Colorado 2024 Regular Session

Colorado House Bill HB1086 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
	1	+	Second Regular Session
	2	+	Seventy-fourth General Assembly
	3	+	STATE OF COLORADO
	4	+	REREVISED
	5	+	This Version Includes All Amendments
	6	+	Adopted in the Second House
	7	+	LLS NO. 24-0802.01 Shelby Ross x4510
1	8		HOUSE BILL 24-1086
2		-	BY REPRESENTATIVE(S) Holtorf and Amabile, Bacon, Bird,
3		-	Boesenecker, Brown, Clifford, deGruy Kennedy, Duran, Epps, Froelich,
4		-	Hamrick, Hernandez, Herod, Jodeh, Lieder, Lindsay, Lindstedt, Mabrey,
5		-	Martinez, Mauro, McCormick, Ortiz, Rutinel, Sirota, Snyder, Soper,
6		-	Taggart, Titone, Valdez, Vigil, Weissman, Young, McCluskie;
7		-	also SENATOR(S) Michaelson Jenet, Buckner, Danielson, Priola,
8		-	Rodriguez.
	9	+	House Committees Senate Committees
	10	+	Health & Human Services Health & Human Services
	11	+	A BILL FOR AN ACT
9	12		C
10		-	ONCERNING THE OPERATION OF THE DENVER HEALTH AND HOSPITAL
11		-	AUTHORITY
12		-	.
13		-
14		-	Be it enacted by the General Assembly of the State of Colorado:
15		-	SECTION 1. Legislative declaration. (1) The general assembly
16		-	finds that:
17		-	(a) Safety net hospitals are experiencing significant financial
18		-	hardships due to uncompensated care, increased staffing costs, inflation,
19		-	and federal money that is no longer available. Hospitals are seeing more
20		-	uninsured, underinsured, and medicaid patients. Safety net hospitals are
21		-	caring for patients longer, with less revenue and increased expenses, and
22		-	they are struggling with how to provide care for their communities. Rural
23		-	________
24		-	Capital letters or bold & italic numbers indicate new material added to existing law; dashes
25		-	through words or numbers indicate deletions from existing law and such material is not part of
26		-	the act. safety net hospitals and Denver health are the mostly heavily burdened by
27		-	these increasing financial hardships.
28		-	(b) Denver health and hospital authority is the largest safety net
29		-	hospital in Colorado, serving patients from 63 out of the 64 counties in the
30		-	state;
31		-	(c) From 2020 to 2023, uncompensated care at Denver health has
32		-	increased 127% due to underpayment from public insurance companies and
33		-	increases in uninsured patients, including migrants and people experiencing
34		-	homelessness;
35		-	(d) In 2023, Denver health is projected to provide more than $135
36		-	million in uncompensated care;
37		-	(e) Increased demand for services among uninsured and
38		-	underinsured patients and increases in the number of homeless patients and
39		-	those with a mental health diagnosis, together with the increasing expenses
40		-	and stagnating public funding from federal, state, and local governments,
41		-	have created an unsustainable financial situation for Denver health;
42		-	(f) As a safety net hospital on the front line of providing health-care
43		-	services statewide, it is important for the health of Coloradans that Denver
44		-	health is financially stable and remains a valuable health-care resource; and
45		-	(g) As the largest safety net hospital in Colorado, Denver health
46		-	maintains and invests in administrative infrastructure necessary to carry out
47		-	the responsibilities of serving a disproportionate share of medicaid members
48		-	and uninsured individuals. Because of this, Denver health is unable to
49		-	generate sufficient revenue to fulfill the ongoing investment need.
50		-	(2) Therefore, the general assembly declares it is important to
51		-	provide authority to the department of health care policy and financing to
52		-	assist safety net hospitals, such as Denver health, in becoming financially
53		-	stable.
54		-	SECTION 2. In Colorado Revised Statutes, 25.5-5-402, amend
55		-	(7.5)(a) and (7.5)(b)(II) as follows:
56		-	25.5-5-402. Statewide managed care system - rules - definitions
57		-	PAGE 2-HOUSE BILL 24-1086 - repeal. (7.5) (a) The state department shall offer to enter into a direct
58		-	contract
59		-	FOR PHYSICAL HEALTH-CARE SERVICES with the MCO operated by
60		-	or under the control of Denver health and hospital authority, created
61		-	pursuant to article 29 of title 25, until the MCO ceases to operate a medicaid
62		-	managed care program or until June 30, 2025, unless sooner reprocured
63		-	FROM JULY 1, 2025, UNTIL JUNE 30, 2032, AS LONG AS THE MCO MEETS ALL
64		-	MCO CRITERIA REQUIRED BY THE STATE DEPARTMENT . If the state
65		-	department designates an MCE
66		-	OTHER THAN THE MCO OPERATED BY OR
67		-	UNDER THE CONTROL OF
68		-	DENVER HEALTH AND HOSPITAL AUTHORITY to
69		-	manage behavioral health
70		-	HEALTH-CARE services pursuant to this article 5,
71		-	Denver health and hospital authority, or any subsidiary, thereof, shall
72		-	collaborate with the MCO MCE during the term of contract.
73		-	(b) The MCO operated by or under the control of Denver health and
74		-	hospital authority shall:
75		-	(II) Accept rates determined by the state department, through
	13	+	ONCERNING THE OPERATION OF THE DENVER HEALTH AND HOSPITAL101
	14	+	AUTHORITY.102
	15	+	Bill Summary
	16	+	(Note: This summary applies to this bill as introduced and does
	17	+	not reflect any amendments that may be subsequently adopted. If this bill
	18	+	passes third reading in the house of introduction, a bill summary that
	19	+	applies to the reengrossed version of this bill will be available at
	20	+	http://leg.colorado.gov
	21	+	.)
	22	+	Current law requires the department of health care policy and
	23	+	financing (department) to offer to enter into a direct contract with the
	24	+	managed care organization (MCO) operated by or under the control of the
	25	+	Denver health and hospital authority (Denver health) until Denver health
	26	+	ceases to operate a medicaid managed care program or until June 30,
	27	+	2025. The bill removes the option for the department to enter into a direct
	28	+	SENATE
	29	+	3rd Reading Unamended
	30	+	March 13, 2024
	31	+	SENATE
	32	+	2nd Reading Unamended
	33	+	March 12, 2024
	34	+	HOUSE
	35	+	3rd Reading Unamended
	36	+	February 5, 2024
	37	+	HOUSE
	38	+	Amended 2nd Reading
	39	+	January 29, 2024
	40	+	HOUSE SPONSORSHIP
	41	+	Holtorf and Amabile, Bacon, Bird, Boesenecker, Brown, Clifford, deGruy Kennedy,
	42	+	Duran, Epps, Froelich, Hamrick, Hernandez, Herod, Jodeh, Lieder, Lindsay, Lindstedt,
	43	+	Mabrey, Martinez, Mauro, McCluskie, McCormick, Ortiz, Rutinel, Sirota, Snyder, Soper,
	44	+	Taggart, Titone, Valdez, Vigil, Weissman, Young
	45	+	SENATE SPONSORSHIP
	46	+	Michaelson Jenet, Buckner, Danielson, Priola, Rodriguez
	47	+	Shading denotes HOUSE amendment. Double underlining denotes SENATE amendment.
	48	+	Capital letters or bold & italic numbers indicate new material to be added to existing law.
	49	+	Dashes through the words or numbers indicate deletions from existing law. contract until June 30, 2025, and instead requires the department to enter
	50	+	into the contract until Denver health ceases to operate a managed care
	51	+	program.
	52	+	The bill prohibits the MCO from reimbursing contracted medicaid
	53	+	providers at rates that are higher than the department's medicaid fee for
	54	+	service rates unless the provider enters into a quality incentive agreement
	55	+	with the MCO. The bill requires the MCO's contract to provide physical
	56	+	and behavioral health-care services to the population it serves.
	57	+	For the 2023-24 state fiscal year, the department distributed money
	58	+	appropriated for a supplemental state payment to Denver health. The bill
	59	+	authorizes the department to continually distribute any money
	60	+	appropriated for payment to Denver health.
	61	+	Be it enacted by the General Assembly of the State of Colorado:1
	62	+	SECTION 1. Legislative declaration. (1) The general assembly2
	63	+	finds that:3
	64	+	(a) Safety net hospitals are experiencing significant financial4
	65	+	hardships due to uncompensated care, increased staffing costs, inflation,5
	66	+	and federal money that is no longer available. Hospitals are seeing more6
	67	+	uninsured, underinsured, and medicaid patients. Safety net hospitals are7
	68	+	caring for patients longer, with less revenue and increased expenses, and8
	69	+	they are struggling with how to provide care for their communities. Rural9
	70	+	safety net hospitals and Denver health are the mostly heavily burdened by10
	71	+	these increasing financial hardships.11
	72	+	(b) Denver health and hospital authority is the largest safety net12
	73	+	hospital in Colorado, serving patients from 63 out of the 64 counties in13
	74	+	the state;14
	75	+	(c) From 2020 to 2023, uncompensated care at Denver health has15
	76	+	increased 127% due to underpayment from public insurance companies16
	77	+	and increases in uninsured patients, including migrants and people17
	78	+	experiencing homelessness;18
	79	+	(d) In 2023, Denver health is projected to provide more than $13519
	80	+	1086-2- million in uncompensated care;1
	81	+	(e) Increased demand for services among uninsured and2
	82	+	underinsured patients and increases in the number of homeless patients3
	83	+	and those with a mental health diagnosis, together with the increasing4
	84	+	expenses and stagnating public funding from federal, state, and local5
	85	+	governments, have created an unsustainable financial situation for Denver6
	86	+	health;7
	87	+	(f) As a safety net hospital on the front line of providing8
	88	+	health-care services statewide, it is important for the health of Coloradans9
	89	+	that Denver health is financially stable and remains a valuable health-care10
	90	+	resource; and11
	91	+	(g) As the largest safety net hospital in Colorado, Denver health12
	92	+	maintains and invests in administrative infrastructure necessary to carry13
	93	+	out the responsibilities of serving a disproportionate share of medicaid14
	94	+	members and uninsured individuals. Because of this, Denver health is15
	95	+	unable to generate sufficient revenue to fulfill the ongoing investment16
	96	+	need.17
	97	+	(2) Therefore, the general assembly declares it is important to18
	98	+	provide authority to the department of health care policy and financing to19
	99	+	assist safety net hospitals, such as Denver health, in becoming financially20
	100	+	stable.21
	101	+	SECTION 2. In Colorado Revised Statutes, 25.5-5-402, amend22
	102	+	(7.5)(a) and (7.5)(b)(II) as follows:23
	103	+	25.5-5-402. Statewide managed care system - rules -24
	104	+	definitions - repeal. (7.5) (a) The state department shall offer to enter25
	105	+	into a direct contract FOR PHYSICAL HEALTH-CARE SERVICES with the26
	106	+	MCO operated by or under the control of Denver health and hospital27
	107	+	1086
	108	+	-3- authority, created pursuant to article 29 of title 25, until the MCO ceases1
	109	+	to operate a medicaid managed care program or until June 30, 2025,2
	110	+	unless sooner reprocured FROM JULY 1, 2025, UNTIL JUNE 30, 2032, AS3
	111	+	LONG AS THE MCO MEETS ALL MCO CRITERIA REQUIRED BY THE STATE4
	112	+	DEPARTMENT. If the state department designates an MCE OTHER THAN5
	113	+	THE MCO OPERATED BY OR UNDER THE CONTROL OF DENVER HEALTH6
	114	+	AND HOSPITAL AUTHORITY to manage behavioral health HEALTH-CARE7
	115	+	services pursuant to this article 5, Denver health and hospital authority,8
	116	+	or any subsidiary, thereof, shall collaborate with the MCO MCE during9
	117	+	the term of contract.10
	118	+	(b) The MCO operated by or under the control of Denver health11
	119	+	and hospital authority shall:12
	120	+	13
	121	+	(II) Accept rates determined by the state department, through14
76	122		standard methodologies, to cover the population it is serving. R
77		-	ATES PAID
78		-	BY THE
79		-	MCO TO CONTRACTED PROVIDERS MUST NOT BE HIGHER THAN THE
80		-	STATE DEPARTMENT
81		-	'S MEDICAID FEE FOR SERVICE RATES UNLESS THE
82		-	PROVIDER ENTERS INTO A QUALITY INCENTIVE AGREEMENT WITH THE
83		-	MCO.
84		-	SECTION 3. In Colorado Revised Statutes, amend 25.5-4-427 as
85		-	follows:
86		-	25.5-4-427. State payment to the Denver health and hospital
87		-	authority. (1) The state department shall distribute money appropriated for
88		-	a supplemental
89		-	payment to the Denver health and hospital authority created
90		-	in section 25-29-103.
91		-	(2) This section is repealed, effective July 1, 2024.
92		-	SECTION 4. Safety clause. The general assembly finds,
93		-	determines, and declares that this act is necessary for the immediate
94		-	PAGE 3-HOUSE BILL 24-1086 preservation of the public peace, health, or safety or for appropriations for
95		-	the support and maintenance of the departments of the state and state
96		-	institutions.
97		-	____________________________ ____________________________
98		-	Julie McCluskie Steve Fenberg
99		-	SPEAKER OF THE HOUSE PRESIDENT OF
100		-	OF REPRESENTATIVES THE SENATE
101		-	____________________________ ____________________________
102		-	Robin Jones Cindi L. Markwell
103		-	CHIEF CLERK OF THE HOUSE SECRETARY OF
104		-	OF REPRESENTATIVES THE SENATE
105		-	APPROVED________________________________________
106		-	(Date and Time)
107		-	_________________________________________
108		-	Jared S. Polis
109		-	GOVERNOR OF THE STATE OF COLORADO
110		-	PAGE 4-HOUSE BILL 24-1086
	123	+	ATES PAID15
	124	+	BY THE MCO TO CONTRACTED PROVIDERS MUST NOT BE HIGHER THAN THE16
	125	+	STATE DEPARTMENT'S MEDICAID FEE FOR SERVICE RATES UNLESS THE17
	126	+	PROVIDER ENTERS INTO A QUALITY INCENTIVE AGREEMENT WITH THE18
	127	+	MCO.19
	128	+	20
	129	+	SECTION 3. In Colorado Revised Statutes, amend 25.5-4-42721
	130	+	as follows:22
	131	+	25.5-4-427. State payment to the Denver health and hospital23
	132	+	authority. (1) The state department shall distribute money appropriated24
	133	+	for a supplemental payment to the Denver health and hospital authority25
	134	+	created in section 25-29-103.26
	135	+	(2) This section is repealed, effective July 1, 2024.27
	136	+	1086
	137	+	-4- SECTION 4. Safety clause. The general assembly finds,1
	138	+	determines, and declares that this act is necessary for the immediate2
	139	+	preservation of the public peace, health, or safety or for appropriations for3
	140	+	the support and maintenance of the departments of the state and state4
	141	+	institutions.5
	142	+	1086
	143	+	-5-