACTION: PASS


BILL:	HB10-1021
TIME:	02:40:03 PM
MOVED:	Balmer
MOTION:	Amend Amendment L.003, line 5, strike "17" and insert "21". The motion passed without objection.
SECONDED:	Gagliardi
		VOTE
	Balmer
	Bradford
	Casso
	Kerr A.
	Liston
	Middleton
	Priola
	Soper
	Stephens
	Gagliardi
	Rice
Not Final YES: 0 NO: 0 EXC: 0 ABS: 0 FINAL ACTION: Pass Without Objection

02:50 PM

Representative McCann commented on the bill.


BILL:	HB10-1021
TIME:	02:51:15 PM
MOVED:	Gagliardi
MOTION:	Moved to refer House Bill 10-1021, as amended, to the Committee of the Whole. The motion passed 11-0.
SECONDED:	Balmer
		VOTE
	Balmer	Yes
	Bradford	Yes
	Casso	Yes
	Kerr A.	Yes
	Liston	Yes
	Middleton	Yes
	Priola	Yes
	Soper	Yes
	Stephens	Yes
	Gagliardi	Yes
	Rice	Yes
Final YES: 11 NO: 0 EXC: 0 ABS: 0 FINAL ACTION: PASS

02:53 PM -- House Bill 10-1202

The committee took a brief recess.

02:57 PM

The committee was called back to order. Representative McNulty and Representative Primavera, co-prime sponsors, presented House Bill 10-1202 concerning health benefit coverage for chemotherapy treatment. This bill requires a health benefit plan that provides coverage for cancer chemotherapy treatment to cover orally administered anticancer medication at the same copayment percentage or relative coinsurance amount as is applied to intravenously administered or injected anticancer medication. An oral medication is covered by the bill if it is approved by the federal Food and Drug Administration, determined to be medically necessary, and not prescribed primarily for the convenience of the patient, physician, or other health care provider. The carrier cannot increase patient out-of-pocket costs for intravenously administered or injected chemotherapy to comply with the bill. Carriers can specify which oral medications they cover (formulary) and substitute an oral generic medication when available.
02:59 PM

Representative Primavera talked about her experience with cancer and chemotherapy. Representative McNulty talked about the dangers of cancer and the treatment. He talked about a similar bill that was brought last year and the differences between that bill and House Bill 10-1202. Representative Stephens asked whether the bill would go to the mandate commission and whether it will increase health insurance premiums. A discussion ensued regarding the costs involved with the bill.

03:10 PM -- Marc Reece, representing the Colorado Association of Health Plans, testified against the bill as introduced. Representative Rice asked Mr. Reece to comment on Representative Middleton's earlier comments about her father having coverage for the intravenous treatment in the nursing home, but not at his home, thus making it more beneficial to stay in the nursing home.

03:13 PM -- Susan Cox, representing Kaiser Permanente, testified on the bill and distributed a handout (Attachment G). She said the bill would cause an administrative burden with no additional health benefits to members because they already cover this. She explained the code changes that would need to be changed if the bill passes and the time involved. Representative Rice asked why anything would need to change since they already cover this. Ms. Cox responded. A discussion ensued regarding why changes are necessary and how to avoid them since Kaiser Permanente is complying with the provisions of the bill. Ms. Cox responded to additional questions from the committee.

03:28 PM -- Jared Freml, representing Kaiser Permanente, testified on the bill. He said the bill has good intentions, but there will be some negative unintended consequences. Mr. Freml went over the handout that was distributed earlier and directed the committee to page two. Representative Liston asked a question about the handout and the costs related involved with certain medications and how that would affect premiums.

03:34 PM -- Travis Berry, representing the Colorado Competitive Council, testified against the bill. He said costs are going to affect the cost of health insurance. Mr. Berry talked about the fiscal note.

03:37 PM -- Dana Dzwankowski, representing the American Cancer Society and the Cancer Action Network, testified in support of the bill and distributed a handout (Attachment H). Ms. Dzwankowski talked about costs involved. She walked the committee through the handout. Ms. Dzwankowski talked about the Food and Drug Administration approval process. Representative Liston asked what percent of individuals that may be eligible for these drugs are receiving them and how many of those are in an ERISA plan. Ms. Dzwankowski responded.

03:49 PM -- Dr. Nicholas DiBella, representing Rocky Mountain Cancer Centers, testified in support of the bill. He explained that there are many cancers that are treated only with oral chemotherapy and cannot be treated with IV drugs. Dr. DiBella responded to questions from the committee. He also addressed the discussion of the danger of these drugs from earlier.

03:54 PM -- Ron Lanning, representing himself, testified in support of the bill. He said his oncology nurse brought the bill to his attention. Mr. Lanning talked about his experience with pancreatic and liver cancer. He discussed the number of treatments he received, including chemotherapy. Mr. Lanning said he was prescribed an oral anticancer medication that would cost him $600 a month. He used a patient assistance program for a different medication that ended up costing $200. Mr. Lanning then tried the original medication again, but it was still too costly and talked about the adverse effects of another medication he tried that did not work. Mr. Lanning said once he was eligible for Medicare, he started the original medication that was too costly before because it was covered under Medicare. He said once he went on that medication late last year, his cancer went into remission and he can function now. Mr. Lanning said he wonders how his life would have been if he could have had the medication from the start when it was first prescribed in January 2008. (Attachment I)

04:17 PM -- Jill Fricker, representing the Susan G. Komen Foundation, testified in support of the bill.


BILL:	HB10-1202
TIME:	04:21:10 PM
MOVED:	Gagliardi
MOTION:	Moved amendment L.003 (Attachment J). The motion passed without objection.
SECONDED:	Soper
		VOTE
	Balmer
	Bradford
	Casso
	Kerr A.
	Liston
	Middleton
	Priola
	Soper
	Stephens
	Gagliardi
	Rice
Not Final YES: 0 NO: 0 EXC: 0 ABS: 0 FINAL ACTION: Pass Without Objection


BILL:	HB10-1202
TIME:	04:22:34 PM
MOVED:	Bradford
MOTION:	Moved to refer House Bill 10-1202, as amended, to the Committee of the Whole. The motion passed 10-1.
SECONDED:	Gagliardi
		VOTE
	Balmer	Yes
	Bradford	Yes
	Casso	Yes
	Kerr A.	Yes
	Liston	No
	Middleton	Yes
	Priola	Yes
	Soper	Yes
	Stephens	Yes
	Gagliardi	Yes
	Rice	Yes
Final YES: 10 NO: 1 EXC: 0 ABS: 0 FINAL ACTION: PASS

04:23 PM

The committee adjourned.