NOTE: The governor signed this measure on 3/18/2016.
      
      
      HOUSE BILL 16-1081
      
      
      BY REPRESENTATIVE(S) Ransom and Esgar, Becker K., Brown, Conti,
      Duran, Ginal, Kagan, Klingenschmitt, Kraft-Tharp, Landgraf, Lee,
      Lontine, Mitsch Bush, Neville P., Rosenthal, Saine, Van Winkle, Williams,
      Windholz;
      also SENATOR(S) Lundberg and Newell, Aguilar, Baumgardner, Cooke,
      Garcia, Grantham, Guzman, Heath, Holbert, Jahn, Kefalas, Lambert,
      Marble, Martinez Humenik, Scheffel, Scott, Steadman, Tate, Todd, Woods,
      Cadman.
      
      
      Concerning removing obsolete reporting provisions in title 25.5
           of the Colorado Revised Statutes.
      
      
      Be it enacted by the General Assembly of the State of Colorado:
      
           SECTION 1.  In Colorado Revised Statutes, 25.5-1-109.5, repeal
      (2) (b) as follows:
      
           25.5-1-109.5.  Clinical standards - development. (2) (b)  The state
      department shall review data collected pursuant to paragraph (a) of this
      subsection (2) and assess the health outcomes for programs administered
      by the state department. On or before July 1, 2008, and on or before each
      July 1 thereafter, based on the review of this data, the state department shall
      recommend to the health and human services committees of the senate and
      the house of representatives, or any successor committees, strategies to
      improve health outcomes.
      
           SECTION 2.  In Colorado Revised Statutes, 25.5-4-300.7, repeal
      (2) as follows:
      
           25.5-4-300.7.  Prevention of coding errors - prepayment review
      of claims. (2)  On or before January 31, 2011, and on or before January 31
      each year thereafter, the state department shall submit to the joint budget
      committee of the general assembly and to the health and human services
      committees of the house of representatives and senate, or any successor
      committees, a report concerning the system implemented and maintained
      by the state department pursuant to subsection (1) of this section. The
      report shall include, at a minimum, the number and dollar value of medical
      services coding errors identified during the previous year through the use
      of the system.
      
           SECTION 3.  In Colorado Revised Statutes, 25.5-5-410, amend
      (2); and repeal (1) as follows:
      
           25.5-5-410.  Data collection for managed care programs. (1)  In
      addition to any other data collection or reporting requirements set forth in
      this article and articles 4 and 6 of this title, the state department shall access
      and compile data concerning health data and outcomes. In addition, no later
      than July 1, 1998, the state department shall conduct or shall contract with
      an independent evaluator to conduct a quality assurance analysis of each
      managed care program in the state for medical assistance recipients. No
      later than July 1, 1999, and each fiscal year thereafter, the state department,
      using the compiled data and results from the quality assurance analysis,
      shall submit a report to the house and senate committees on health and
      human services, or any successor committees, on the cost-efficiency of each
      managed care program or component thereof, with recommendations
      concerning statewide implementation of the respective programs or
      components. For the purposes of this subsection (1), "quality assurance"
      means costs weighed against benefits provided to consumers, health
      outcomes or maintenance of the individual's highest level of functioning,
      and the overall change in the health status of the population served. The
      state department's report shall address capitation, including methods for
      adjusting rates based on risk allocations, fees-for-services, copayments,
      chronically ill populations, long-term care, community-supported services,
      and the entitlement status of medical assistance. The state department's
      report shall include a comparison of the effectiveness of the MCE program
      and the PCCM program based upon common performance standards that
      shall include but not be limited to recipient satisfaction.
      
           (2)  In addition, The state department of human services, in
      conjunction with the state department, shall continue its existing efforts,
      which include obtaining and considering consumer input, to develop
      managed care systems for the developmentally disabled population and to
      consider a pilot program for a certificate system to enable the
      developmentally disabled population to purchase managed care services or
      fee-for-service care, including long-term care community services. The
      department of human services shall not implement any managed care
      system for developmentally disabled services without the express approval
      of the joint budget committee. Any proposed implementation of fully
      capitated managed care in the developmental disabilities community
      service system shall require legislative review.
      
           SECTION 4.  In Colorado Revised Statutes, 25.5-5-506, repeal (3)
      (b) as follows:
      
           25.5-5-506.  Prescribed drugs - utilization review. (3) (b)  The
      state department shall report to the health and human services committees
      for the house of representatives and the senate, or any successor
      committees, and the joint budget committee no later than December 1,
      2003, and each December 1 thereafter, on plan utilization mechanisms that
      have been implemented or that will be implemented by the state
      department, the time frames for implementation, the expected savings
      associated with each utilization mechanism, and any other information
      deemed appropriate by the health and human services committees, or any
      successor committees, or the joint budget committee.
      
           SECTION 5.  In Colorado Revised Statutes, repeal 25.5-8-113 as
      follows:
      
           25.5-8-113.  Reports by contractors to medical services board.
      Any personal services contractor that contracts with the department to
      provide services under this article shall provide quarterly reports to the
      medical services board relating to the functions performed by the
      contractor, including reports on enrollment, utilization, marketing, and any
      concerns or recommendations relating to improving the administration of
      or the quality of the program. In addition, any contractor shall submit any
      data requested by the medical services board relating to the children's basic
      health plan and the functions provided by that contractor.
      
           SECTION 6.  In Colorado Revised Statutes, repeal 25.5-4-202 as
      follows:
      
           25.5-4-202.  Comprehensive plan for other services and benefits.
      In accordance with federal requirements pertaining to the development of
      a broad-based medical care program for low-income families, the state
      department shall prepare a comprehensive medical plan for consideration
      by the house and senate committees on health and human services, or any
      successor committees. The comprehensive plan shall include alternate
      means of expanding the medical care benefits and coverage provided in this
      article and articles 5 and 6 of this title. The comprehensive plan shall be
      reevaluated annually and shall be based upon a documented review of
      medical needs of low-income families in Colorado, a detailed analysis of
      priorities of service, coverage, and program costs, and an evaluation of
      progress. The medical advisory council appointed pursuant to this article
      shall assist the state department in the preparation of the comprehensive
      plan.
      
           SECTION 7.  In Colorado Revised Statutes, 25.5-6-1403, amend
      (2); and repeal (1) as follows:
      
           25.5-6-1403.  Waivers and amendments. (1)  On or before January
      1, 2010, the state department shall submit to the joint budget committee of
      the general assembly a report on the actuarial study and the fiscal analysis
      of the premiums based on the study and the rules adopted pursuant to this
      section.
      
           (2)  If approved by the joint budget committee following its review
      of the report and subject to available appropriations, the state department
      shall submit to the federal centers for medicare and medicaid services an
      amendment to the state medical assistance plan, and shall request any
      necessary waivers from the secretary of the federal department of health
      and human services, to permit the state department to expand medical
      assistance eligibility as provided in this part 14 for the purpose of
      implementing a medicaid buy-in program for people with disabilities who
      are in the basic coverage group or the medical improvement group. In
      addition, the state department shall apply to the secretary of the federal
      department of health and human services for a medicaid infrastructure
      grant, if available, to develop and implement the federal "Ticket to Work
      and Work Incentives Improvement Act of 1999", Pub.L. 106-170.
      
           SECTION 8.  In Colorado Revised Statutes, repeal 25.5-8-106 as
      follows:
      
           25.5-8-106.  Annual savings report. (1)  By October 1 of each year,
      the department shall submit to the joint budget committee of the general
      assembly, to the health and human services committees of the house of
      representatives and the senate, or any successor committees, and to the
      office of state planning and budgeting an annual savings report stating the
      cost-savings anticipated in the previous, current, and subsequent fiscal
      years from health care program reforms, consolidations, and streamlining.
      
           (2)  The annual savings report shall include a description of net
      savings factoring in increased administrative expenses from the following:
      
           (a)  Enrollment of medicaid clients in medicaid managed care
      programs. In calculating savings from enrollment of medicaid clients into
      medicaid managed care programs, the department shall calculate the total
      annual savings from growth in managed care enrollment subsequent to
      June 30, 1997.
      
           (b)  Consolidation of the children's portions of the Colorado
      indigent care program into the plan. In calculating the savings accrued
      and anticipated from consolidation of the children's portions of the
      Colorado indigent care program, created in part 1 of article 3 of this title,
      into the plan, the department shall use the following methodology: Estimate
      the reduction in expenditures due to the reduction in the number of children
      under age nineteen served by the Colorado indigent care program for each
      fiscal year in which children have been enrolled in the children's basic
      health plan.
      
           (3)  As reported in the annual savings report, the total savings from
      consolidation of the children's portions of the Colorado indigent care
      program, created in part 1 of article 3 of this title, into the plan shall not
      reduce the reimbursement rate of expenditures made on behalf of children
      to the Colorado indigent care program enrolled providers below the
      reimbursement rates used in the fiscal year prior to the first child enrolling
      in the plan.
      
           (4)  The department shall modify total savings calculated in
      paragraph (b) of subsection (2) of this section according to the geographic
      residence of subsidized enrollees and to the probable location of their
      health care providers under the Colorado indigent care program, created in
      part 1 of article 3 of this title.
      
           SECTION 9.  In Colorado Revised Statutes, 25.5-5-406, amend (1)
      (f) (I) as follows:
      
           25.5-5-406.  Required features of managed care system.
      (1)  General features. All medicaid managed care programs shall contain
      the following general features, in addition to others that the state
      department and the state board consider necessary for the effective and
      cost-efficient operation of those programs:
      
           (f)  Access to prescription drugs. (I)  The state department shall
      encourage an MCE to solicit competitive bids for the prescription drug
      benefit and discourage an MCE that has prescription drugs as a covered
      benefit from contracting for the prescription drug benefit with a sole source
      provider as much as possible. The state department's reports required by
      section 25.5-5-410 shall include a summary of each MCE's pharmacy
      network by geographic catchment area.
      
           SECTION 10.  In Colorado Revised Statutes, 25.5-8-105, amend
      (6) as follows:
      
           25.5-8-105.  Trust - created. (6)  As part of its annual savings
      report to the general assembly on November 1 of each year, the department
      may identify efficiencies and consolidations that produce savings in the
      department's annual budget request that result in actual reductions in
      administrative and programmatic costs associated with the implementation
      of this article and not decreases in the number of caseloads of such
      programs. These identified savings shall not duplicate the savings reported
      in the annual savings report described in section 25.5-8-106.
      
           SECTION 11.  Act subject to petition - effective date. This act
      takes effect at 12:01 a.m. on the day following the expiration of the
      ninety-day period after final adjournment of the general assembly (August
      10, 2016, if adjournment sine die is on May 11, 2016); except that, if a
      referendum petition is filed pursuant to section 1 (3) of article V of the state
      constitution against this act or an item, section, or part of this act within
      such period, then the act, item, section, or part will not take effect unless
      approved by the people at the general election to be held in November 2016
      and, in such case, will take effect on the date of the official declaration of
      the vote thereon by the governor.
      
      
      
      
      ________________________________________________________
      Dickey Lee Hullinghorst                Bill L. Cadman
      SPEAKER OF THE HOUSE                     PRESIDENT OF
      OF REPRESENTATIVES                         THE SENATE
      
      
      
      
      
      
      ____________________________  ____________________________
      Marilyn Eddins                            Effie Ameen
      CHIEF CLERK OF THE HOUSE                 SECRETARY OF
      OF REPRESENTATIVES                         THE SENATE
      
      
      
      
                  APPROVED________________________________________
      
      
      
      
      
                                    _________________________________________
                                    John W. Hickenlooper
                                    GOVERNOR OF THE STATE OF COLORADO