First Regular Session
Seventy-fifth General Assembly
STATE OF COLORADO
INTRODUCED
LLS NO. 25-0667.01 Shelby Ross x4510
HOUSE BILL 25-1288
House Committees Senate Committees
Health & Human Services
A BILL FOR AN ACT
C
ONCERNING FINANCIAL SUPPORT FO R FEDERALLY QUALIFIED HEALTH101
CENTERS.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
.)
The bill authorizes the department of health care policy and
financing (state department) to seek and accept gifts from private or
public sources for the primary care fund. Upon receiving federal
authorization, if the state department receives gifts designated for a
federally qualified health center (FQHC) or a qualified provider, the state
department is required to allocate 115% of the total amount of gifts
HOUSE SPONSORSHIP
Martinez and Winter T.,
SENATE SPONSORSHIP
Roberts and Simpson,
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. received to the designated FQHC or qualified provider. The bill prohibits
the state department from allocating money to a qualified provider if the
donor is an FQHC or a qualified provider that has a direct or indirect
relationship to medicaid payments and the allocation amount is positively
correlated to the donation.
The bill authorizes an FQHC to establish a separate subsidiary
company for the purpose of providing fee-for-service services outside of
the FQHC's standard cost report if the subsidiary is providing
fee-for-service services that have historically been provided and
reimbursed on a fee-for-service basis, or if the state department
determines that the subsidiary's reimbursements would be budget neutral.
Upon receiving any necessary federal authorization, the state department
is required to reimburse a subsidiary of an FQHC on a fee-for-service
basis for services that are eligible for fee-for-service reimbursement. A
subsidiary that receives reimbursement is authorized to pass through
money received from the reimbursement directly to the FQHC operating
as the subsidiary's parent corporation. Services reimbursed to an FQHC's
subsidiary are excluded from the FQHC's cost report.
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) Federally qualified health centers (FQHC) play an important4
role in the safety net system by serving roughly 30% of medicaid patients5
in Colorado; however, FQHCs receive less than 2% of the state's6
medicaid provider reimbursement;7
(b) The primary care fund (fund) was created to allocate money8
to qualified providers who provide comprehensive primary care services9
in an outpatient setting to uninsured and medically indigent patients, or10
individuals enrolled in medicaid;11
(c) Each dollar in the fund receives a one-for-one match by the12
federal centers for medicare and medicaid (CMS); and13
(d) CMS adopted rules that prohibit qualified providers who14
would benefit from the federal match from donating to the fund, but the15
HB25-1288-2- rules do not prohibit other gifts from being made to the fund.1
(2) Therefore, the general assembly declares that it is necessary to2
allow the state to seek and accept gifts for the primary care fund that are3
designated for an FQHC in order to receive the federal match and allocate4
115% of the total amount of gifts received to the designated FQHC.5
SECTION 2. In Colorado Revised Statutes, 24-22-117, amend6
(2) introductory portion and (2)(b)(I) as follows:7
24-22-117. Tobacco tax cash fund - accounts - creation -8
legislative declaration. (2) There are hereby created in the state treasury9
the following funds:10
(b) (I) The primary care fund to be administered by the department11
of health care policy and financing. The state treasurer and the controller12
shall transfer an amount equal to nineteen percent of the moneys MONEY13
deposited into the cash fund, plus nineteen percent of the interest and14
income earned on the deposit and investment of those moneys THE15
MONEY, to the primary care fund. except that, for the 2008-09, 2009-10,16
2010-11, and 2011-12 fiscal years, the state treasurer and the controller17
shall transfer to the primary care fund only an amount equal to nineteen18
percent of the moneys deposited into the cash fund. IN ADDITION TO THE19
MONEY TRANSFERRED FROM THE CASH FUND , THE PRIMARY CARE FUND20
CONSISTS OF GIFTS RECEIVED PURSUANT TO SECTION 25.5-3-302 AND ANY21
OTHER MONEY THE GENERAL ASSEMBLY MAY APPROPRIATE OR TRANSFER22
INTO THE PRIMARY CARE FUND. All interest and income derived from the23
deposit and investment of moneys MONEY in the primary care fund shall24
be IS credited to the primary care fund. except that all interest and income25
derived from the deposit and investment of moneys in the primary care26
fund during the 2008-09, 2009-10, 2010-11, and 2011-12 fiscal years27
HB25-1288
-3- shall be credited to the general fund. Any unexpended and unencumbered1
moneys MONEY remaining in the primary care fund at the end of a fiscal2
year shall remain REMAINS in the fund and shall IS not be credited or3
transferred to the general fund or any other fund.4
SECTION 3. In Colorado Revised Statutes, 25.5-3-302, amend5
(1); and add (3.5) as follows:6
25.5-3-302. Annual allocation - primary care services -7
qualified provider - rules. (1) The state department shall annually8
allocate the moneys MONEY appropriated by the general assembly to the9
primary care fund created in section 24-22-117 (2)(b) C.R.S., to all10
eligible qualified providers in the state who comply with the requirements11
of subsection (2) of this section. E
XCEPT AS PROVIDED IN SUBSECTION12
(3.5)
OF THIS SECTION, the state department shall allocate the moneys
13
MONEY in amounts proportionate to the number of uninsured or medically14
indigent patients served by the qualified provider. For a qualified provider15
to be eligible for an allocation pursuant to this section, the qualified16
provider shall MUST meet either of the following criteria:17
(a) The qualified provider is a community health center, as18
defined in section 330 of the federal "Public Health Service Act", 4219
U.S.C. sec. 254b; or20
(b) At least fifty percent of the patients served by the qualified21
provider are uninsured or medically indigent patients, or patients who are22
enrolled in the medical assistance program, articles 4, 5, and 6 of this23
title, or the children's basic health plan, article 8 of this title, or any24
combination thereof.25
(3.5) (a) T
HE STATE DEPARTMENT MAY SEEK AND ACCEPT GIFTS26
FROM PRIVATE OR PUBLIC SOURCES FOR THE PURPOSES OF THIS SECTION .27
HB25-1288
-4- THE STATE DEPARTMENT SHALL TRANSMIT ALL MONEY RECEIVED1
THROUGH GIFTS TO THE STATE TREASURER , WHO SHALL CREDIT THE2
MONEY TO THE PRIMARY CARE FUND CREATED IN SECTION 24-22-1173
(2)(b).4
(b) U
PON RECEIVING ANY NECESSARY FEDERAL AUTHORIZATION ,5
IF THE STATE DEPARTMENT RECEIVES GIFTS PURSUANT TO SUBSECTION6
(3.5)(a)
OF THIS SECTION DESIGNATED FOR A FEDERALLY QUALIFIED7
HEALTH CENTER, AS DEFINED IN THE FEDERAL "SOCIAL SECURITY ACT",8
42
U.S.C. SEC. 1395x (aa)(4), OR A QUALIFIED PROVIDER, THE STATE9
DEPARTMENT SHALL ALLOCATE ONE HUNDRED FIFTEEN PERCENT OF THE10
TOTAL AMOUNT OF GIFTS RECEIVED TO THE DESIGNATED FEDERALLY11
QUALIFIED HEALTH CENTER OR QUALIFIED PROVIDER .12
(c) N
OTWITHSTANDING THIS SUBSECTION (3.5) TO THE CONTRARY,13
THE STATE DEPARTMENT SHALL NOT ALLOCATE MONEY TO A FEDERALLY14
QUALIFIED HEALTH CENTER OR QUALIFIED PROVIDER PURSUANT TO15
SUBSECTION (3)(b) OF THIS SECTION IF THE DONOR IS A FEDERALLY16
QUALIFIED HEALTH CENTER OR A QUALIFIED PROVIDER THAT HAS A DIRECT17
OR INDIRECT RELATIONSHIP TO MEDICAID PAYMENTS AND THE18
ALLOCATION AMOUNT IS POSITIVELY CORRELATED TO THE DONATION .19
SECTION 4. In Colorado Revised Statutes, add 25.5-4-434 as20
follows:21
25.5-4-434. Federally qualified health center - subsidiary -22
fee-for-service reimbursement. (1) A
FEDERALLY QUALIFIED HEALTH23
CENTER, AS DEFINED IN THE FEDERAL "SOCIAL SECURITY ACT", 42 U.S.C.24
SEC. 1395x (aa)(4), MAY ESTABLISH A SEPARATE SUBSIDIARY COMPANY25
FOR THE PURPOSE OF PROVIDING FEE-FOR-SERVICE SERVICES OUTSIDE OF26
THE FEDERALLY QUALIFIED HEALTH CENTER 'S STANDARD COST REPORT IF:27
HB25-1288
-5- (a) THE SUBSIDIARY IS PROVIDING FEE-FOR-SERVICE SERVICES1
THAT HAVE HISTORICALLY BEEN PROVIDED AND REIMBURSED ON A2
FEE-FOR-SERVICE BASIS; OR3
(b) T
HE STATE DEPARTMENT DETERMINES THAT THE SUBSIDIARY 'S4
REIMBURSEMENTS WOULD BE BUDGET NEUTRAL .5
(2) U
PON RECEIVING ANY NECESSARY FEDERAL AUTHORIZATION ,6
THE STATE DEPARTMENT SHALL REIMBURSE A SUBSIDIARY COMPANY , AS7
DESCRIBED IN SUBSECTION (1) OF THIS SECTION, ON A FEE-FOR-SERVICE8
BASIS FOR SERVICES THAT ARE ELIGIBLE FOR FEE -FOR-SERVICE9
REIMBURSEMENT.10
(3) A
SUBSIDIARY THAT RECEIVES REIMBURSEMENT PURSUANT TO11
THIS SECTION MAY PASS THROUGH MONEY RECEIVED FROM THE12
REIMBURSEMENT DIRECTLY TO THE FEDERALLY QUALIFIED HEALTH13
CENTER OPERATING AS THE SUBSIDIARY 'S PARENT CORPORATION.14
(4) S
ERVICES REIMBURSED PURSUANT TO THIS SECTION ARE15
EXCLUDED FROM THE FEDERALLY QUALIFIED HEALTH CENTER 'S COST16
REPORT.17
SECTION 5. Safety clause. The general assembly finds,18
determines, and declares that this act is necessary for the immediate19
preservation of the public peace, health, or safety or for appropriations for20
the support and maintenance of the departments of the state and state21
institutions.22
HB25-1288
-6-