Date: 04/26/2006

Final
BILL SUMMARY for SB06-213

HOUSE COMMITTEE ON BUSINESS AFFAIRS AND LABOR

Votes: View--> Action Taken:
Moved amendment L.007 (Attachment A). The motion
Moved to refer Senate Bill 06-213, as amended, to 		Pass Without Objection
PASS



11:48 AM -- Senate Bill 06-213

Representative Penry, prime sponsor, presented Senate Bill 06-213. He explained that the bill requires that health care services provided at an in-network facility, including services provided by an out-of-network provider, be provided to the covered person at no greater cost to the covered person than if the services were obtained from an in-network provider. He discussed Colorado's current law regarding network adequacy and participating and nonparticipating providers, stating that the Division of Insurance has interpreted current law as is specified in Senate Bill 06-213, but a recent court case struck down the division's interpretation. Therefore, the bill is codifying what was already the practice by the Division of Insurance for some time.

11:51 AM

Representative Penry explained amendment L.007 that would require a sunset review in 2010 by the Division of Insurance (Attachment A). Representative Penry responded to questions from the committee pertaining to balanced billing.

11:57 AM -- Julie Hoerner, Department of Regulatory Agencies, testified in support of the bill. Ms. Hoerner discussed the Division of Insurance's interpretation of current law and the recent court case that struck down the interpretation. She stated that the bill is attempting to avoid balanced billing and is limited to services in an in-network center. Ms. Hoerner discussed amendment L.007. There was committee discussion about whether amendment L.007 would create a fiscal impact for the Division of Insurance. Ms. Hoerner stated that it would not.

12:07 PM -- Rebecca Weiss, Anthem Blue Cross and Blue Shield, testified in opposition of the bill. She stated that under the bill, the requirement that insurers cover a provider's full billed charges would increase costs and those costs are passed onto consumers in the form of increased premiums. She stated that Anthem is interested in contracting with as many providers as possible, but that the bill may be used as a negotiating tool for physicians to obtain higher rates or to refuse to join the insurer's network. She stated that the bill, as drafted, may allow policyholders to intentionally seek out-of-network providers with the belief that Anthem will cover the entire cost. Ms. Weiss stated that Anthem is concerned because Senate Bill 06-213 does not differentiate between whether the consumer knowingly or unknowingly used an out-of-network provider. She discussed the differences between the Division of Insurance's interpretation of the law prior to the court decision and what the bill states.

12:19 PM

In response to a committee question, Ms. Weiss explained why there would be an out-of-network provider in an in-network hospital. She explained that out-of-network providers could charge whatever they choose under Senate Bill 06-213, and that could give in-network providers an incentive to leave the network. Ms. Weiss stated that she would like to see the bill clarify that the insurance company would pay the full charges if the consumer knowingly went to an out-of-network provider. Representative Penry responded to Ms. Weiss' testimony.

12:36 PM -- Lynn Perry, representing the Colorado Medical Society, testified in support of the bill. She talked about how her office currently handles patients under these circumstances. Ms. Perry stated that the bill would protect patients in instances where they need care in a timely manner and must use an out-of-network doctor.

12:40 PM -- Penny Baldwin, representing herself, testified in support of the bill. She distributed and explained a handout illustrating how a consumer's costs increase if the provider "balance bills" the consumer (Attachment B). Ms. Baldwin talked about a personal experience she had where she had to receive out-of-network care.

12:48 PM -- Carrie Curtiss, Colorado Consumer Health Initiative, testified in support of the bill. She stated that balanced billing should not take place. She stated that it is the health insurance companies' responsibility to ensure an adequate network of providers. She explained that in these situations the consumer is following the rules by going to an in-network center and should not be penalized.

12:49 PM -- Patrick Boyle, representing United Health Care and Pacificare, testified in support of the bill and stated that amendment L.007 is absolutely imperative.
BILL:SB06-213
TIME: 12:52:01 PM
MOVED:Penry
MOTION:Moved amendment L.007 (Attachment A). The motion passed without objection.
SECONDED:McCluskey
VOTE
Balmer
Borodkin
Butcher
Carroll M.
Coleman
Knoedler
Liston
McCluskey
Paccione
Penry
Welker
Cerbo
Marshall
Not Final YES: 0 NO: 0 EXC: 0 ABS: 0 FINAL ACTION: Pass Without Objection


BILL:SB06-213
TIME: 12:52:48 PM
MOVED:Penry
MOTION:Moved to refer Senate Bill 06-213, as amended, to the Committee of the Whole. The motion passed 12-0.
SECONDED:Paccione
VOTE
Balmer
Yes
Borodkin
Yes
Butcher
Yes
Carroll M.
Excused
Coleman
Yes
Knoedler
Yes
Liston
Yes
McCluskey
Yes
Paccione
Yes
Penry
Yes
Welker
Yes
Cerbo
Yes
Marshall
Yes
Final YES: 12 NO: 0 EXC: 1 ABS: 0 FINAL ACTION: PASS




12:55 PM

The committee adjourned.