Primary care - collaborative created - affordability standards - targets - payment reform recommendations. The act: Establishes a primary care payment reform collaborative in the division of insurance in the department of regulatory agencies; Requires the commissioner of insurance to establish affordability standards for premiums, including adding targets for carrier investments in primary care; and Requires the department of health care policy and financing and carriers who offer health benefit plans to state employees to set targets for investment in primary care.(Note: This summary applies to this bill as enacted.) Read More
Advance directives - health care providers - electronic advance health care directive system - appropriation. The act requires the department of public health and environment (department) to contract with one or more health information organization networks for the creation, administration, and maintenance of a statewide electronic system (system) that allows qualified providers to upload and access advance health care directives. The act defines an advance health care directive as a directive concerning medical orders for scope of treatment, a declaration as to medical treatment, a directive relating to cardiopulmonary resuscitation, or a medical durable power of attorney. The act also requires the department to promulgate rules to oversee the system. The act allows a qualified provider to upload an individual's advanced health care directive upon the request of the individual after the individual has consulted with the qualified provider in person or through telehealth. A qualified provider who uploads an advance health care directive to the system is not subject to criminal or civil liability. The act requires the individual whose medical treatment is the subject of the advance health care directive, or the authorized surrogate decision-maker, to sign an electronic affidavit, prior to uploading the advance health care directive to the system, attesting that the advance health care directive uploaded to the system is appropriately executed, current, and accurate. The act does not allow for any civil or criminal liability or regulatory sanctions for any emergency personnel, health care provider, health care facility, or any other person that complies with a legally executed advance medical directive that is accessed from the system. For the 2019-20 state fiscal year, the act appropriates $993,147 from the general fund to the department of public health and environment for personal services related to health statistics and vital records, operating expenses, and for the purchase of information technology services. (Note: This summary applies to this bill as enacted.) Read More
Professional review committees - knowledge of reporting data - requirement to update information - rules - original source documents - committee membership - requirement to notify medical and nursing board - continuation under sunset law. The act implements the recommendations of the department of regulatory agencies' sunset review and report on the functions of professional review committees as follows: Repeals references to the committee on anticompetitive conduct because the committee no longer exists and replaces the term "utilization and quality control peer review organization" with "quality improvement organization" to be consistent with federal law; Clarifies that governing boards reporting data, and the data reported, to the division of professions and occupations in the department of regulatory agencies or a regulatory board may be known to staff of the division; Requires governing boards to annually update their information with the division; and Requires the division to promulgate rules to determine the information a governing board is required to report and to establish a process to remove governing boards from the registry. The act also: Defines "original source document", exempts such documents from the definition of "records", and specifies when the documents may be subject to subpoena, discovery, or use in a civil action; Encourages each professional review committee of a hospital to appoint a consumer to serve on the committee; and Repeals language requiring, in certain situations, a professional review committee for individuals licensed under the "Colorado Medical Practice Act" or the "Nurse Practice Act" to notify the medical board or nursing board, as applicable. The automatic termination date of the functions of professional review committees is extended until September 1, 2030, pursuant to the provisions of the sunset law. Specified provisions of the act are contingent upon House Bill 19-1172 becoming law. (Note: This summary applies to this bill as enacted.) Read More
Prescription drugs - Canadian prescription drug importation program - federal approval - eligible importers and suppliers - eligible prescription drugs - distribution requirements - reports - rules - appropriations. The act creates the "Canadian Prescription Drug Importation Program" (program) in the department of health care policy and financing (department). On or before September 1, 2020, the department shall submit a request to the United States secretary of health and human services for approval of the program. The department shall begin operating the program not later than 6 months after receiving such approval. The department may expend money for the purpose of requesting approval of the program, but the department cannot spend any other money to implement the program until the department receives approval of the program. Upon receiving approval of the program, the department shall contract with 1 or more vendors to provide services under the program. Each vendor, in consultation with the department and any other vendors, shall establish a wholesale prescription drug importation list (importation list) that identifies the prescription drugs that have the highest potential for cost savings to the state. Each vendor shall revise the list at least annually and at the direction of the department. The department shall review the importation list at least every 3 months to ensure that it continues to meet the requirements of the program. The department may direct a vendor to revise the list, as necessary. Each vendor shall: Identify, in consultation with the department, Canadian suppliers who are in full compliance with relevant Canadian federal and provincial laws and regulations and who have agreed to export prescription drugs identified on the importation list; Verify that such Canadian suppliers meet the requirements of the program and will export prescription drugs at prices that provide cost savings to the state; Contract with such eligible Canadian suppliers, or facilitate contracts between eligible importers and Canadian suppliers, to import prescription drugs under the program; Assist the department in developing and administering a distribution program within the program; Assist the department with the preparation of an annual report and provide any information requested by the department for the report; Ensure the safety and quality of drugs imported under the program; Maintain a list of all eligible importers that participate in the program; Ensure compliance with the federal "Drug Quality and Security Act" by all Canadian suppliers, eligible importers, distributors, and other participants in the program; Provide an annual financial audit of its operations to the department; Provide to the department quarterly financial reports specific to the program, which reports must include information concerning the performance of the vendor's subcontractors and vendors; Submit evidence of a surety bond in an amount of at least $25,000 with any bid or initial contract negotiation documents and maintain documentation of evidence of the surety bond with the department throughout the contract term; and Maintain the information and documentation submitted to the department for at least 7 years. The act imposes certain requirements for drugs that are imported under the program, and the act prohibits certain drugs from being imported under the program. The act states that the following entities are eligible importers under the program: A pharmacist or wholesaler employed by or under contract with a medicaid pharmacy, for dispensing to the pharmacy's medicaid recipients; A pharmacist or wholesaler employed by or under contract with the department of corrections, for dispensing to inmates in the custody of the department of corrections; Commercial plans, as defined by rules promulgated by the medical services board and as approved by the federal government; and A licensed Colorado pharmacist or wholesaler approved by the department. An eligible importer may import a prescription drug from a Canadian supplier if: The drug meets federal food and drug administration standards and is not a controlled substance, biological product, infused or intravenously injected drug, a drug that is inhaled during surgery, or a parenteral drug deemed a threat to public health; and Importing the drug is expected to generate cost savings and would not violate federal patent laws. The act requires the department to designate an office or division that must be a licensed pharmaceutical wholesaler or that shall contract with a licensed pharmaceutical wholesaler. The designated office shall: Set a maximum profit margin so that a wholesaler, distributor, pharmacy, or other licensed provider participating in the program maintains a profit margin that is no greater than the profit margin that the wholesaler, distributor, pharmacy, or other licensed provider would have earned on the equivalent nonimported drug; Exclude generic products if the importation of the products would violate United States patent laws applicable to United States-branded products; Comply with certain federal requirements concerning drug quality and security; and Determine a method for covering the administrative costs of the program. Each participating eligible importer and Canadian supplier shall submit to the vendor specified information about each drug to be acquired by the importer or to be supplied by the Canadian supplier under the program. The department shall immediately suspend the importation of a specific drug or the importation of drugs by a specific eligible importer if it discovers that any drug or activity is in violation of the act or any federal or state law or regulation. The department may revoke the suspension if, after conducting an investigation, it determines that the public is adequately protected from counterfeit or unsafe drugs being imported into this state. The executive director of the department shall promulgate rules as necessary for the administration of the program. The department shall approve a method of financing the administrative costs of the program, which method may include imposing a fee on each prescription pharmaceutical product sold through the program or any other appropriate method determined by the department to finance administrative costs. The department shall not require a fee in an amount that the department determines would significantly reduce consumer savings. On or before December 1, 2021, and on or before December 1 each year thereafter, the department shall submit a report to the governor, the president of the senate, and the speaker of the house of representatives concerning the operation of the program during the previous fiscal year. For the 2019-20 fiscal year, the act appropriates $1,041,802 to the department to implement the act, $134,719 of which is reappropriated to the department of law to provide legal services to the department. (Note: This summary applies to this bill as enacted.) Read More
Adoption assistance program - department of human services - appropriation. The act repeals and reenacts provisions of the state's adoption assistance program (adoption program) that provides cash subsidies and other noncash benefits to families who adopt eligible children and youth who might not otherwise be adopted in order to update the adoption program. The department of human services (state department) supervises the administration of the adoption program by county departments of human or social services (county departments). The act outlines eligibility for the adoption program and the available benefits. Determination of the type and amount of benefits to be provided through the adoption program must take into consideration the circumstances of the adopting family and the needs of the eligible child or youth being adopted. Specific benefits for an adoption made through the adoption program are detailed in a written adoption assistance agreement (agreement). The terms of an agreement are negotiated among all parties involved. The agreement must be reviewed at least every 3 years but may be reviewed sooner at the request of the adoptive parents or the county department. The adoptive parents may appeal any decision made pursuant to the provisions of the adoption program with a hearing before an administrative law judge. The act outlines the conditions under which adoption program subsidies may be suspended or terminated and under which the agreement may be terminated. The state department is required to keep data on the adoption program to help evaluate the adoption program's ongoing effectiveness in providing stability to families involved in the adoption of eligible children and youth. As appropriate, the state department, a county department, or a nonprofit child placement agency is required to provide prospective adoptive families, at the time the family is matched, with information on the various benefits available through the adoption program. For the 2019-20 state fiscal year, the act appropriates: $42,143 from the general fund to the department of human services for information technology services relating to the TRAILS system, and anticipates the receipt of $18,061 in federal funds; and $60,204 from reappropriated funds to the office of the governor, to provide information technology services to the department of human services.(Note: This summary applies to this bill as enacted.) Read More
Barbers, cosmetologists, estheticians, nail technicians, and hairstylists - examination for license - foreign work experience substitute - rules. The act allows an applicant for a barber, cosmetologist, esthetician, nail technician, or hairstylist examination to substitute foreign work experience for the required contact hours. The act authorizes the director of the division of professions and occupations in the department of regulatory agencies to promulgate rules to determine the manner in which an applicant must submit proof of foreign work experience and when an attestation of work experience may replace employment records as proof of experience. Specified provisions of the act are contingent upon House Bill 19-1172 becoming law. (Note: This summary applies to this bill as enacted.) Read More
Drug manufacturer, representative, agent, or employee - prescription drug marketing - disclosure of drug information required. The act requires a drug manufacturer, or a representative, agent, or employee of the manufacturer, who while employed by or under contract to represent a manufacturer engages in prescription drug marketing, to provide to a prescriber, in writing, the wholesale acquisition cost of a prescription drug when, in the course of conducting business, the manufacturer, representative, agent, or employee provides information concerning the drug to the prescriber. The act also requires the drug manufacturer, or a representative, agent, or employee of the manufacturer, to also disseminate the names of at least 3 generic prescription drugs from the same therapeutic class, or if 3 are not available, as many as are available for prescriptive use. Specified provisions of the act are contingent upon House Bill 19-1172 becoming law. (Note: This summary applies to this bill as enacted.) Read More
Health care providers' accountability to communities - community health needs assessments - community benefit implementation plans - public meetings. The act requires the following hospitals to complete a community health needs assessment every 3 years and an annual community benefit implementation plan every year: A hospital that is licensed as a general hospital and exempt from federal taxation; A hospital established pursuant to the Denver health and hospital authority; and A hospital established pursuant to the University of Colorado hospital authority. Each such hospital must report to the department of health care policy and financing (department) concerning certain community benefits, costs, and shortfalls in the preceding year, and the department is required to submit an annual summary report to subject matter committees of the general assembly. Hospitals that are licensed as general hospitals but that are not required to report may report in like fashion. The department shall develop and provide a website at which each reporting hospital shall submit reports. The act requires each hospital to convene a public meeting at least once each year to seek feedback regarding the hospital's community benefit activities during the previous year and the hospital's community benefit implementation plan for the following year. Each hospital shall invite representatives from certain local entities and state agencies to participate in the meeting. Each hospital shall also invite the general public to the meeting in an advertisement placed in any major newspaper published in the hospital's community. (Note: This summary applies to this bill as enacted.) Read More
Psychotherapy services - treatment of a minor without parental consent - mental health education resource bank - appropriation. The act allows a minor 12 years of age or older to seek and obtain psychotherapy services with or without the consent of the minor's parent or guardian if the mental health professional determines the minor is knowingly and voluntarily seeking the psychotherapy services and the psychotherapy services are clinically necessary. A mental health professional providing psychotherapy services to a minor may, with the consent of the minor, advise the minor's parent or legal guardian of the psychotherapy services provided, unless notifying the parent or legal guardian would be inappropriate or detrimental to the minor's care and treatment. However, the mental health professional is permitted to notify the minor's parent or legal guardian without the minor's consent if, in the opinion of the mental health professional, the minor is unable to manage his or her care or treatment. The mental health professional is required to engage the minor in a discussion about the importance of involving and notifying the minor's parent or legal guardian and document any attempt to contact the minor's parent or legal guardian. If a minor communicates a clear and imminent threat to commit suicide, the mental health professional is required to notify the minor's parent or legal guardian of the minor's suicidal ideation. The act requires the department of education, in consultation with the office of suicide prevention, the youth advisory council, and the suicide prevention commission, to create and maintain a mental health education literacy resource bank. The resource bank is available to the public free of charge. The act also requires the state board of education to adopt standards related to mental health, including suicide prevention. The act appropriates $116,550 from the general fund to the department of education for the mental health education resource bank and technical assistance. Specifies that certain provisions take effect only if House Bill 19-1172 becomes law. (Note: This summary applies to this bill as enacted.) Read More
Maternal mortality review committee - creation - appointments - duties - sunset review - appropriation. The act creates the Colorado maternal mortality review committee (committee), which is required to review maternal deaths, identify the causes of maternal mortality, and develop recommendations to address preventable maternal deaths, including legislation, policies, rules, and best practices that will support the health and safety of the pregnant and postpartum population in Colorado and prevent maternal deaths. The executive director of the department of public health and environment (department) is directed to appoint at least 11 members to serve on the committee. The act requires certain health care providers and law enforcement officials to provide medical records to the department concerning each maternal death for access by the members of the committee. The records, notes, information, and activities of the committee are confidential. The committee is repealed, effective September 1, 2029, and is subject to sunset review by the department of regulatory agencies prior to its repeal. $145,167 is appropriated to the department for implementation of the act. (Note: This summary applies to this bill as enacted.) Read More
Health insurance - out-of-network health care services - disclosures - claims - reimbursement rates - deceptive trade practice - rules - appropriation. The act: Requires health insurance carriers, health care providers, and health care facilities to provide patients covered by health benefit plans with information concerning the provision of services by out-of-network providers and in-network and out-of-network facilities; Outlines the disclosure requirements and the claims and payment process for the provision of out-of-network services; Requires the commissioner of insurance, the state board of health, and the director of the division of professions and occupations in the department of regulatory agencies to promulgate rules that specify the requirements for disclosures to consumers, including the timing, the format, and the contents and language in the disclosures; Establishes the reimbursement amount for out-of-network providers that provide health care services to covered persons at an in-network facility and for out-of-network providers or facilities that provide emergency services to covered persons; and Creates a penalty for failure to comply with the payment requirements for out-of-network health care services. The act appropriates $33,884 from the general fund to the department of public health and environment and $63,924 from the division of insurance cash fund to the division of insurance to implement the act. Specified provisions of the act are contingent upon House Bill 19-1172 becoming law. (Note: This summary applies to this bill as enacted.) Read More
Dental program for seniors - review - maximum reimbursement rates. The act adds to the duties of the department of health care policy and financing (department) under the Colorado dental health care program for low-income seniors (program) to review the operation and effectiveness of the program in the next annual report. Qualified grantees under the program and the department shall report recommendations concerning the operations and effectiveness of the program. Under current law, the senior dental advisory committee recommends to the medical services board the maximum reimbursement rate for dental procedures under the Colorado dental health care program for low-income seniors that cannot be less than the reimbursement rate previously adopted by the state board of health for the program. The act changes the maximum reimbursement rate that the committee may recommend to not less than the medicaid fee-for-service rate. (Note: This summary applies to this bill as enacted.) Read More
