Final
STAFF SUMMARY OF MEETING

HOUSE COMMITTEE ON HEALTH, INSURANCE, & ENVIRONMENT

Date:01/22/2015
ATTENDANCE
Time:01:33 PM to 04:35 PM
Brown
X
Esgar
X
Place:HCR 0107
Humphrey
X
Joshi
X
This Meeting was called to order by
Klingenschmitt
X
Representative McCann
Landgraf
X
Lontine
X
This Report was prepared by
Mitsch Bush
X
Amanda King
Primavera
X
Ransom
X
Ryden
*
Ginal
X
McCann
X
X = Present, E = Excused, A = Absent, * = Present after roll call
Bills Addressed: Action Taken:
HB15-1029
HB15-1067		Amended, Referred to the Committee of the Whole
Referred to Appropriations


01:34 PM -- HB 15-1029

Representative Ginal and Representative Buck presented House Bill 15-1029. Effective January 1, 2016, the bill requires all health benefit plans in Colorado to provide beneficiaries with telemedicine options when telemedicine is considered an equal standard of care. The bill does not require telemedicine when a health care provider determines that telemedicine is not the most appropriate standard of care. Health insurance carriers must reimburse providers for telemedicine services on the same basis as in-person care for the diagnosis, treatment, or consultation of care. Payment from carriers must include reasonable compensation for the transmission of telemedicine care. Deductibles, copayments, or coinsurance requirements for health care services delivered through telemedicine must not exceed any of the costs associated with in-person diagnosis, consultation, or treatment. The bill provides related definitions and exclusions. The committee was provided a handout on telehealth (Attachment A).

150122 AttachA.pdf150122 AttachA.pdf


01:41 PM

Representative Ginal and Representative Buck responded to questions about the bill. Amendments L.001, L.002, and L.003 (Attachments B through D) were distributed to the committee. Representatives Ginal and Buck explained the amendments.

150122 AttachB.pdf150122 AttachB.pdf150122 AttachC.pdf150122 AttachC.pdf150122 AttachD.pdf150122 AttachD.pdf

01:55 PM -- Janet Stephens, representing the Colorado Hospital Association, testified in support of the bill. She discussed her organization.

01:56 PM -- Ryan Westberry, representing the Colorado Hospital Association and the Colorado Telehealth Network, testified in support of the bill. He discussed his organization and the telehealth working group that was formed to identified barriers to telehealth. Mr. Westberry responded to questions about the difference between telehealth and telemedicine, which technologies and equipment can be used for telemedicine, and the types of settings in which telemedicine can be used.

02:04 PM -- Samantha Lippolis, representing Centura Health, testified in support of the bill. She explained that patients can choose whether or not to utilize telemedicine. Ms. Lippolis discussed how telemedicine can save patients time and provide access to care. Ms. Lippolis responded to questions about the provider training for telemedicine and the locations where patients can access telemedicine. She responded to a question about amendment L.001.

02:13 PM -- Dr. Fred Thomas, representing Children's Hospital Colorado, testified in support of the bill. He discussed how Children's Hospital Colorado utilizes telemedicine. Dr. Thomas responded to questions about when telemedicine is not appropriate and whether telemedicine can be used for behavioral health. Dr. Thomas responded to questions about which health care providers can use telemedicine.

02:27 PM -- Dr. Clay Watson, representing himself, testified in support of the bill. He discussed his experience providing care through telemedicine. Dr. Watson responded to questions about whether providers are currently compensated by insurance carriers for providing care through telemedicine.

02:41 PM -- Debbie Voyles, representing Colorado Access, testified in support of the bill with the proposed amendments. She discussed the Colorado Access telehealth platform for mental health services. Ms. Voyles responded to questions about how the bill will benefit her organization, whether video consultations are recorded, and what billing codes are used for care provided via telemedicine.

02:45 PM -- Dr. Jay Shore, representing Colorado Access and the University of Colorado, testified in support of the bill if amended. He discussed his experience providing care via telemedicine.

02:48 PM -- Dr. Jeff Wagner, representing Health One, testified in support of the bill. He discussed his experience treating strokes via telemedicine.

02:53 PM -- Dr. Charlie Lippolis, representing Colorado Psychiatric Society, testified in support of the bill. She discussed her experience providing care via telemedicine.


02:57 PM -- Ben Price, representing the Colorado Association of Health Plans, testified on the bill. He stated that his organization supports the bill if the proposed amendments are adopted. He discussed how telemedicine can modernize health care. He discussed how the bill and proposed amendments address out-of-network providers and the importance of amendment L.002 that changes the effective date of the bill. Mr. Price and Ms. Lippolis responded to questions about what is reasonable compensation as the term is used in the bill. Mr. Price responded to questions about how much can be charged and reimbursed for telehealth visits.

03:07 PM -- John Conklin, representing the Colorado Medical Society, responded to questions about medical malpractice claims related to telemedicine. Mr. Conklin responded to questions about potentially amending the bill to exclude surgery from telemedicine.

03:14 PM

A preamended version of the bill was distributed (Attachment E).

150122 AttachE.pdf150122 AttachE.pdf
BILL:HB15-1029
TIME: 03:16:41 PM
MOVED:Mitsch Bush
MOTION:Adopt amendment L.003 (Attachment D). The motion passed without objection.
SECONDED:Esgar
VOTE
Brown
Esgar
Humphrey
Joshi
Klingenschmitt
Landgraf
Lontine
Mitsch Bush
Primavera
Ransom
Ryden
Ginal
McCann
YES: 0 NO: 0 EXC: 0 ABS: 0 FINAL ACTION: Pass Without Objection


BILL:HB15-1029
TIME: 03:17:11 PM
MOVED:Landgraf
MOTION:Adopt amendment L.002 (Attachment C). The motion passed without objection.
SECONDED:Brown
VOTE
Brown
Esgar
Humphrey
Joshi
Klingenschmitt
Landgraf
Lontine
Mitsch Bush
Primavera
Ransom
Ryden
Ginal
McCann
YES: 0 NO: 0 EXC: 0 ABS: 0 FINAL ACTION: Pass Without Objection
BILL:HB15-1029
TIME: 03:17:37 PM
MOVED:Brown
MOTION:Adopt amendment L.001 (Attachment B), as amended. The motion passed without objection.
SECONDED:Mitsch Bush
VOTE
Brown
Esgar
Humphrey
Joshi
Klingenschmitt
Landgraf
Lontine
Mitsch Bush
Primavera
Ransom
Ryden
Ginal
McCann
YES: 0 NO: 0 EXC: 0 ABS: 0 FINAL ACTION: Pass Without Objection




03:18 PM

Representative Buck and Representative Ginal gave concluding remarks regarding the bill.
BILL:HB15-1029
TIME: 03:20:26 PM
MOVED:Ginal
MOTION:Refer House Bill 15-1029, as amended, to the Committee of the Whole. The motion passed on a vote of 13-0.
SECONDED:Brown
VOTE
Brown
Yes
Esgar
Yes
Humphrey
Yes
Joshi
Yes
Klingenschmitt
Yes
Landgraf
Yes
Lontine
Yes
Mitsch Bush
Yes
Primavera
Yes
Ransom
Yes
Ryden
Yes
Ginal
Yes
McCann
Yes
Final YES: 13 NO: 0 EXC: 0 ABS: 0 FINAL ACTION: PASS

03:21 PM

The committee took a brief recess.

03:32 PM -- HB 15-1067

The committee came back to order. Representative Kraft-Tharp and Representative Landgraf presented House Bill 15-1067. The bill requires licensed psychologists to complete at least 40 hours of continuing professional development and education during each two-year license renewal cycle in order to maintain their professional license. The State Board of Psychologist Examiners (state board) in the Department of Regulatory Agencies is required to adopt rules establishing the continuing professional development program and the bill specifies certain requirements that the program must meet. The state board is allowed to audit up to five percent of licensed psychologists during each renewal cycle to check compliance with the continuing professional development requirement. Continuing education under the bill may include attending or teaching an academic course, authoring a paper, or attending workshops and symposia, among other things. References were made to fact sheets distributed prior to the committee meeting.


03:38 PM -- Dr. Laura Knudtson, representing the Colorado Psychological Association, testified in support of the bill. She discussed the education requirements for psychologists and the current continuing competency requirements for other mental health professionals. She provided background information on the bill and discussed the stakeholder process involved in developing the bill. Dr. Knudtson responded to questions about the support for the bill by psychologists and whether psychologists are currently voluntarily participating in professional development. Dr. Knudtson responded to questions about how the bill differs from the current continuing competency requirements for other mental health providers. In response to a question, she discussed the American Psychological Association. Dr. Knudtson responded to questions about the credits offered for teaching a course and for authoring, editing, and reviewing a psychological publication.

03:57 PM

Dr. Knudtson responded to questions about the current licensure requirements for psychologists and the possible costs to psychologists to meet the proposed continuing professional development requirements. She responded to questions about the Colorado Psychological Association. Dr. Knudtson continued to respond to questions about the bill.

04:05 PM -- Dr. Tom Gray, representing the Colorado Psychological Association, testified in support of the bill. He stated he has not heard any objection from his colleagues about establishing a continuing professional development program for psychologists. He discussed his experience as a psychologist. Dr. Gray responded to questions about whether the requirements in the bill are attainable.

04:13 PM

Dr. Knudtson and Dr. Gray responded to questions about why the Colorado Psychologist Association could not require continuing professional development of its members. Dr. Knudtson said that there are about 2,000 psychologists in Colorado and just under 500 are members of the Colorado Psychologist Association. Dr. Knudtson responded to questions about the fiscal note.


04:18 PM -- Ronne Hines, representing the Department of Regulatory Agencies, responded to questions about how the department enforces and monitors the continuing professional development requirements for other professions. She responded to questions about what currently happens if a psychologist is suspected of being incompetent or has a complaint filed against him or her.


04:23 PM

Representative Kraft-Tharp and Representative Landgraf gave concluding remarks regarding the bill. The committee dialogued about the bill.
BILL:HB15-1067
TIME: 04:33:53 PM
MOVED:Landgraf
MOTION:Refer House Bill 15-1067 to the Committee on Appropriations. The motion passed on a vote of 8-5.
SECONDED:Ginal
VOTE
Brown
No
Esgar
Yes
Humphrey
No
Joshi
No
Klingenschmitt
No
Landgraf
Yes
Lontine
Yes
Mitsch Bush
Yes
Primavera
Yes
Ransom
No
Ryden
Yes
Ginal
Yes
McCann
Yes
Final YES: 8 NO: 5 EXC: 0 ABS: 0 FINAL ACTION: PASS

04:35 PM

The committee adjourned.