Advanced Practice Nurses, a New Look at Medicaid Provider Rates and Everything in Between

The budget continues to be the hot topic around the Capitol. The Joint Budget Committee has submitted a balanced budget and left $18.5 million for the legislature to spend on initiatives that will be considered after the budget bill, also called the Long Bill, is passed. However, $8.5 million has been promised for a package of bipartisan workforce development initiatives, which leaves $10 million ($5 million in each chamber) to fund line items that are not included in the budget bill.

The draft of the Long Bill is complete, with all six JBC members as sponsors, and we’ll see it introduced in the Senate shortly. Talks about TABOR and potential bills to change the Hospital Provider Fee are continuing. If you’d like more background on these issues, look for a blog from Joe next week that will more clearly explain them.

Updates since our last post:

Sen. Ellen Roberts (R) is the new chair of the Legislative Health Benefit Exchange Implementation Review Committee and is jumping into her role with enthusiasm. She hopes to double the scheduled number of meetings on the state insurance marketplace, Connect for Health Colorado. The committee plans to meet at 7:30 a.m. every other Wednesday, with the next session planned for April 1.

The House Public Health Care and Human Services Committee voted 12-1 in favor of House Bill 1242, which would require hospitals to ask patients or their guardians to designate a caregiver within 24 hours of arriving at the hospital. The bill passed its third reading in the House and is moving to the Senate soon. The committee also sent House Bill 1281 on to Appropriations on an 11-2 vote. This bill would require that all newborns born below an elevation of 7,000 feet be screened for congenital health defects using a pulse oximeter. These instruments perform quick, non-invasive tests of infants’ oxygen levels through a sensor placed on their feet. The requirement would extend to all birthing centers, regardless of elevation, once the oximeters are deemed to have been tested sufficiently.

The House Health, Insurance and Environment Committee approved Senate Bill 15, aiming to require parity in insurance coverage for autism spectrum disorders, on a vote of 12-0 (with one excused). The bill quickly passed its second and third readings in the House and is on its way to the governor. The committee also moved House Bill 1258 forward to the House Finance Committee on a 7-6 party-line vote. This bill would create the family and medical leave insurance (FAMLI) program, a state-run, paid-medical-leave program that would pay workers about two-thirds of their normal salary if they’re forced to take a medical leave of absence for themselves or a family member. The bill faces an uphill battle because Republicans, who control the Senate, are opposed.

Senate Bill 197, which seeks to reduce the training time required for advanced practice nurses to qualify to write prescriptions, passed the full Senate and has been assigned to the House Health, Insurance and Environment Committee for an April 2 hearing. During bill discussion on the Senate floor, Sen. Linda Newell (D) remarked, “I thought the battle was going to be between the Republicans and Democrats, but often it’s between the doctors and nurses.” Amendments to the bill helped temper opposition from physician groups and legislators, and it passed its final reading in the Senate 35-0.

The Senate Health and Human Services Committee voted 4-1 to send House Bill 1111, which seeks to create a maternal mortality review committee, to Senate Finance. Senate Bill 136, concerning the labeling of marijuana packaging, met a different fate: the committee voted 5-0 to postpone it indefinitely. The bill would have repealed the Department of Revenue’s authority to regulate labeling of retail marijuana and instituted new requirements for the labels.

In the full House, House Bill 1147 (regulation of genetic counselors), House Bill 1220 (responding to sexual assaults on college campuses) and House Bill 1097 (fetal alcohol spectrum disorders commission) passed their final readings in the chamber. The House also gave the final OK to House Bill 1067 (professional development for psychologists), which had passed the Senate but needed approval of late amendments. The Senate is sending another bill to the governor for signature: House Bill 1164, which allows a person who is breast-feeding to postpone jury service.

It should be relatively quiet for the rest of the week in health care legislation. The Health, Insurance and Environment Committee will consider House Bill 1283, which proposes the creation of a “reference lab” for marijuana testing. The House Business Affairs and Labor Committee was scheduled to discuss Senate Bill 137, which would allow for-profit companies to offer the Program of All-Inclusive Care for the Elderly (PACE), but the hearing has been pushed back to April 2.

Of much interest to us is Senate Bill 228, up soon in Senate Health and Human Services. It is a response to the failed House Bill 1151, which would have set a floor for Medicaid provider reimbursement rates but was voted down unanimously due to cost concerns. The new bill aims to establish a periodic review of provider rates so that every rate would be reviewed once every five years, and it would establish a review advisory committee whose members would be appointed by the leadership in both chambers.

A couple of new bills we’ll be watching are House Bill 1297 and House Bill 1298. 

HB 1297 would prohibit insurance carriers who offer plans for optometric services from doing several things, including limiting the fees that optometrists may charge for services and requiring optometrists to participate in the carriers’ other plans or networks. The bill is sponsored by four health committee members with widely varying views on health care: Reps. Joann Ginal (D) and Janak Joshi (R) and Sens. Irene Aguilar (D) and Kevin Lundberg (R). It is set for a March 31 hearing in the House Health, Insurance and Environment Committee.

HB 1298 is a re-worked version of an earlier bill (House Bill 1036) that failed. Once again, the goal is to warn pregnant women of the dangers of marijuana use by posting information at retail and medical marijuana centers. This time, however, the bill is less controversial because it avoids mentions of specific danger to fetuses, which had elicited opposition from pro-choice groups and others. HB 1036 sponsor Rep. Jack Tate (R) is joined by Rep. Jonathan Singer (D) in support of this bill. It will be heard by House Public Health Care and Human Services on March 31.