Date: 04/09/2013

Final
BILL SUMMARY for SB13-137

HOUSE COMMITTEE ON PUBLIC HEALTH CARE & HUMAN SERVICES

Votes: View--> Action Taken:
Refer Senate Bill 13-137, as amended, to the Commi
Strike the bill's effective date clause and substi		PASS
Pass Without Objection



01:48 PM -- Senate Bill 13-137

Representative Navarro introduced Senate Bill 13-137. The bill directs the Department of Health Care Policy and Financing to issue a request for information (RFI) by September 30, 2013, regarding the use of predictive analytics technologies in Medicaid. She responded to questions from the committee regarding how the bill's provisions relate to existing Medicaid fraud statutes and distributed a handout to the committee regarding Medicaid fraud and abuse (Attachment A). She continued to respond to questions from the committee regarding amendments made to the bill in the Senate, and the RFI process. She further addressed questions from the committee regarding whether there is Medicaid fraud that is not being addressed by current fraud and abuse prevention statutes, specific provisions of the bill addressing waste, and the bill's language regarding delaying the payment of claims until the claims are determined to be valid. Representative Joshi clarified that the bill concerns the issuance of an RFI and not the specific provisions of the fraud and abuse system that may be implemented as a result of the RFIs that are received. The committee discussed whether the Office of Information Technology should be involved in the RFI process.

130409 AttachA.pdf130409 AttachA.pdf

02:09 PM -- Chris Underwood, Department of Health Care Policy and Financing, testified in support of the bill, explaining that the bill was amended in the Senate to change the provisions of the bill to require the issuance of an RFI. He stated that the RFI is a first step in gathering additional information about the potential return on investment for a data analytics system and determining whether such a system would save enough money to cover its costs. He noted that the point of such a system is to stop fraudulent claims at the point of payment so the department doesn't have to recover fraudulent payments after the fact. He stated that protections for providers need to be built into the system, and discussed the timeline on which Medicaid payments are currently paid. He stated the RFI will help determine how to ensure that claims are reviewed before they are paid, but are still paid in a timely manner. He gave examples of the types of fraud and abuse that a data analytics system could potentially address and noted that the General Assembly would have to approve funding for a data analytics system prior to the department's use of such a system. He responded to questions from the committee regarding the potential cost savings of the implementation of a data analytics system, the other states that are developing similar systems, and the interaction of the bill with the Medicaid False Claims Act. He additionally responded to questions from the committee regarding acts that constitute Medicaid fraud, waste, and abuse, and whether the department is currently employing data analytics in its billing systems.

02:32 PM

The committee discussed whether the bill should be amended to include a safety clause.

02:33 PM

Brita Darling, Office of Legislative Legal Services, responded to questions from the committee regarding the bill's effective date clause.

BILL:SB13-137
TIME: 02:34:29 PM
MOVED:Young
MOTION:Strike the bill's effective date clause and substitute a safety clause. The motion passed without objection.
SECONDED:Singer
VOTE
Conti
Everett
Joshi
Landgraf
May
McCann
Schafer
Singer
Stephens
Tyler
Wilson
Young
Primavera
YES: 0 NO: 0 EXC: 0 ABS: 0 FINAL ACTION: Pass Without Objection



02:34 PM

Representative Navarro gave concluding remarks regarding the bill.


BILL:SB13-137
TIME: 02:35:55 PM
MOVED:Landgraf
MOTION:Refer Senate Bill 13-137, as amended, to the Committee of the Whole. The motion passed on a vote of 13-0.
SECONDED:Young
VOTE
Conti
Yes
Everett
Yes
Joshi
Yes
Landgraf
Yes
May
Yes
McCann
Yes
Schafer
Yes
Singer
Yes
Stephens
Yes
Tyler
Yes
Wilson
Yes
Young
Yes
Primavera
Yes
Final YES: 13 NO: 0 EXC: 0 ABS: 0 FINAL ACTION: PASS