Second Regular Session
Seventy-fourth General Assembly
STATE OF COLORADO
REENGROSSED
This Version Includes All Amendments
Adopted in the House of Introduction
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
3rd Reading Unamended
February 5, 2024
HOUSE
Amended 2nd Reading
January 29, 2024
HOUSE SPONSORSHIP
Holtorf and Amabile, Bacon, Bird, Boesenecker, Brown, Clifford, deGruy Kennedy,
Duran, Epps, Froelich, Hamrick, Hernandez, Herod, Jodeh, Lieder, Lindsay, Lindstedt,
Mabrey, Martinez, Mauro, McCluskie, McCormick, Ortiz, Rutinel, Sirota, Snyder, Soper,
Taggart, Titone, Valdez, Vigil, Weissman, Young
SENATE SPONSORSHIP
Michaelson Jenet,
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
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)(a) and (7.5)(b)(II) 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 FOR PHYSICAL HEALTH-CARE SERVICES with the26
MCO operated by or under the control of Denver health and hospital27
1086
-3- authority, created pursuant to article 29 of title 25, until the MCO ceases1
to operate a medicaid managed care program or until June 30, 2025,2
unless sooner reprocured FROM JULY 1, 2025, UNTIL JUNE 30, 2032, AS3
LONG AS THE MCO MEETS ALL MCO CRITERIA REQUIRED BY THE STATE4
DEPARTMENT. If the state department designates an MCE OTHER THAN5
THE MCO OPERATED BY OR UNDER THE CONTROL OF DENVER HEALTH6
AND HOSPITAL AUTHORITY to manage behavioral health HEALTH-CARE7
services pursuant to this article 5, Denver health and hospital authority,8
or any subsidiary, thereof, shall collaborate with the MCO MCE during9
the term of contract.10
(b) The MCO operated by or under the control of Denver health11
and hospital authority shall:12
13
(II) Accept rates determined by the state department, through14
standard methodologies, to cover the population it is serving. R
ATES PAID15
BY THE MCO TO CONTRACTED PROVIDERS MUST NOT BE HIGHER THAN THE16
STATE DEPARTMENT'S MEDICAID FEE FOR SERVICE RATES UNLESS THE17
PROVIDER ENTERS INTO A QUALITY INCENTIVE AGREEMENT WITH THE18
MCO.19
20
SECTION 3. In Colorado Revised Statutes, amend 25.5-4-42721
as follows:22
25.5-4-427. State payment to the Denver health and hospital23
authority. (1) The state department shall distribute money appropriated24
for a supplemental payment to the Denver health and hospital authority25
created in section 25-29-103.26
(2) This section is repealed, effective July 1, 2024.27
1086
-4- SECTION 4. Safety clause. The general assembly finds,1
determines, and declares that this act is necessary for the immediate2
preservation of the public peace, health, or safety or for appropriations for3
the support and maintenance of the departments of the state and state4
institutions.5
1086
-5-