House Committee on Public Health Care & Human Services (03/03/2015)

Final
STAFF SUMMARY OF MEETING

HOUSE COMMITTEE ON PUBLIC HEALTH CARE & HUMAN SERVICES

Date:	03/03/2015	ATTENDANCE

Time:	01:32 PM to 04:34 PM	Conti	X
		Danielson	X
Place:	HCR 0107	Everett	X
		Ginal	X
This Meeting was called to order by		Joshi	X
	Representative Primavera	Landgraf	X
		Melton	X
This Report was prepared by		Moreno	X
	Elizabeth Burger	Sias	X
		Tyler	X
		Windholz	X
		Singer	X
		Primavera	X
		X = Present, E = Excused, A = Absent, * = Present after roll call

Bills Addressed:		Action Taken:
HB15-1214 HB15-1112		Witness Testimony and/or Committee Discussion Only Postponed Indefinitely

01:34 PM -- HB 15-1214

Representative Singer introduced House Bill 15-1214. The bill prohibits a pharmacist from substituting a non-abuse-deterrent opioid analgesic drug if the prescription issued for a patient includes instructions to "dispense as written" an abuse-deterrent version of the drug. Insurance carriers are required to cover the abuse-deterrent drug at the lowest cost-sharing level for opioid analgesic drugs. A carrier cannot require that a patient experience treatment failure with a non-abuse-deterrent opioid analgesic in order for an abuse-deterrent prescription to be filled. Representative Singer discussed the technology that makes a pill resistant to crushing, and demonstrated how easily pills without the technology can be crushed. He discussed amendment L.003 (Attachment A) which directs the Governor's consortium on drug abuse to study barriers to and the efficacy of the use of abuse-deterrent opioid analgesic drug products as a way to reduce abuse and diversion of opioid drug products. He responded to questions from the committee.

150303 AttachA.pdf

01:48 PM -- Dr. Gareth Shemesh, representing himself, testified in support of the bill and spoke regarding his practice as a physician managing patients' chronic pain. He discussed efforts to reduce the misuse, abuse, and diversion of opioid analgesics, including tamper-proof formulations of the medications, which he stated has reduced the abuse of the medications. He responded to questions from the committee. Representative Singer distributed a handout to the committee (Attachment B) and responded to questions from the committee regarding the cost of opioid medications.

150303 AttachB.pdf

02:05 PM -- Pat Ratliff, Colorado Association of Nurse Anesthetists, testified in support of the bill and stated that efforts that promote abuse-deterrent versions of opioid medication are valuable. She responded to questions from the committee.

02:10 PM -- Corey Candelaria, representing himself, testified regarding his practice as an addiction counselor and regarding prescription drug abuse, misuse, and diversion. He responded to questions from the committee.

02:24 PM -- Sara Orrange, Colorado Association of Health Plans, testified in opposition to the bill. She stated her opposition to the provisions of the bill that require the medications to be covered at the lowest cost-sharing level for opioid analgesic drugs. She explained that Colorado law already allows prescriptions to be dispensed as written and that the bill will result in cheaper drugs in appearance only and the costs will be redistribute throughout the system. She stated that the drugs are tamper-resistant, rather than abuse-resistant, and noted that the drug manufacturers themselves acknowledge that the medications could result in abuse. She responded to questions from the committee.

02:29 PM -- Bridget Flavin, Anthem Blue Cross Blue Shield, testified in opposition to the bill. She stated that abuse-deterrent opioid medications treat a symptom of abuse rather than the underlying abuse, and the medications are simply more costly versions of existing medications. She stated that the bill limits her company's ability to implement its evidence-based drug formulary.

02:33 PM -- Denese Clark, Kaiser Permanente, testified in opposition to the bill. She stated that the bill will increase insurance premiums for all patients, regardless of whether the patient is at risk for abuse and that even tamper-resistant versions of the medications can be abused. She stated that there are questions about whether these versions of medications can reduce abuse, and Colorado law already allows physicians to require that prescriptions be dispensed as written. Ms. Clark responded to questions from the committee.

02:37 PM

Representative Singer listed organizations that are in support of the bill. Representative Singer explained amendment L.003 (Attachment A). Representative Primavera laid the bill over.

02:46 PM -- HB 15-1112

Representative Landgraf introduced House Bill 15-1112. The bill creates the Born-Alive Infant Protection Act. The act prohibits any person from denying or depriving an infant of nourishment with the intent to cause or allow the death of the infant for any reason, and denying appropriate medical care, even if the infant was born alive during an abortion procedure. Representative Landgraf stated that a woman can obtain a late-term abortion, and the bill protects infants who are born alive after a failed attempt at an induced abortion. She discussed federal legislation on the issue. She distributed two handouts (Attachments C and D) and explained amendment L.001 (Attachment E). She stated that incidents in other states have demonstrated to her that protections for unborn infants should be enacted in Colorado.

150303 AttachC.pdf

150303 AttachD.pdf

150303 AttachE.pdf

02:53 PM -- Karen Middleton, NARAL Pro-Choice Colorado, testified in opposition to the bill. She stated that existing laws cover the situations addressed by the bill and there is no evidence this practice occurs in Colorado. She responded to questions from the committee.

03:01 PM -- Leslie Chomic, League of Women Voters of Colorado, testified in opposition to the bill. She stated that the bill duplicates existing law and adds additional burdens.

03:04 PM -- Kevin Paul, Planned Parenthood, testified in opposition to the bill. He discussed the federal law, and stated that the federal law, unlike House Bill 15-1112, does not create criminal penalties for physicians. He stated that the bill contains conflicting terms, which makes it difficult to understand. He stated that the likelihood of an infant being born alive during an abortion procedure is extremely minimal. He responded to questions from the committee.

03:16 PM -- Stephen Reynolds, representing himself, testified in support of the bill and amendment L.001. He discussed the definition of life.

03:20 PM -- Scott Horak, representing himself, testified in support of the bill. He responded to questions from the committee.

03:27 PM -- Debbie Haskins, Office of Legislative Legal Services, responded to questions from the committee regarding the provisions of the bill that allow a person to bring a civil action.

03:36 PM -- Dr. Charmaine Yoest, Americans United for Life Action, testified in support of the bill, stating the bill will protect Colorado's most vulnerable citizens. She stated that the bill does not infringe on a women's ability to terminate her pregnancy and clarified that federal law does not apply to private doctors and doctors in private practice. She responded to questions from the committee.

03:57 PM

Representative Landgraf responded to questions from the committee.

03:58 PM -- Dr. Tom Perille, Protect Life Coalition, distributed a copy of his testimony (Attachment F) and testified in support of the bill. He discussed incidents in which infants are born alive during abortions. He responded to questions from the committee.

150303 AttachF.pdf

04:05 PM -- Michael Norton, Colorado Family Action, distributed a copy of his testimony (Attachment G) and testified in support of the bill. He stated that the bill should be the public policy of the state. He discussed the federal law and its applicability to Planned Parenthood, and stated that existing Colorado laws would not apply to an infant who is born alive in Colorado after a failed abortion. He responded to questions from the committee.

150303 AttachG.pdf

04:14 PM -- Sarah Zagurski, Colorado Citizens for Life and herself, testified in support of the bill and shared her personal story regarding her childhood and her mother's failed abortion.


BILL:	HB15-1112
TIME:	04:19:43 PM
MOVED:	Landgraf
MOTION:	Adopt amendment L.001 (Attachment E). The motion passed without objection.
SECONDED:	Conti
		VOTE
	Conti
	Danielson
	Everett
	Ginal
	Joshi
	Landgraf
	Melton
	Moreno
	Sias
	Tyler
	Windholz
	Singer
	Primavera

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

04:21 PM

Representative Landgraf gave concluding remarks regarding the bill. Members of the committee commented on the bill.


BILL:	HB15-1112
TIME:	04:33:14 PM
MOVED:	Landgraf
MOTION:	Refer House Bill 15-1112, as amended, to the Committee on Appropriations. The motion failed on a vote of 6-7.
SECONDED:	Conti
		VOTE
	Conti	Yes
	Danielson	No
	Everett	Yes
	Ginal	No
	Joshi	Yes
	Landgraf	Yes
	Melton	No
	Moreno	No
	Sias	Yes
	Tyler	No
	Windholz	Yes
	Singer	No
	Primavera	No

YES: 6 NO: 7 EXC: 0 ABS: 0 FINAL ACTION: FAIL


BILL:	HB15-1112
TIME:	04:34:10 PM
MOVED:	Melton
MOTION:	Postpone House Bill 15-1112 indefinitely. The motion passed on a vote of 7-6.
SECONDED:	Singer
		VOTE
	Conti	No
	Danielson	Yes
	Everett	No
	Ginal	Yes
	Joshi	No
	Landgraf	No
	Melton	Yes
	Moreno	Yes
	Sias	No
	Tyler	Yes
	Windholz	No
	Singer	Yes
	Primavera	Yes

Final YES: 7 NO: 6 EXC: 0 ABS: 0 FINAL ACTION: PASS

04:34 PM

The committee adjourned.