Date: 02/02/2009

BILL SUMMARY for HB09-1084


Votes: View--> Action Taken:

03:59 PM -- House Bill 09-1084

Representative Gagliardi presented House Bill 09-1084 concerning the procedures for audits of Medicaid providers.

04:04 PM --
Dr. Gordon Rheaume, representing himself, testified in support of the bill. Dr. Rheaume spoke to the process of auditing. He said that when he was audited he was asked to provide over 400 pages of information from over six years. He stated that the process was extremely cumbersome, lasted over 18 months, and cost him approximately $30,000. He provided two handouts to the committee illustrating his costs (Attachments H and I respectively). He stated that he does not think an audit should punish the doctor or cost them their livelihood.

04:15 PM --
Brad Young, RxPlus Pharmacies, testified in support of the bill. He stated that Val Kalnins, Colorado Pharmacist Society and Colorado Pharmacists are in support of the bill as well. He spoke to the complexity of audit reporting and said the bill may simplify some of the processes.

04:19 PM --
Gary Cummins, Colorado Dental Association, testified in support of the bill. Mr. Cummins stated that there are less than 400 dentists providing services to Medicaid clients. He stated that one of the concerns about becoming a provider is the auditing process.

04:25 PM --
Dr. David Griffin, podiatrist representing himself, testified in support of the bill. He spoke to the complexities of the auditing process. Dr. Griffin provided correspondence between himself and the Medicaid Audit Committee (Attachment J). He stated that he had been threatened by the Attorney General's to settle his case otherwise every piece of paper in his office would be requested and audited (Attachment J).

04:32 PM --
Tom Murphy, A Step Ahead Foot and Ankle Center, testified in support of the bill. He concurred with previous testimony and stated that several thousand pages of documentation was required for his Medicaid audit. He stated that it was a significantly large cost to his business.

04:35 PM --
James Dill, All Colorado Podiatry Group, testified in support of the bill. He recounted his audit experience. He stated it was extremely strenuous to track down documents from six years prior. He mentioned that the company that is hired to do the audit works on a contingency fee. He spoke to how his company provide services to Medicaid clients and how it has become extremely difficult to continue serving these clients. Dr. Dill provided his written testimony to the committee (Attachment K).

04:39 PM --
June Laird, attorney who represents licensed doctors in an appeal process for Medicaid audits, testified in support of the bill. She stated that the audit is extremely inconsistent.

04:47 PM --
Corky Kyle, Executive Director, Colorado Podiatrist Medical Society (CPMS), testified in support of the bill.

04:52 PM --
Jim Driscoll, Colorado Hospital Association, testified in support of the bill with amendments. He stated that on page 4, line 24, that the stricken language regarding the January 1, 2009 date pertaining to the status report should be put back in the bill. He stated there is a need to build something in the system that allows mistakes to be caught sooner rather than later.

04:57 PM --
Amy Larsen, Office of Legislative Council, fiscal analyst, explained the fiscal note. She pointed out that the bill limits the provider audits to three years, and record requests to 15 days per month in any given year. She stated that currently, a Medicaid audit can request records from an unlimited amount of time. Representative Kerr wanted to know how much was saved through Medicaid audits for the purpose of reviewing if audits are an effective tool. Ms. Larsen stated she would try to get that information for him. Committee members asked several questions of Ms. Larsen.

05:08 PM --
Jennifer Evans, Deputy Director, Financing, Department of Health Care Policy and Financing, stated that the department has some concerns with the bill, but are hoping to make some progress. She mentioned they are significant requirements that the department must meet in order to comply with program integrity from the federal Centers for Medicare and Medicaid. Members asked several questions of the witness. She spoke to the concern that the number of days that may be audited is limited to fifteen noting that some entities bill once a month. She stated that 15 days is not a statistically significant number to procure information regarding the provider.

05:27 PM

Representative Gagliardi stated she would like to work with the department on the bill. The bill was laid over to Thursday, February 5, 2009. The committee adjourned.