Second Regular Session
Seventy-fourth General Assembly
STATE OF COLORADO
INTRODUCED
LLS NO. 24-0802.01 Shelby Ross x4510
HOUSE BILL 24-1086
House Committees Senate Committees
Health & Human Services
A BILL FOR AN ACT
C
ONCERNING THE OPERATION OF THE DENVER HEALTH AND HOSPITAL101
AUTHORITY.102
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://leg.colorado.gov
.)
Current law requires the department of health care policy and
financing (department) to offer to enter into a direct contract with the
managed care organization (MCO) operated by or under the control of the
Denver health and hospital authority (Denver health) until Denver health
ceases to operate a medicaid managed care program or until June 30,
2025. The bill removes the option for the department to enter into a direct
HOUSE SPONSORSHIP
Holtorf and Amabile,
SENATE SPONSORSHIP
(None),
Shading denotes HOUSE amendment. Double underlining denotes SENATE amendment.
Capital letters or bold & italic numbers indicate new material to be added to existing law.
Dashes through the words or numbers indicate deletions from existing law. contract until June 30, 2025, and instead requires the department to enter
into the contract until Denver health ceases to operate a managed care
program.
The bill prohibits the MCO from reimbursing contracted medicaid
providers at rates that are higher than the department's medicaid fee for
service rates unless the provider enters into a quality incentive agreement
with the MCO. The bill requires the MCO's contract to provide physical
and behavioral health-care services to the population it serves.
For the 2023-24 state fiscal year, the department distributed money
appropriated for a supplemental state payment to Denver health. The bill
authorizes the department to continually distribute any money
appropriated for payment to Denver health.
Be it enacted by the General Assembly of the State of Colorado:1
SECTION 1. Legislative declaration. (1) The general assembly2
finds that:3
(a) Safety net hospitals are experiencing significant financial4
hardships due to uncompensated care, increased staffing costs, inflation,5
and federal money that is no longer available. Hospitals are seeing more6
uninsured, underinsured, and medicaid patients. Safety net hospitals are7
caring for patients longer, with less revenue and increased expenses, and8
they are struggling with how to provide care for their communities. Rural9
safety net hospitals and Denver health are the mostly heavily burdened by10
these increasing financial hardships.11
(b) Denver health and hospital authority is the largest safety net12
hospital in Colorado, serving patients from 63 out of the 64 counties in13
the state;14
(c) From 2020 to 2023, uncompensated care at Denver health has15
increased 127% due to underpayment from public insurance companies16
and increases in uninsured patients, including migrants and people17
experiencing homelessness;18
(d) In 2023, Denver health is projected to provide more than $13519
HB24-1086-2- million in uncompensated care;1
(e) Increased demand for services among uninsured and2
underinsured patients and increases in the number of homeless patients3
and those with a mental health diagnosis, together with the increasing4
expenses and stagnating public funding from federal, state, and local5
governments, have created an unsustainable financial situation for Denver6
health;7
(f) As a safety net hospital on the front line of providing8
health-care services statewide, it is important for the health of Coloradans9
that Denver health is financially stable and remains a valuable health-care10
resource; and11
(g) As the largest safety net hospital in Colorado, Denver health12
maintains and invests in administrative infrastructure necessary to carry13
out the responsibilities of serving a disproportionate share of medicaid14
members and uninsured individuals. Because of this, Denver health is15
unable to generate sufficient revenue to fulfill the ongoing investment16
need.17
(2) Therefore, the general assembly declares it is important to18
provide authority to the department of health care policy and financing to19
assist safety net hospitals, such as Denver health, in becoming financially20
stable.21
SECTION 2. In Colorado Revised Statutes, 25.5-5-402, amend22
(7.5) as follows:23
25.5-5-402. Statewide managed care system - rules -24
definitions - repeal. (7.5) (a) The state department shall offer to enter25
into a direct contract with the MCO operated by or under the control of26
Denver health and hospital authority, created pursuant to article 29 of title27
HB24-1086
-3- 25, until the MCO ceases to operate a medicaid managed care program.1
or until June 30, 2025, unless sooner reprocured. If the state department2
designates an MCO to manage behavioral health services pursuant to this3
article 5, Denver health and hospital authority, or any subsidiary thereof,4
shall collaborate with the MCO during the term of contract.5
(b) The MCO operated by or under the control of Denver health6
and hospital authority shall:7
(I) Maintain adequate financials to ensure proper solvency as a8
risk manager;9
(II) Accept rates determined by the state department, through10
standard methodologies, to cover the population it is serving. R
ATES PAID11
BY THE MCO TO CONTRACTED PROVIDERS MUST NOT BE HIGHER THAN THE12
STATE DEPARTMENT'S MEDICAID FEE FOR SERVICE RATES UNLESS THE13
PROVIDER ENTERS INTO A QUALITY INCENTIVE AGREEMENT WITH THE14
MCO.15
(III) Maintain service and quality metrics, as determined by the16
state department; and
17
(IV) Meet statewide managed care system standards and operate18
as part of the overall managed care system;
AND19
(V) P
ROVIDE PHYSICAL AND BEHAVIORAL HEALTH -CARE SERVICES20
TO THE POPULATION IT SERVES.21
SECTION 3. In Colorado Revised Statutes, amend 25.5-4-42722
as follows:23
25.5-4-427. State payment to the Denver health and hospital24
authority. (1) The state department shall distribute money appropriated25
for a supplemental
payment to the Denver health and hospital authority26
created in section 25-29-103.27
HB24-1086
-4- (2) This section is repealed, effective July 1, 2024.1
SECTION 4. Act subject to petition - effective date. This act2
takes effect at 12:01 a.m. on the day following the expiration of the3
ninety-day period after final adjournment of the general assembly; except4
that, if a referendum petition is filed pursuant to section 1 (3) of article V5
of the state constitution against this act or an item, section, or part of this6
act within such period, then the act, item, section, or part will not take7
effect unless approved by the people at the general election to be held in8
November 2024 and, in such case, will take effect on the date of the9
official declaration of the vote thereon by the governor.10
HB24-1086
-5-