House Committee on Health, Insurance & Environment (03/28/2013)

Final
STAFF SUMMARY OF MEETING

HOUSE COMMITTEE ON HEALTH, INSURANCE & ENVIRONMENT

Date:	03/28/2013	ATTENDANCE

Time:	01:32 PM to 03:55 PM	Conti	*
		Fields	X
Place:	HCR 0107	Ginal	X
		Humphrey	X
This Meeting was called to order by		Joshi	X
	Representative McCann	Primavera	*
		Stephens	*
This Report was prepared by		Swalm	X
	Amanda King	Young	X
		Schafer	X
		McCann	X
		X = Present, E = Excused, A = Absent, * = Present after roll call

Bills Addressed:		Action Taken:
Presentation by the Colorado Ambulatory Surgery Center Association HB13-1239 HB13-1245 HB13-1266		Witness Testimony and/or Committee Discussion Only Amended, Referred to Appropriations Amended, Referred to Finance Amended, Referred to the Committee of the Whole

01:33 PM -- Presentation by the Colorado Ambulatory Surgery Center Association

Lisa Austin, R.N., and Dr. James DeLine, made a presentation to the committee, and provided a binder of information to the committee (Attachment A). Ms. Austin stated that ambulatory surgery centers provide surgeries that do not require hospital admissions. She discussed the economic impact of ambulatory surgery centers. Dr. DeLine discussed the types of procedures that can be performed at ambulatory surgery centers. He stated that procedures performed at ambulatory surgery centers have lower infection rates than hospitals. He discussed the cost-effectiveness of ambulatory surgery centers and the state-level goals of the Colorado Ambulatory Surgery Center Association. Ms. Austin and Dr. DeLine responded to a question about the relationship between hospitals and ambulatory surgery centers. Ms. Austin responded to questions about the rate structures and billing codes for procedures at ambulatory surgery centers for Medicaid clients.

130328 AttachA.pdf

01:48 PM -- House Bill 13-1239

Representative McCann provided an overview of House Bill 13-1239 concerning the creation of a statewide youth development plan. Witness testimony was taken on the bill at the committee's meeting on March 19. Representative McCann discussed amendment L.004 (Attachment B).

130328 AttachB.pdf


BILL:	HB13-1239
TIME:	01:52:54 PM
MOVED:	McCann
MOTION:	Adopt amendment L.004 (Attachment B). The motion passed without objection.
SECONDED:	Stephens
		VOTE
	Conti	Excused
	Fields
	Ginal
	Humphrey
	Joshi
	Primavera
	Stephens
	Swalm
	Young
	Schafer
	McCann
YES: 0 NO: 0 EXC: 1 ABS: 0 FINAL ACTION: Pass Without Objection

01:54 PM

Representative McCann discussed amendment L.005 (Attachment C). She responded to a question about the amendment.

130328 AttachC.pdf


BILL:	HB13-1239
TIME:	01:56:07 PM
MOVED:	McCann
MOTION:	Adopt amendment L.005 (Attachment C). The motion passed without objection.
SECONDED:	Young
		VOTE
	Conti	Excused
	Fields
	Ginal
	Humphrey
	Joshi
	Primavera
	Stephens
	Swalm
	Young
	Schafer
	McCann
YES: 0 NO: 0 EXC: 1 ABS: 0 FINAL ACTION: Pass Without Objection

01:56 PM

Representative McCann discussed amendment L.006 (Attachment D). Representative McCann responded to questions about the amendment. Jane Ritter, Office of Legislative Legal Services, came to the table to respond to a question about amendment L.006.

130328 AttachC.pdf


BILL:	HB13-1239
TIME:	01:59:02 PM
MOVED:	McCann
MOTION:	Adopt amendment L.006 (Attachment D). The motion passed without objection.
SECONDED:	Young
		VOTE
	Conti	Excused
	Fields
	Ginal
	Humphrey
	Joshi
	Primavera
	Stephens
	Swalm
	Young
	Schafer
	McCann

YES: 0 NO: 0 EXC: 1 ABS: 0 FINAL ACTION: Pass Without Objection

130328 AttachD.pdf

02:01 PM

Representative McCann discussed amendment L.003 (Attachment E). Representative Stephens and Representative Fields made comments on the bill.


BILL:	HB13-1239
TIME:	02:03:26 PM
MOVED:	McCann
MOTION:	Adopt amendment L.003 (Attachment E), as amended. The motion passed on a vote of 6-5.
SECONDED:	Schafer
		VOTE
	Conti	No
	Fields	Yes
	Ginal	Yes
	Humphrey	No
	Joshi	No
	Primavera	Yes
	Stephens	No
	Swalm	No
	Young	Yes
	Schafer	Yes
	McCann	Yes

YES: 6 NO: 5 EXC: 0 ABS: 0 FINAL ACTION: PASS

130321 AttachE.pdf


BILL:	HB13-1239
TIME:	02:04:41 PM
MOVED:	McCann
MOTION:	Refer House Bill 13-1239, as amended, to the Committee on Appropriations. The motion passed on a vote of 6-5.
SECONDED:	Fields
		VOTE
	Conti	No
	Fields	Yes
	Ginal	Yes
	Humphrey	No
	Joshi	No
	Primavera	Yes
	Stephens	No
	Swalm	No
	Young	Yes
	Schafer	Yes
	McCann	Yes

Final YES: 6 NO: 5 EXC: 0 ABS: 0 FINAL ACTION: PASS

02:07 PM -- House Bill 13-1245

Representative McCann discussed House Bill 13-1245 concerning funding mechanisms for the Colorado Health Benefit Exchange. Witness testimony on the bill was taken at the committee's meeting on March 19. A memorandum regarding the fiscal assessment of proposed amendment HB1245_L.008 (Attachment F) was distributed to the committee. Representative McCann discussed amendment L.008 (Attachment G). Kristen Forrestal, Office of Legislative Legal Services, came to the table to respond to a question about amendment L.008.

130328 AttachF.pdf

130328 AttachG.pdf

02:15 PM

Representative McCann discussed amendment L.009 (Attachment H). Ms. Forrestal explained amendment L.009.

130328 AttachH.pdf


BILL:	HB13-1245
TIME:	02:15:39 PM
MOVED:	McCann
MOTION:	Adopt amendment L.009 (Attachment H). The motion passed without objection.
SECONDED:	Schafer
		VOTE
	Conti
	Fields
	Ginal
	Humphrey
	Joshi
	Primavera
	Stephens
	Swalm
	Young
	Schafer
	McCann

YES: 0 NO: 0 EXC: 0 ABS: 0 FINAL ACTION: Pass Without Objection


BILL:	HB13-1245
TIME:	02:17:00 PM
MOVED:	McCann
MOTION:	Adopt amendment L.008 (Attachment G), as amended. The motion passed without objection.
SECONDED:	Stephens
		VOTE
	Conti
	Fields
	Ginal
	Humphrey
	Joshi
	Primavera
	Stephens
	Swalm
	Young
	Schafer
	McCann

YES: 0 NO: 0 EXC: 0 ABS: 0 FINAL ACTION: Pass Without Objection


BILL:	HB13-1245
TIME:	02:18:00 PM
MOVED:	McCann
MOTION:	Refer House Bill 13-1245, as amended, to the Committee of Finance. The motion passed on a vote of 9-2.
SECONDED:	Ginal
		VOTE
	Conti	Yes
	Fields	Yes
	Ginal	Yes
	Humphrey	No
	Joshi	No
	Primavera	Yes
	Stephens	Yes
	Swalm	Yes
	Young	Yes
	Schafer	Yes
	McCann	Yes

Final YES: 9 NO: 2 EXC: 0 ABS: 0 FINAL ACTION: PASS

02:18 PM

The committee took a brief recess.

02:25 PM -- House Bill 13-1266

Representative Schafer called the committee back to order. Representative McCann and Representative Gardner presented House Bill 13-1266. Representative McCann referenced a summary that was distributed to the committee prior to the meeting (Attachment I). The bill aligns state health insurance laws with the requirements of the federal health care reform under the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act. Among other things, the bill:

130328 AttachI.pdf

conforms Colorado's mandatory coverage provisions to those in federal law;
enacts the terms of Colorado's essential health benefits package;
requires all individual and small employer health insurance carriers selling health plans to issue and renew plans to all eligible individuals;
requires health plans to cover dependents up to age 26;
prohibits exclusions based on preexisting conditions;
prohibits discrimination against licensed or certified health care providers in individual or group health benefit plans;
aligns the process in Colorado law with that in federal law for the internal and external independent review of adverse determinations with respect to denial of benefits;
conforms wellness and prevention program requirements with federal laws;
authorize the Insurance Commissioner to adopt rules necessary to comply with federal law; and
makes various definitions consistent with federal law.

Representative Primavera and Representative Gardner discussed coverage for services for people with autism and breast cancer. Representative Ginal asked about domestic partner coverage. Representative Schafer discussed statutes preventing discrimination based on sexual orientation.

02:36 PM -- Commissioner Jim Riesberg, Division of Insurance in the Department of Regulatory Agencies, testified in support of the bill. He provided a legislative fact sheet to the committee (Attachment J). He discussed the Patient Protection and Affordable Care Act and the Colorado Health Benefit Exchange. He stated that the bill changes only the statutes identified as those that must be changed, and provides the Commissioner of Insurance discretion to address ongoing decisions through the rule-making process. Commissioner Riesberg discussed essential health benefits in response to a question about the amount of flexibility that is allowed to states under the Affordable Care Act. He responded to questions about how the bill addresses health care and consumer choice in rural areas. He stated 9 counties are without a gynecologist and 17 counties are without a dentist. He discussed expanding scopes of practice and telemedicine to address health care needs in Colorado. Commissioner Riesberg responded to questions about state mandates and essential health benefits. He responded to questions about whether plan rates will increase in the next few years, plan choice under the federal exchange and the Colorado Health Benefit Exchange, and the affordability threshold established by the Affordable Care Act. Representative Schafer requested that Commissioner Riesberg provide a copy of his testimony to the committee (Attachment K).

130328 AttachJ.pdf

130328 AttachK.pdf

03:10 PM -- Peg Brown and Dayle Axman, Division of Insurance in the Department of Regulatory Agencies, responded to questions about the changes the bill makes to state mandates concerning autism services, breast cancer prevention services, and mammographies. Ms. Brown responded to questions about domestic partner coverage, the potential costs associated with state mandates, and the penalties for not having health insurance. Ms. Brown responded to questions about coverage for prosthetic device and clinical trials.

03:22 PM -- Dr. Chris Eddy, Colorado Optometric Association, testified in support of the bill. He discussed a potential amendment.

03:25 PM -- Marc Reece, Colorado Association of Health Plans, testified in support of the bill. He discussed the regulatory simplifications provided by the bill and how the bill could save money. He stated that the current benefits in Colorado are not changing. Mr. Reece responded to a question about whether federal law preempts state law.

03:30 PM -- Debra Judy, Colorado Consumer Health Initiative, testified in support of the bill. She discussed the consumer protections provided by the bill.

03:33 PM -- Travis Berry, Colorado Competitive Council, testified in support of the bill. Mr. Berry responded to questions about health insurance plan rates. He discussed the simplification the bill creates.

03:39 PM

The committee took a brief recess.

03:48 PM

Representative Schafer called the committee back to order. Representative Gardner discussed amendment L.001 (Attachment L).

130328 AttachL.pdf


BILL:	HB13-1266
TIME:	03:48:46 PM
MOVED:	McCann
MOTION:	Adopt amendment L.001 (Attachment L). The motion passed without objection.
SECONDED:	Schafer
		VOTE
	Conti
	Fields
	Ginal
	Humphrey
	Joshi
	Primavera
	Stephens
	Swalm
	Young
	Schafer
	McCann

YES: 0 NO: 0 EXC: 0 ABS: 0 FINAL ACTION: Pass Without Objection

03:49 PM

Representative Gardner discussed amendment L.002 (Attachment M).

130328 AttachM.pdf


BILL:	HB13-1266
TIME:	03:50:01 PM
MOVED:	McCann
MOTION:	Adopt amendment L.002 (Attachment M). The motion passed without objection.
SECONDED:	Schafer
		VOTE
	Conti
	Fields
	Ginal
	Humphrey
	Joshi
	Primavera
	Stephens
	Swalm
	Young
	Schafer
	McCann

YES: 0 NO: 0 EXC: 0 ABS: 0 FINAL ACTION: Pass Without Objection

03:51 PM

Representative Stephens and Representative Schafer commented on the bill.


BILL:	HB13-1266
TIME:	03:53:47 PM
MOVED:	McCann
MOTION:	Refer House Bill 13-1266, as amended, to the Committee of the Whole. The motion passed on a vote of 9-2.
SECONDED:	Young
		VOTE
	Conti	Yes
	Fields	Yes
	Ginal	Yes
	Humphrey	No
	Joshi	No
	Primavera	Yes
	Stephens	Yes
	Swalm	Yes
	Young	Yes
	Schafer	Yes
	McCann	Yes

Final YES: 9 NO: 2 EXC: 0 ABS: 0 FINAL ACTION: PASS

03:55 PM

Representative Schafer reminded the committee that there would not be meetings the week of April 1 and adjourned the committee.