House Committee on Health, Insurance & Environment (01/29/2013)

Final
STAFF SUMMARY OF MEETING

HOUSE COMMITTEE ON HEALTH, INSURANCE & ENVIRONMENT

Date:	01/29/2013	ATTENDANCE

Time:	09:44 AM to 12:08 PM	Conti	X
		Fields	X
Place:	HCR 0107	Ginal	X
		Humphrey	X
This Meeting was called to order by		Joshi	X
	Representative McCann	Primavera	X
		Stephens	X
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:
HB13-1074 HB13-1015 JR 25 Presentation on the Division of Insurance JR 25 Presentation on the Division of Professions and Occupations		Amended, Referred to Appropriations Referred to the Committee of the Whole Witness Testimony and/or Committee Discussion Only Witness Testimony and/or Committee Discussion Only

09:45 AM -- House Bill 13-1074

Representative Kraft-Tharp presented House Bill 13-1074, concerning the reallocation of the Primary Care Office from the Prevention Services Division to the Department of Public Health and Environment. The bill makes an organizational change within the Department of Public Health and Environment by relocating the Primary Care Office from the Prevention Services Division to the Department of Public Health and Environment. The bill also updates the law to make it consistent with federal requirements for programs operated by the Primary Care Office, reduced the number and revises the qualifications of members of the Colorado Health Service Advisory Council, and clarifies moneys included in the Colorado Health Services Corps Fund. She described the functions and activities of the Primary Care Office, how the Primary Care Office could become more efficient and effective if the bill was enacted, and cleaning up and streamlining the Primary Care Office's funding statutes. Representative Kraft-Tharp responded to questions from Representative Joshi concerning what would happen if the bill was not enacted.

09:51 AM -- Stephen Holloway, Department of Public Health and Environment, testified in support of the bill. He described the activities, programs, and responsibilities of the Primary Care Office. Mr. Holloway stated that fifty-two counties have primary care shortage areas. He discussed the Colorado Health Services Corps Program. Mr. Holloway responded to questions from the committee about the potential impacts of the Patient Protection and Affordable Care Act on the primary care needs of the state, aspects of the Colorado Health Services Corps Program, the lack of compensation for the members of the Colorado Health Service Advisory Council, and whether the Colorado Health Services Corps Program providers are utilizing tele-medicine.

10:05 AM

Mr. Holloway continued to respond to questions from the committee about the Colorado Health Services Corps Program, the Colorado Health Service Advisory Council, and the potential benefits of the bill.

10:12 AM -- Terri Hurst, Colorado Behavioral Healthcare Council, testified in support of the bill. She discussed the Colorado Health Services Corps Program.

10:14 AM

Representative Schafer and Representative Kraft-Tharp explained amendment L.001 (Attachment A), which adds a physician to the Colorado Health Service Advisory Council.


BILL:	HB13-1074
TIME:	10:14:52 AM
MOVED:	Schafer
MOTION:	Adopt amendment L.001 (Attachment A). The motion passed without objection.
SECONDED:	Ginal
		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

130129 AttachA.pdf

10:15 AM

Representative Kraft-Tharp made closing remarks on the bill.


BILL:	HB13-1074
TIME:	10:16:19 AM
MOVED:	Schafer
MOTION:	Refer House Bill 13-1074, as amended, to the Committee of the Whole. The motion failed on a vote of 2-9.
SECONDED:	Ginal
		VOTE
	Conti	No
	Fields	Yes
	Ginal	No
	Humphrey	No
	Joshi	No
	Primavera	Yes
	Stephens	No
	Swalm	No
	Young	No
	Schafer	No
	McCann	No

YES: 2 NO: 9 EXC: 0 ABS: 0 FINAL ACTION: FAIL


BILL:	HB13-1074
TIME:	10:18:15 AM
MOVED:	Stephens
MOTION:	Moved to reconsider House Bill 13-1074. The motion passed on a vote of 10-1.
SECONDED:	Schafer
		VOTE
	Conti	Yes
	Fields	Yes
	Ginal	Yes
	Humphrey	No
	Joshi	Yes
	Primavera	Yes
	Stephens	Yes
	Swalm	Yes
	Young	Yes
	Schafer	Yes
	McCann	Yes

YES: 10 NO: 1 EXC: 0 ABS: 0 FINAL ACTION: PASS


BILL:	HB13-1074
TIME:	10:18:56 AM
MOVED:	Stephens
MOTION:	Refer House Bill 13-1074, as amended, to the Committee on Appropriations. The motion passed on a vote of 11-0.
SECONDED:	Ginal
		VOTE
	Conti	Yes
	Fields	Yes
	Ginal	Yes
	Humphrey	Yes
	Joshi	Yes
	Primavera	Yes
	Stephens	Yes
	Swalm	Yes
	Young	Yes
	Schafer	Yes
	McCann	Yes

Final YES: 11 NO: 0 EXC: 0 ABS: 0 FINAL ACTION: PASS

10:21 AM -- House Bill 13-1015

Representative Kraft-Tharp presented House Bill 13-1015, concerning elimination of the prohibition against disclosure of mental health claims information by small group health plans. The bill repeals the disclosure of certain mental health information by small group carriers, thereby allowing the information to be reported to the All-payer Health Claims Database (APHCD). The committee dialogued with Representative Kraft-Tharp about the APHCD.

10:28 AM -- Phil Kalin, Center for Improving Value in Health Care (CIVHC), testified in support of the bill. Staff distributed two handouts to the committee (Attachments B and C). Mr. Kalin discussed the creation of the APHCD. Mr. Kalin continued to discuss the safety and security of the data and whether the data that is collected will be sold. Jonathan Mathieu, CIVHC, joined Mr. Kalin at the table to respond to questions. Mr. Kalin responded to questions from the committee about the impact of collecting the data has had on health care costs and the security of the data collected. Mr. Kalin discussed the potential selling of the data collected through the APHCD. Mr. Kalin responded to questions about the APHCD concerning the quality of care rating, the potential lack of data about the uninsured or those patients paying cash, how the APHCD is funded, and about the encryption level utilized by the APHCD.

130129 AttachB.pdf

130129 AttachC.pdf

10:57 AM

Mr. Kalin responded to questions from Representative Stephens about the security of the APHCD. Mr. Mathieu responded to a questions from Representative McCann about the data requests that CIVHC is receiving and could potentially receive. Mr. Kalin continued to responded to questions from the committee about requests for the collected data and what potential hackers might be looking for in the data. Representative Ginal made comments about the inclusion of mental health data with the physical health data. Mr. Mathieu responded to a question from Representative Young asked about who performs the analysis of the data. Mr. Kalin responded to a question from Representative McCann about whether physical health data from the small group health plans is provided to the APHCD.

11:14 AM -- Marc Reece, Colorado Association of Health Plans, testified in support of the bill. He discussed the issues of decoupling mental health data.

11:16 AM -- Moe Keller, Mental Health America of Colorado, testified in support of the bill. She discussed how the data collected through the enactment of the bill could be helpful. She referenced the handout about the history of mental health statutes in Colorado that was distributed to the committee (Attachment D).

130129 AttachD.pdf

11:20 AM

Representative Stephens made comments about the bill and the APHCD.


BILL:	HB13-1015
TIME:	11:22:03 AM
MOVED:	Schafer
MOTION:	Refer House Bill 13-1015 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

11:23 AM

The committee took a short recess.

11:29 AM -- Division of Insurance Presentation

Representative McCann called the committee back to order. Commissioner Jim Riesberg, Division of Insurance, briefed the committee on the Division of Insurance. He discussed the different types of insurance that are regulated by the Division of Insurance and the various reports that the division issues. Commissioner Riesberg said the division receives about 24,000 inquiries a year and the division intervenes in about 4,400 of those inquiries. He discussed premiums, claims, and the functions of the division. He discussed major issues the division is looking at related to health care issues, which includes the implementation of the Patient Protection and Affordable Care Act, the establishment of the Colorado Health Benefit Exchange, the APHCD, accountable care organizations, and health cooperatives. Commissioner Riesberg discussed the outreach and education activities of the division. He discussed recent legislation concerning health insurance, the Colorado Health Benefit Exchange, and potential legislation that will be offered during 2013 to align Colorado laws with Patient Protection and Affordable Care Act. Commissioner Riesberg discussed the selection of the essential health benefits benchmark plan. Commissioner Riesberg discussed premium rates, trend factors, medical cost shifting, and new products and technology. He said the division regulate about 40 percent of the health insurance in Colorado. Commissioner Riesberg discussed the division's website. He discussed the regulation process the division follows and the bulletins the division issues. He discussed the market conduct examinations and the recent achievements of the division. Commissioner Riesberg said that the division can send representatives to town hall meetings and other constituent meetings if requested. He continued to discuss the health insurance complaints the division receives and the implementation of Senate Bill 11-200.

11:47 AM

Commissioner Riesberg responded to questions regarding how many requests for increased rates are approved or denied, how quickly the rate request responses are processed, and the relationship between state mandates and Patient Protection and Affordable Care Act. He continued to respond to questions about the recent Colorado Health Benefit Exchange name change and creating additional state mandates for health insurance. He introduced Jo Donlin, Director of External Affairs. A packet of information concerning the Division of Insurance was distributed to the committee (Attachments E and F).

130129 AttachE.pdf

130129 AttachF.pdf

11:58 AM -- Division of Professions and Occupations

Lauren Larson, Division of Professions and Occupations, briefed the committee on the Division of Professions and Occupations. She provided the committee with a handout that outlines the division's organizational structure (Attachment G). She discussed the functions of the division. Ms. Larson discussed the fees that are accessed by the division and how those fees are minimized through efficiencies in the division. She discussed the division's call center, the electronic licensing system, and the licensing of veterans as they pursue private employment. Ms. Larson discussed how the division is involved addressing issues in the health care system, including addressing prescription drug abuse and empowering consumers through the provider information available through the division. She introduced Mike Skorupka, Ronne Hines, Dino Ioannides, and Cory Everett-Lozano from the division.

130129 AttachG.pdf

12:06 PM

Ms. Larson responded to questions from the committee about the regulation of certain professions by the division.

12:08 PM

Representative McCann adjourned the committee.