HOUSE 3rd Reading Unamended April 14, 2011 HOUSE Amended 2nd Reading April 13, 2011 SENATE 3rd Reading Unamended April 11, 2011 SENATE Amended 2nd Reading April 8, 2011First Regular Session Sixty-eighth General Assembly STATE OF COLORADO REREVISED This Version Includes All Amendments Adopted in the Second House LLS NO. 11-0971.01 Brita Darling SENATE BILL 11-213 SENATE SPONSORSHIP Hodge, Steadman, Lambert HOUSE SPONSORSHIP Gerou, Becker, Ferrandino Senate Committees House Committees Appropriations Appropriations A BILL FOR AN ACT Concerning enrollee cost-sharing for children enrolled in the children's basic health plan, and making an appropriation therefor. Bill Summary (Note: This summary applies to this bill as introduced and does not reflect any amendments that may be subsequently adopted. If this bill passes third reading in the house of introduction, a bill summary that applies to the reengrossed version of this bill will be available at http://www.leg.state.co.us/billsummaries.) The department of health care policy and financing (the department) currently has the duty to implement a cost-sharing system using an enrollment fee for enrollees in the children's basic health plan (plan), excluding pregnant women and enrollees with a family income of less than 150% of the federal poverty line (FPL). The bill directs the department to assess an annual enrollment fee for persons with a family income up to 205% of FPL, and to assess a monthly enrollment fee, capped at $50 per month, per family, for children in families with a family income that exceeds 205% of the FPL. The bill authorizes the department to provide information to the department of revenue concerning unpaid enrollment fees for offset against a state income tax refund. The department shall establish a process for an enrollee to contest and appeal the determination of debt. Be it enacted by the General Assembly of the State of Colorado: SECTION 1. 25.5-8-107 (1) (b) and (1) (e), Colorado Revised Statutes, are amended to read: 25.5-8-107. Duties of the department - schedule of services - premiums - copayments - subsidies. (1) In addition to any other duties pursuant to this article, the department shall have the following duties: (b) (I) (A) To design and implement a system of cost-sharing with enrollees using an annual enrollment fee that is based on a sliding fee scale; The sliding fee scale shall be developed based on the enrollee's family income; except that no enrollment fee shall be assessed against an enrollee whose family income is at or below one hundred fifty percent of the federal poverty line and no enrollment fee shall be assessed against an enrollee who is a pregnant woman. As permitted by federal and state law, enrollees in the plan may use funds from a medical savings account to pay the annual enrollment fee fees. On or before November 1 of each year, the department shall submit for approval to the joint budget committee its annual proposal for cost sharing for the plan based upon a family's income. (B) For children in families with a family income equal to or greater than one hundred fifty percent of the federal poverty line, but no more than two hundred and five percent of the federal poverty line, the department shall assess an annual enrollment fee. (C) For children in families with a family income greater than two hundred and five percent of the federal poverty line, the department shall assess a monthly enrollment fee that is not less than twenty dollars for the first child enrolled in the plan and not less than ten dollars for each additional child enrolled in the plan. The total monthly enrollment fee assessed for a family shall not exceed fifty dollars per month. The department may adjust the amounts specified in this sub-subparagraph (C) for inflation. (II) The department may provide information to the department of revenue pursuant to section 26-2-133, C.R.S., regarding persons who are obligated to the state for nonpayment of enrollment fees pursuant to this paragraph (b). Prior to providing information to the department of revenue pursuant to section 26-2-133, C.R.S., the department shall establish a process to ensure that the obligated person has been afforded the opportunity to contest and appeal the determination of the debt. (e) To design a procedure whereby a financial sponsor may pay the annual enrollment fee or some portion thereof on behalf of a subsidized or nonsubsidized enrollee; except that the payment made on behalf of said enrollee shall not exceed the total enrollment fee due from the enrollee; SECTION 2. 26-2-133 (2), Colorado Revised Statutes, is amended to read: 26-2-133. State income tax refund offset. (2) As a condition of certifying an overpayment to the department of revenue as provided in subsection (1) of this section, the state department shall ensure that the obligated person has been afforded the opportunity for a conference at the county department level pursuant to section 26-2-127 or 25.5-4-207, C.R.S., and the opportunity for an appeal to the state department pursuant to section 26-2-127 or 26-2-304, or that the obligated person has been afforded the process established pursuant to section 25.5-8-107, C.R.S. In addition, the state department, prior to final certification of the information specified in subsection (1) of this section to the department of revenue, shall notify the obligated person, in writing, at his or her last-known address, that the state intends to refer the person's name to the department of revenue in an attempt to offset the obligation against the person's state income tax refund. Such notification shall inform the obligated person of the opportunity for a conference with the county department pursuant to section 26-2-127 or 25.5-4-207, C.R.S., and of the opportunity for an appeal to the state department pursuant to section 26-2-127 or 26-2-304, or of the process established pursuant to section 25.5-8-107, C.R.S. In addition, the notice shall specify issues that may be raised at an evidentiary conference or on appeal, as provided by this subsection (2), by the obligated person in objecting to the offset and shall specify that the obligated person may not object to the fact that an overpayment occurred. A person who has received a notice pursuant to this subsection (2) shall request, within thirty days from the date such notice was mailed, an administrative review or evidentiary conference, as provided in this subsection (2). SECTION 3. Appropriation - adjustments in 2011 long bill. (1) For the implementation of this act, appropriations made in the annual general appropriation act, to the department of health care policy and financing, for the fiscal year beginning July 1, 2011, shall be adjusted as follows: (a) The appropriation for the executive director's office, for general administration, is increased by four thousand eight hundred twenty-one dollars ($4,821) and 0.2 FTE. Of this amount, one thousand six hundred eighty-seven dollars ($1,687) shall be from the general fund and three thousand one hundred thirty-four dollars ($3,134) shall be from federal funds. (b) The appropriation for the indigent care program, for children's basic health plan administration, is increased by eleven thousand eighty-eight dollars ($11,088). Of this amount, three thousand eight hundred eighty-one dollars ($3,881) shall be from the general fund and seven thousand two hundred seven dollars ($7,207) shall be from federal funds. (c) The appropriation for the indigent care program, for children's basic health plan medical and dental costs, is decreased by three hundred ninety-eight thousand eight hundred forty-nine dollars ($398,849). Of this amount, one hundred thirty-nine thousand five hundred ninety-seven dollars ($139,597) shall be cash funds from the hospital provider fee cash fund created in section 25.5-4-402.3 (4), Colorado Revised Statutes, and two hundred fifty-nine thousand two hundred fifty-two dollars ($259,252) shall be from federal funds. (d) The appropriation for the department of human services medicaid-funded programs, office of information technology services - medicaid funding, for the Colorado benefits management system, is increased by three hundred seventy-five thousand nine hundred sixty dollars ($375,960). Of said sum, twenty-nine thousand nine hundred seventy dollars ($29,970) shall be from the general fund, one hundred one thousand six hundred sixteen dollars ($101,616) shall be from the children's basic health plan trust created in section 25.5-8-105 (1), Colorado Revised Statutes, and two hundred forty-four thousand three hundred seventy-four dollars ($244,374) shall be from federal funds. (2) For the implementation of this act, appropriations made in the annual general appropriation act, to the department of human services, office of information technology services, for the Colorado benefits management system for the fiscal year beginning July 1, 2011, is increased by three hundred seventy-five thousand nine hundred sixty dollars ($375,960). Said sum shall be reappropriated funds received from the department of health care policy and financing out of the appropriation made in subsection (1) (d) of this section. (3) For the implementation of this act, appropriations made in the annual general appropriation act, to the governor - lieutenant governor - state planning and budgeting, for the fiscal year beginning July 1, 2011, shall be adjusted as follows: (a) The appropriation for the office of information technology for the Colorado benefits management system, is increased by three hundred seventy-five thousand nine hundred sixty dollars ($375,960). Said sum shall be reappropriated funds received from the department of human services out of the appropriation made in subsection (2) of this section. (b) The appropriation for the office of information technology for computer services is increased by five thousand nine hundred twenty dollars ($5,920). Said sum shall be reappropriated funds received from the department of revenue out of the appropriations made in subsection (4) of this section. (4) For the implementation of this act, the general fund appropriation made in the annual general appropriation act, to the department of revenue, information technology division, for system support, is increased by five thousand nine hundred twenty dollars ($5,920). SECTION 4. Effective date. This act shall take effect July 1, 2011. SECTION 5. Safety clause. The general assembly hereby finds, determines, and declares that this act is necessary for the immediate preservation of the public peace, health, and safety.