Colorado 2022 Regular Session

Colorado House Bill HB1268 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
	1	+	Second Regular Session
	2	+	Seventy-third General Assembly
	3	+	STATE OF COLORADO
	4	+	REVISED
	5	+	This Version Includes All Amendments Adopted
	6	+	on Second Reading in the Second House
	7	+	LLS NO. 22-0608.01 Chelsea Princell x4335
1	8		HOUSE BILL 22-1268
2		-	BY REPRESENTATIVE(S) Holtorf and Amabile, Bernett, Bird,
3		-	Boesenecker, Kipp, Lontine, Michaelson Jenet, Titone, Weissman;
4		-	also SENATOR(S) Ginal and Simpson, Hinrichsen, Jaquez Lewis,
5		-	Kirkmeyer, Kolker, Lee, Liston, Moreno, Rodriguez, Sonnenberg,
6		-	Zenzinger, Fenberg.
	9	+	House Committees Senate Committees
	10	+	Public & Behavioral Health & Human Services Health & Human Services
	11	+	Appropriations Appropriations
	12	+	A BILL FOR AN ACT
7	13		C
8		-	ONCERNING A REPORTING OF MEDICAID REIMBURSEMENT RATES PAID TO
9		-	MENTAL HEALTH PROVIDERS
10		-	.
11		-
12		-	Be it enacted by the General Assembly of the State of Colorado:
13		-	SECTION 1. Legislative declaration. The general assembly finds
14		-	and declares that it is imperative to determine whether a disparity exists, and
15		-	the reasons for such possible disparities, in medicaid reimbursement rates
16		-	among providers of mental health services in an effort to ensure
17		-	transparency and parity in reimbursement rates.
18		-	SECTION 2. In Colorado Revised Statutes, add 25.5-1-132 as
19		-	follows:
20		-	25.5-1-132. Report of medicaid reimbursement rates paid to
21		-	community mental health center providers and independent providers
22		-	NOTE: This bill has been prepared for the signatures of the appropriate legislative
23		-	officers and the Governor. To determine whether the Governor has signed the bill
24		-	or taken other action on it, please consult the legislative status sheet, the legislative
25		-	history, or the Session Laws.
26		-	________
27		-	Capital letters or bold & italic numbers indicate new material added to existing law; dashes
28		-	through words or numbers indicate deletions from existing law and such material is not part of
29		-	the act. - definition. (1) O N OR BEFORE AUGUST 15, 2022, THE STATE DEPARTMENT
30		-	SHALL PUBLISH A BEHAVIORAL HEALTH RATES REPORT OF MEDICAID
31		-	REIMBURSEMENT RATES FOR PROVIDERS OF COMMUNITY MENTAL HEALTH
32		-	CENTERS
33		-	, AS DEFINED IN SECTION 27-66-101 (2), AND INDEPENDENT MENTAL
34		-	HEALTH AND SUBSTANCE ABUSE TREATMENT PROVIDERS
35		-	, AS DESCRIBED IN
36		-	SUBSECTION
37		-	(2) OF THIS SECTION. THE STATE DEPARTMENT SHALL
38		-	CONTRACT WITH AN INDEPENDENT AUDITOR TO PREPARE THE BEHAVIORAL
39		-	HEALTH RATES REPORT
40		-	, AS DESCRIBED IN THIS SUBSECTION (1). THE STATE
41		-	DEPARTMENT SHALL PREPARE
42		-	, IN COORDINATION WITH THE BEHAVIORAL
43		-	HEALTH RATES REPORT
44		-	, A SET OF RECOMMENDATIONS ON CREATING
45		-	EQUITABLE PAYMENT AND PAYMENT MODELS THAT MINIMIZE
46		-	INAPPROPRIATE PAYMENT VARIATION IN COMPARABLE BEHAVIORAL HEALTH
47		-	SERVICES BETWEEN THE PROVIDERS OF COMMUNITY MENTAL HEALTH
48		-	CENTERS AND INDEPENDENT MENTAL HEALTH AND SUBSTANCE USE
49		-	TREATMENT PROVIDERS
50		-	. THE STATE DEPARTMENT SHALL PRESENT THE
51		-	BEHAVIORAL HEALTH RATES REPORT AND RECOMMENDATIONS TO THE
52		-	HOUSE OF REPRESENTATIVES PUBLIC AND BEHAVIORAL HEALTH AND HUMAN
53		-	SERVICES COMMITTEE
54		-	, OR ANY SUCCESSOR COMMITTEE .
	14	+	ONCERNING A REPORTING OF MEDICAID REIMBURSEMENT RATES PAID101
	15	+	TO MENTAL HEALTH PROVIDERS .102
	16	+	Bill Summary
	17	+	(Note: This summary applies to this bill as introduced and does
	18	+	not reflect any amendments that may be subsequently adopted. If this bill
	19	+	passes third reading in the house of introduction, a bill summary that
	20	+	applies to the reengrossed version of this bill will be available at
	21	+	http://leg.colorado.gov
	22	+	.)
	23	+	The bill requires the department of health care policy and
	24	+	financing (department) to prepare a report of medicaid reimbursement
	25	+	rates for community mental health providers and independent mental
	26	+	health and substance use treatment providers. The department must hire
	27	+	an independent auditor to prepare the report and provide
	28	+	recommendations on the report to be presented to the house of
	29	+	SENATE
	30	+	2nd Reading Unamended
	31	+	April 25, 2022
	32	+	HOUSE
	33	+	3rd Reading Unamended
	34	+	April 6, 2022
	35	+	HOUSE
	36	+	Amended 2nd Reading
	37	+	April 5, 2022
	38	+	HOUSE SPONSORSHIP
	39	+	Holtorf and Amabile, Bernett, Bird, Boesenecker, Kipp, Lontine, Michaelson Jenet,
	40	+	Titone, Weissman
	41	+	SENATE SPONSORSHIP
	42	+	Ginal and Simpson,
	43	+	Shading denotes HOUSE amendment. Double underlining denotes SENATE amendment.
	44	+	Capital letters or bold & italic numbers indicate new material to be added to existing statute.
	45	+	Dashes through the words indicate deletions from existing statute. representatives public and behavioral health and human services
	46	+	committee. The department is required to prepare recommendations based
	47	+	on the audit findings and recommendations to create equitable payment
	48	+	models between providers of community mental health centers and
	49	+	independent mental health and substance use treatment providers
	50	+	providing comparable behavioral health services.
	51	+	The audit conducted must reflect data from state fiscal year
	52	+	2020-21 and include a determination and recommendations on the
	53	+	adequacy of reimbursement rates paid to medicaid mental health
	54	+	providers. The department must present an action plan to implement
	55	+	changes to reimbursement rates based on the findings of the audit to the
	56	+	joint budget committee before November 15, 2022. The department must
	57	+	also prepare an annual report and provide an update at the "State
	58	+	Measurement for Accountable, Responsive, and Transparent (SMART)
	59	+	Government Act" hearing annually through August 1, 2025.
	60	+	The bill requires the department to publish an annual cost report
	61	+	on or before March 15 of each year. The department must establish a cost
	62	+	report template and cost reporting schedule to assist providers in relaying
	63	+	cost information to the state department. The bill requires the department
	64	+	to establish a transparency report that translates the cost report data into
	65	+	meaningful and actionable information to ensure equity in provider
	66	+	compensation and adequate access to care for medicaid members.
	67	+	Be it enacted by the General Assembly of the State of Colorado:1
	68	+	SECTION 1. Legislative declaration. The general assembly2
	69	+	finds and declares that it is imperative to determine whether a disparity3
	70	+	exists, and the reasons for such possible disparities, in medicaid4
	71	+	reimbursement rates among providers of mental health services in an5
	72	+	effort to ensure transparency and parity in reimbursement rates.6
	73	+	SECTION 2. In Colorado Revised Statutes, add 25.5-1-132 as7
	74	+	follows:8
	75	+	25.5-1-132. Report of medicaid reimbursement rates paid to9
	76	+	community mental health center providers and independent10
	77	+	providers - definition. (1) O N OR BEFORE AUGUST 15, 2022, THE STATE11
	78	+	DEPARTMENT SHALL PUBLISH A BEHAVIORAL HEALTH RATES REPORT OF12
	79	+	MEDICAID REIMBURSEMENT RATES FOR PROVIDERS OF COMMUNITY13
	80	+	1268-2- MENTAL HEALTH CENTERS , AS DEFINED IN SECTION 27-66-101 (2), AND1
	81	+	INDEPENDENT MENTAL HEALTH AND SUBSTANCE ABUSE TREATMENT2
	82	+	PROVIDERS, AS DESCRIBED IN SUBSECTION (2) OF THIS SECTION. THE STATE3
	83	+	DEPARTMENT SHALL CONTRACT WITH AN INDEPENDENT AUDITOR TO4
	84	+	PREPARE THE BEHAVIORAL HEALTH RATES REPORT, AS DESCRIBED IN THIS5
	85	+	SUBSECTION (1). THE STATE DEPARTMENT SHALL PREPARE , IN6
	86	+	COORDINATION WITH THE BEHAVIORAL HEALTH RATES REPORT, A SET OF7
	87	+	RECOMMENDATIONS ON CREATING EQUITABLE PAYMENT AND PAYMENT8
	88	+	MODELS THAT MINIMIZE INAPPROPRIATE PAYMENT VARIATION IN9
	89	+	COMPARABLE BEHAVIORAL HEALTH SERVICES BETWEEN THE PROVIDERS10
	90	+	OF COMMUNITY MENTAL HEALTH CENTERS AND INDEPENDENT MENTAL11
	91	+	HEALTH AND SUBSTANCE USE TREATMENT PROVIDERS . THE STATE12
	92	+	DEPARTMENT SHALL PRESENT THE BEHAVIORAL HEALTH RATES REPORT13
	93	+	AND RECOMMENDATIONS TO THE HOUSE OF REPRESENTATIVES PUBLIC AND14
	94	+	BEHAVIORAL HEALTH AND HUMAN SERVICES COMMITTEE, OR ANY15
	95	+	SUCCESSOR COMMITTEE.16
55	96		(2) T
56		-	HE REPORT PREPARED PURSUANT TO SUBSECTION (1) OF THIS
57		-	SECTION MUST REFLECT DATA FROM STATE FISCAL YEAR
58		-	2020-21 AND
59		-	IDENTIFY DISCREPANCIES
60		-	, IF ANY, AND THE REASONS FOR SUCH
61		-	DISCREPANCIES IN MEDICAID REIMBURSEMENT RATES PAID TO PROVIDERS OF
62		-	A COMMUNITY MENTAL HEALTH CENTER AND INDEPENDENT MENTAL HEALTH
63		-	AND SUBSTANCE ABUSE TREATMENT PROVIDERS FOR COMPARABLE
64		-	SERVICES
65		-	. THE REPORT MUST INCLUDE A DETERMINATION OF AND
66		-	RECOMMENDATIONS ON WHETHER REIMBURSEMENT RATES PAID TO
67		-	COMMUNITY MENTAL HEALTH CENTER PROVIDERS AND INDEPENDENT
68		-	MENTAL HEALTH AND SUBSTANCE USE TREATMENT PROVIDERS ARE
69		-	ADEQUATE TO MEET OR EXCEED NETWORK ADEQUACY ST ANDARDS IN EVERY
70		-	REGION OF THE STATE
71		-	. THE DATA MUST BE AGGREGATED TO ENSURE
72		-	INDIVIDUAL COMMUNITY MENTAL HEALTH CENTERS AND INDEPENDENT
73		-	PROVIDERS ARE NOT IDENTIFIABLE AND MUST COMPLY WITH ANY OTHER
74		-	STATE AND FEDERAL PRIVACY LAWS
75		-	. ON OR BEFORE NOVEMBER 15, 2022,
76		-	THE STATE DEPARTMENT SHALL PRESENT AN ACTION PLAN FOR
77		-	IMPLEMENTATION TO THE JOINT BUDGET COMMITTEE
78		-	. THE STATE
79		-	DEPARTMENT SHALL PRODUCE A PROGRESS REPORT ON THE STATE
80		-	DEPARTMENT
81		-	'S PROGRESS MADE IN IMPLEMENTING THE ACTION PLAN
82		-	PRESENTED TO THE JOINT BUDGET COMMITTEE ON
83		-	NOVEMBER 15, 2022, ON
84		-	OR BEFORE
85		-	AUGUST 1, 2023, AND ANNUALLY THEREAFTER THROUGH
86		-	PAGE 2-HOUSE BILL 22-1268 AUGUST 1, 2025, AND PROVIDE AN UPDATE DURING ITS "STATE
87		-	MEASUREMENT FOR ACCOUNTABLE, RESPONSIVE, AND TRANSPARENT
88		-	(SMART) GOVERNMENT ACT" HEARING PURSUANT TO SECTION 2-7-203 ON
89		-	THE FINDINGS AND ADDITIONAL RECOMMENDATIONS
90		-	. THE STATE
91		-	DEPARTMENT MUST FULLY IMPLEMENT THE ACTION PLAN NO LATER THAN
92		-	DECEMBER 31, 2025.
93		-	(3) A
94		-	S USED IN THIS SECTION, UNLESS THE CONTEXT OTHERWISE
95		-	REQUIRES
96		-	, "INDEPENDENT MENTAL HEALTH AND SUBSTANCE ABUSE
97		-	TREATMENT PROVIDERS
98		-	" MEANS ANY OUTPATIENT BEHAVIORAL HEALTH
99		-	PROVIDER ENROLLED IN MEDICAID AND CONTRACTED WITH A M ANAGED
100		-	CARE ENTITY
101		-	, AS DEFINED IN SECTION 25.5-5-403 (4), THAT IS NOT LICENSED
102		-	OR DESIGNATED AS A COMMUNITY MENTAL HEALTH CENTER
103		-	.
104		-	SECTION 3. In Colorado Revised Statutes, add 25.5-4-403.1 as
105		-	follows:
106		-	25.5-4-403.1. Providers - community mental health centers - cost
107		-	reporting. (1) F
108		-	OR THE PURPOSES OF INCREASED PAYMENT METHODOLOGY
109		-	TRANSPARENCY
110		-	, NO LATER THAN MARCH 15, 2023, AND EACH MARCH 15
111		-	THEREAFTER, THE STATE DEPARTMENT SHALL :
112		-	(a) P
113		-	UBLISH COST REPORTS FOR COMMUNITY MENTAL HEALTH
114		-	CENTERS
115		-	;
116		-	(b) E
117		-	STABLISH A COST-REPORTING TEMPLATE AND COST -REPORTING
118		-	SCHEDULE TO ASSIST PROVIDERS IN PROVIDING COST REPORTS
119		-	;
120		-	(c) R
121		-	EDACT INFORMATION TO MAINTAIN COMPLIANCE WITH STATE
122		-	AND FEDERAL LAW INCLUDING
123		-	, BUT NOT LIMITED TO , PERSONALLY
124		-	IDENTIFYING INFORMATION AND PROTECTED HEALTH INFORMATION AS
125		-	NECESSARY TO PROTECT THE PRIVACY OF PATIENTS
126		-	;
127		-	(d) C
128		-	REATE A PUBLICLY AVAILABLE WEBSITE THAT PROVIDES
129		-	INSIGHT TO MEDICAID MEMBERS
130		-	, MEDICAID PROVIDERS, AND MEMBERS OF
131		-	THE PUBLIC REGARDING BEHAVIORAL HEALTH REIMBURSEMENT RATES
132		-	. THE
133		-	WEBSITE MUST INCLUDE THE FOLLOWING
134		-	:
135		-	(I) A
136		-	LL COMPLETED COST REPORTS FOR EACH BEHAVIORAL HEALTH
137		-	SAFETY NET PROVIDER
138		-	, AS DEFINED IN 27-50-101 (7);
139		-	PAGE 3-HOUSE BILL 22-1268 (II) AN OVERVIEW OF THE PURPOSE OF THE COST REPORT DESCRIBED
140		-	IN THIS SUBSECTION
141		-	(1);
142		-	(III) I
143		-	NFORMATION ON HOW TO INTERPRET THE COST REPORTS AND
144		-	WHERE TO FIND INFORMATION IN THE COST REPORTS
145		-	;
146		-	(IV) A
147		-	N OVERVIEW OF:
148		-	(A) H
149		-	OW REIMBURSEMENT RATES ARE DETERMINED ;
150		-	(B) W
151		-	HAT CONSTITUTES A REASONABLE AND ALLOWABLE COST ; AND
152		-	(C) HOW VALUE-BASED PAYMENTS IMPACT REIMBURSEMENT RATES ;
153		-	AND
154		-	(V) THE STATE DEPARTMENT 'S PLAN TO IMPROVE BEHAVIORAL
155		-	HEALTH REIMBURSEMENT RATES AND ANNUAL UPDATES TO THE PLAN
156		-	.
157		-	PAGE 4-HOUSE BILL 22-1268 SECTION 4. Safety clause. The general assembly hereby finds,
158		-	determines, and declares that this act is necessary for the immediate
159		-	preservation of the public peace, health, or safety.
160		-	____________________________ ____________________________
161		-	Alec Garnett Steve Fenberg
162		-	SPEAKER OF THE HOUSE PRESIDENT OF
163		-	OF REPRESENTATIVES THE SENATE
164		-	____________________________ ____________________________
165		-	Robin Jones Cindi L. Markwell
166		-	CHIEF CLERK OF THE HOUSE SECRETARY OF
167		-	OF REPRESENTATIVES THE SENATE
168		-	APPROVED________________________________________
169		-	(Date and Time)
170		-	_________________________________________
171		-	Jared S. Polis
172		-	GOVERNOR OF THE STATE OF COLORADO
173		-	PAGE 5-HOUSE BILL 22-1268
	97	+	HE REPORT PREPARED PURSUANT TO SUBSECTION (1) OF THIS17
	98	+	SECTION MUST REFLECT DATA FROM STATE FISCAL YEAR 2020-21 AND18
	99	+	IDENTIFY DISCREPANCIES, IF ANY, AND THE REASONS FOR SUCH19
	100	+	DISCREPANCIES IN MEDICAID REIMBURSEMENT RATES PAID TO PROVIDERS20
	101	+	OF A COMMUNITY MENTAL HEALTH CENTER AND INDEPENDENT MENTAL21
	102	+	HEALTH AND SUBSTANCE ABUSE TREATMENT PROVIDERS FOR22
	103	+	COMPARABLE SERVICES. THE REPORT MUST INCLUDE A DETERMINATION23
	104	+	OF AND RECOMMENDATIONS ON WHETHER REIMBURSEMENT RATES PAID24
	105	+	TO COMMUNITY MENTAL HEALTH CENTER PROVIDERS AND INDEPENDENT25
	106	+	MENTAL HEALTH AND SUBSTANCE USE TREATMENT PROVIDERS ARE26
	107	+	ADEQUATE TO MEET OR EXCEED NETWORK ADEQUACY ST ANDARDS IN27
	108	+	1268
	109	+	-3- EVERY REGION OF THE STATE . THE DATA MUST BE AGGREGATED TO1
	110	+	ENSURE INDIVIDUAL COMMUNITY MENTAL HEALTH CENTERS AND2
	111	+	INDEPENDENT PROVIDERS ARE NOT IDENTIFIABLE AND MUST COMPLY WITH3
	112	+	ANY OTHER STATE AND FEDERAL PRIVACY LAWS . ON OR BEFORE4
	113	+	N
	114	+	OVEMBER 15, 2022, THE STATE DEPARTMENT SHALL PRESENT AN ACTION5
	115	+	PLAN FOR IMPLEMENTATION TO THE JOINT BUDGET COMMITTEE . THE6
	116	+	STATE DEPARTMENT SHALL PRODUCE A
	117	+	PROGRESS REPORT ON THE STATE7
	118	+	DEPARTMENT'S PROGRESS MADE IN IMPLEMENTING THE ACTION PLAN8
	119	+	PRESENTED TO THE JOINT BUDGET COMMITTEE ON NOVEMBER 15, 2022,9
	120	+	ON OR BEFORE AUGUST 1, 2023, AND ANNUALLY THEREAFTER THROUGH10
	121	+	AUGUST 1, 2025, AND PROVIDE AN UPDATE DURING ITS "STATE11
	122	+	M
	123	+	EASUREMENT FOR ACCOUNTABLE, RESPONSIVE, AND TRANSPARENT12
	124	+	(SMART)
	125	+	GOVERNMENT ACT" HEARING PURSUANT TO SECTION 2-7-20313
	126	+	ON THE FINDINGS AND ADDITIONAL RECOMMENDATIONS .
	127	+	THE STATE14
	128	+	DEPARTMENT MUST FULLY IMPLEMENT THE ACTION PLAN NO LATER THAN15
	129	+	DECEMBER 31, 2025.16
	130	+	(3) AS USED IN THIS SECTION, UNLESS THE CONTEXT OTHERWISE17
	131	+	REQUIRES:18
	132	+	(a) "INDEPENDENT MENTAL HEALTH AND SUBSTANCE ABUSE19
	133	+	TREATMENT PROVIDERS" MEANS ANY OUTPATIENT BEHAVIORAL HEALTH20
	134	+	PROVIDER ENROLLED IN MEDICAID AND CONTRACTED WITH A MANAGED21
	135	+	CARE ENTITY, AS DEFINED IN SECTION 25.5-5-403 (4), THAT IS NOT22
	136	+	LICENSED OR DESIGNATED AS A COMMUNITY MENTAL HEALTH CENTER .23
	137	+	SECTION 3. In Colorado Revised Statutes, add 25.5-4-403.1 as24
	138	+	follows:25
	139	+	25.5-4-403.1. Providers - community mental health centers26
	140	+	- cost reporting. (1) FOR THE PURPOSES OF INCREASED PAYMENT27
	141	+	1268
	142	+	-4- METHODOLOGY TRANSPARENCY , NO LATER THAN MARCH 15, 2023, AND1
	143	+	EACH MARCH 15 THEREAFTER, THE STATE DEPARTMENT SHALL :2
	144	+	(a) PUBLISH COST REPORTS FOR COMMUNITY MENTAL HEALTH3
	145	+	CENTERS;4
	146	+	(b) ESTABLISH A COST -REPORTING TEMPLATE AND5
	147	+	COST-REPORTING SCHEDULE TO ASSIST PROVIDERS IN PROVIDING COST6
	148	+	REPORTS;7
	149	+	(c) REDACT INFORMATION TO MAINTAIN COMPLIANCE WITH STATE8
	150	+	AND FEDERAL LAW INCLUDING, BUT NOT LIMITED TO, PERSONALLY9
	151	+	IDENTIFYING INFORMATION AND PROTECTED HEALTH INFORMATION AS10
	152	+	NECESSARY TO PROTECT THE PRIVACY OF PATIENTS ;11
	153	+	(d) CREATE A PUBLICLY AVAILABLE WEBSITE THAT PROVIDES12
	154	+	INSIGHT TO MEDICAID MEMBERS, MEDICAID PROVIDERS, AND MEMBERS OF13
	155	+	THE PUBLIC REGARDING BEHAVIORAL HEALTH REIMBURSEMENT RATES.14
	156	+	THE WEBSITE MUST INCLUDE THE FOLLOWING :15
	157	+	(I) ALL COMPLETED COST REPORTS FOR EACH BEHAVIORAL HEALTH16
	158	+	SAFETY NET PROVIDER, AS DEFINED IN 27-50-101 (7);17
	159	+	(II) AN OVERVIEW OF THE PURPOSE OF THE COST REPORT18
	160	+	DESCRIBED IN THIS SUBSECTION (1);19
	161	+	(III) INFORMATION ON HOW TO INTERPRET THE COST REPORTS AND20
	162	+	WHERE TO FIND INFORMATION IN THE COST REPORTS ;21
	163	+	(IV) AN OVERVIEW OF:22
	164	+	(A) HOW REIMBURSEMENT RATES ARE DETERMINED ;23
	165	+	(B) WHAT CONSTITUTES A REASONABLE AND ALLOWABLE COST ;24
	166	+	AND25
	167	+	(C) HOW VALUE-BASED PAYMENTS IMPACT REIMBURSEMENT26
	168	+	RATES; AND27
	169	+	1268
	170	+	-5- (V) THE STATE DEPARTMENT'S PLAN TO IMPROVE BEHAVIORAL1
	171	+	HEALTH REIMBURSEMENT RATES AND ANNUAL UPDATES TO THE PLAN .2
	172	+	SECTION 4. Safety clause. The general assembly hereby finds,3
	173	+	determines, and declares that this act is necessary for the immediate4
	174	+	preservation of the public peace, health, or safety.5
	175	+	1268
	176	+	-6-