Medical practice - physician assistants - supervision requirements - liability - representation on Colorado medical board - appropriation. The act establishes supervisory requirements for physician assistants who: Have practiced for less than 3 years; Have practiced for 3 years or more; or Have practiced for at least 12 months and are making a substantive change in their scope of practice or practice area. The act states that a licensed physician may be responsible for the direction and supervision of up to 8 physician assistants at any one time. A licensed physician shall not be made responsible for the direction and supervision of more than 4 physician assistants unless the licensed physician agrees to assume the responsibility. The act adds one more physician assistant as a member of the Colorado medical board (board), for a total of 2 physician assistant members, and adds a fourth member to the licensing panel established by the board president, which fourth member must be a physician assistant board member. The act states that a physician assistant who has practiced for at least 3 years may be liable for damages resulting from negligence in providing care to a patient, unless the damages occur as a result of the physician assistant following a direct order from a supervising physician, and shall maintain professional liability insurance in an amount not less than $1 million per claim and $3 million for all claims. For the 2019-20 fiscal year, the act appropriates $4,650 to the department of regulatory agencies for use by the division of professions and occupations. 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
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Behavioral health entities - single license - advisory committee timelines - appropriation. Currently, certain entities that provide behavioral health services must hold various licenses issued by the department of public health and environment (CDPHE) or the department of human services (DHS). The act combines the various licenses into a single license as a behavioral health entity (BHE) and authorizes the state board of health to promulgate rules for the new license. To accomplish the transition, the act establishes a behavioral health entity implementation and advisory committee consisting of executive directors of certain state departments, or the director's designee, and representatives from various stakeholder groups. The act requires a BHE that was previously licensed by CDPHE to obtain a BHE license by July 1, 2022. It requires a BHE that was previously licensed or approved by DHS to obtain a BHE license by July 1, 2024. The act makes conforming amendments, some of which have later effective dates. For the 2019-20 state fiscal year, the act appropriates $51,472 from the general fund to the department of public health and environment to implement the new license. (Note: This summary applies to this bill as enacted.) Read More
Waste diversion - front range waste diversion enterprise created - increased waste diversion goals established - new tipping fee - grant program. Section 1 of the act creates the front range waste diversion enterprise. The enterprise will collect a user fee on each load of waste disposed of at a landfill in the front range and credit the fee to the new front range waste diversion cash fund to finance the front range waste diversion grant program. Section 2 sets the user fee at 15 cents per cubic yard per load from January 1, 2020, through December 31, 2020. The fee increases 15 cents per year so that on and after January 1, 2023, the fee is 60 cents per cubic yard per load; except that this amount is adjusted annually by inflation after January 1, 2024. Section 3 adjusts the fine amount for littering on public or private property annually, commencing on January 1, 2020, by inflation and credits the increased amount of the fine to the fund. The front range is defined as the counties of Adams, Arapahoe, Boulder, Douglas, Elbert, El Paso, Jefferson, Larimer, Pueblo, Teller, and Weld and the cities and counties of Broomfield and Denver. The following entities that are located or provide services in the front range are eligible to apply for grants: Municipalities, counties, and cities and counties; nonprofit and for-profit businesses involved in waste disposal or diversion; and institutions of higher education and public or private schools. The enterprise shall administer the grant program and provide technical assistance to eligible entities to achieve the following municipal waste diversion goals within the front range: 32% diversion by 2021; 39% diversion by 2026; and 51% diversion by 2036. The board of directors of the enterprise shall submit a report by July 1 of each year to the committees of reference of the general assembly with jurisdiction over the environment regarding the grant program. The enterprise, increased user fee, and increased amount of the littering fine are repealed, effective September 1, 2029. (Note: This summary applies to this bill as enacted.) Read More
Computer science education grant program - appropriation. The act creates in the department of education the computer science education grant program (grant program) to provide money to public schools or school districts in order to increase enrollment or participation of traditionally underrepresented students in computer science education activities. The act requires the state board of education (board) to promulgate rules necessary for the implementation of the grant program. The act requires the board to give priority to grant applications that: Demonstrate how the applicant will use the grant to serve a high-poverty student population, a high percentage of minority students, students in rural areas, or a high percentage of female students; Expose students to diverse professionals within the computer science industry; or Demonstrate a low number of computer science education courses or clubs offered in the public school or school district, if any. The act appropriates $250,000 each year for the 2020-21, 2021-22, and 2022-23 fiscal years, from the general fund to the department of education. The department shall distribute the money to the education providers that receive a grant. The act requires each grant recipient to submit a report to the board. (Note: This summary applies to this bill as enacted.) Read More
Fire suppression - registration of contractors - inspection and maintenance of fire suppression systems - continuation under sunset law. The act continues the fire suppression programs of the division of fire prevention and control in the department of public safety for 7 years, until 2026.(Note: This summary applies to this bill as enacted.) Read More
Regulation of lobbyists - clarification of term "client" - heightened disclosure requirements - secretary of state to convene working group to consider upgrades to electronic filing system used by lobbyists - appropriation. The act clarifies that the term "client" used in connection with statutory provisions regulating lobbyists means the person who employs or retains the professional services of one or more lobbyists to undertake lobbying on behalf of that person. The act also clarifies that a professional lobbyist is not, for purposes of the statute, a client of either a lobbying firm or any other person that employs or retains one or more professional lobbyists to undertake lobbying on behalf of one or more clients. The act clarifies that existing provisions that require heightened disclosure when a lobbyist enters into an agreement to engage in lobbying apply when the general assembly is in regular or special session. In addition to any other disclosure, during the period that the general assembly is in regular or special session, the act also requires a professional lobbyist to notify the secretary of state (secretary) by means of the electronic filing system within 72 hours after: The lobbyist agrees to undertake lobbying in connection with new legislation, standards, rules, or rates for either a new or existing client of the lobbyist; or The lobbyist takes a new position on a new or existing bill for a new or existing client of the lobbyist. During this period, where the lobbyist agrees to undertake lobbying in connection with new or existing legislation for either a new or existing client, the disclosure required by the act includes the bill number of the legislation at issue and whether the lobbyist's client is supporting, opposing, amending, or monitoring the legislation at the time the lobbyist agrees to undertake lobbying in connection with the legislation or takes a new position. The act also states that an attorney who is a professional lobbyist may not decline to disclose his or her lobbying as such lobbying is required to be disclosed on the grounds that the lobbying is protected against disclosure as confidential matters between an attorney and a client. In connection with any requirement under existing law to disclose the identity of a client, a professional lobbyist who is a natural person and who is employed or retained by a lobbying firm or any other firm or entity may disclose the name of the lobbying firm or other person or entity by means of which, or under the name of which, a professional lobbyist does business, but to satisfy such disclosure requirement the lobbyist is also required to disclose the name of the client who employs or retains the professional services of the lobbyist, or a lobbying firm or any other person or entity that employs or retains the lobbyist, to undertake lobbying on its behalf. The act also requires the secretary to convene a working group to consider upgrades to the electronic filing system used by lobbyists to file their disclosure reports. The act specifies the mission of the working group and requirements affecting its organization and membership. The working group is required to report its conclusions to the general assembly. For the 2019-20 state fiscal year, the act appropriates $38,160 to the department of state from the department of state cash fund for use by the information technology division. (Note: This summary applies to this bill as enacted.) Read More
Behavioral, mental health, and substance use disorders - parity in coverage - private insurance - medicaid - coverage of medication-assisted treatment - parity reporting requirements - compliance with federal law - complaints from ombudsman for behavioral health access to care - rules - appropriation. The act enacts the "Behavioral Health Care Coverage Modernization Act" to address issues related to coverage of behavioral, mental health, and substance use disorder services under private health insurance and the state medical assistance program (medicaid). With regard to health insurance, the act: Specifies that mandatory insurance coverage for behavioral, mental health, and substance use disorders includes coverage for the prevention of, screening for, and treatment of those disorders and must comply with the federal "Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008" (MHPAEA) (section 3 of the act); Requires services for behavioral, mental health, and substance use disorders to continue while a claim for coverage of those services is under review until the carrier notifies the covered person of the determination on the claim (section 3); Requires carriers to comply with treatment limitation requirements specified in federal regulations and precludes carriers from applying nonquantitative treatment limitations to behavioral, mental health, and substance use disorder services that do not apply to medical and surgical benefits (section 3); Requires carriers to establish procedures to authorize treatment by nonparticipating providers when a participating provider is not available under network adequacy requirements and to reimburse treatment or services for behavioral, mental health, or substance use disorders obtained from a nonparticipating provider because the covered service was not available within established time and distance standards using the same methodology the carrier uses to reimburse covered medical services provided by nonparticipating providers (section 3); Requires the commissioner of insurance (commissioner) to adopt rules to establish reasonable time periods for visits with a provider for treatment of a behavioral, mental health, or substance use disorder after an initial visit with a provider (section 3); Modifies the definition of "behavioral, mental health, and substance use disorder" to include diagnostic categories listed in the mental disorders section of the International Statistical Classification of Diseases and Related Health Problems, the Diagnostic and Statistical Manual of Mental Disorders, or the Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood (section 3); Updates the required coverage related to alcohol use and behavioral health screenings to reflect the current requirements of that coverage as specified in recommendations of the United States preventive services task force (section 3); Requires the commissioner to disapprove a carrier's requested rate increase for failure to demonstrate compliance with the MHPAEA in accordance with rules adopted by the commissioner (section 5); For purposes of denials of reimbursement for behavioral, mental health, or substance use disorder services, other than denials based on nonpayment of premiums, requires carriers to include specified information about the protections included in the MHPAEA, how to contact the division of insurance or the office of the ombudsman for behavioral health access to care (office) related to possible violations of the MHPAEA, and the right to request medical necessity criteria from the carrier free of charge (section 6); For health benefit plans issued or renewed on or after January 1, 2020, requires carriers that provide coverage for an annual physical examination as a preventive health care service to also cover and reimburse for behavioral health screenings using a validated screening tool for behavioral health to the same extent the physical examination is covered (section 8); Requires carriers to submit an annual parity report to the commissioner and requires the commissioner to examine complaints received from the office regarding compliance with the requirements of the act or the MHPAEA upon the request of the office (section 9); Starting January 1, 2020, for a carrier that provides prescription drug benefits for the treatment of substance use disorders, with regard to prescription medications that are on the carrier's formulary, requires the carrier to provide coverage of any FDA-approved prescription medication for treating substance use disorders without prior authorization or step therapy requirements and to place at least one covered substance use disorder prescription medication on the lowest tier of the drug formulary, and precludes those carriers from excluding coverage for those medications and related services solely on the grounds that they were court ordered (section 10); and Requires the commissioner to provide a report by December 1, 2022, to specified legislative committees regarding the effects of the act on premiums (section 10). With regard to medicaid, the act: Requires the department of health care policy and financing (department) to ensure that medicaid covers behavioral, mental health, and substance use disorder services to the extent that medicaid covers a physical illness and complies with the MHPAEA (section 11); Requires the medical services board (state board) to establish a procedure, by rule, to allow for reimbursements of medically necessary state plan behavioral, mental health, or substance use services under medicaid when a managed care entity (MCE) denies coverage of the service based on diagnosis (section 11); Requires the statewide system of community behavioral health care in the managed care system to require MCEs to provide an adequate network of providers of behavioral, mental health, and substance use disorder services and to cover all medically necessary covered treatments for covered behavioral health diagnoses, regardless of any co-occurring conditions (section 12); Requires the department to include utilization management guidelines for the MCEs in state board managed care rules and to provide information on its website specifying how the public may request the network adequacy plans and quarterly network reports for an MCE (section 12); Requires the department to examine complaints received from the office regarding compliance with the requirements of the act or the MHPAEA upon the request of the office (section 12); Requires MCEs to include specified statements regarding the applicability of the MHPAEA to the managed care system in medicaid and how to contact the office regarding possible violations of the MHPAEA (section 14); Requires the department to submit an annual parity report to specified legislative committees and to contract with an external quality review organization annually to monitor MCEs' utilization management programs and policies to ensure compliance with the MHPAEA (section 15); and Starting January 1, 2020, requires an MCE that provides prescription drug benefits for the treatment of substance use disorders to provide coverage of any FDA-approved prescription medication for treating substance use disorders without prior authorization or step therapy requirements and precludes those MCEs from excluding coverage for those medications and related services solely on the grounds that they were court ordered (section 15). The act appropriates $167,000 to the department of health care policy and financing and $88,248 to the department of regulatory agencies to implement the act. (Note: This summary applies to this bill as enacted.) Read More
The federal "Tax Cuts and Jobs Act", which became law in December 2017, added distributions for elementary or secondary school expenses as qualified distributions from a qualified state tuition program, also known as a 529 account, thereby allowing, on the federal level, income tax-free distributions for elementary and secondary school expenses in addition to already authorized income tax-free distributions for higher education expenses. The bill amends Colorado law to ensure that a taxpayer may not claim a deduction for contributions to qualified state tuition programs for elementary or secondary school expenses and clarifies that such expenses are not qualified distributions. The bill also requires Colleginvest to provide the department of revenue with available information related to distributions that are not used to pay qualified higher education expenses. (Note: This summary applies to the reengrossed version of this bill as introduced in the second house.) Read More
Effective January 1, 2024, the bill prohibits a retail food establishment from distributing an expanded polystyrene product for use as a container for off-premises ready-to-eat food in the state. The executive director of the department of public health and environment or the executive director's designee may, through the attorney general, seek injunctive relief against a retail food establishment that violates the prohibition.(Note: This summary applies to this bill as introduced.) Read More
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