by Emily Bishop, Program Manager, CMS Division of Government Relations
Featured in the March/April 2019 Colorado Medicine.
The 2019 session is almost to the halfway point and CMS is working hard to track legislation that affects the physicians of Colorado and their patients.
With staff support, the CMS Council on Legislation (COL) is reviewing each relevant bill to understand its intent, possible outcomes and the political landscape to collectively determine how and at what level CMS should engage.
Here are a handful of particularly interesting bills that align with CMS’s legislative priorities.
SB19-008 Substance Use Treatment Criminal Justice System
Senate Bill 19-008 concerns the treatment of individuals with substance use disorders who come into contact with the criminal justice system. Individuals receiving medication-assisted treatment in local jails are allowed to continue treatment when transferred into the custody of the Department of Corrections. The bill also requires the Colorado Commission on Criminal and Juvenile Justice to report on alternatives for filing criminal charges against individuals suffering from substance use disorders arrested for a drug-related offense and a process for sealing criminal records for drug offense convictions.
Under this bill, Colorado would also seek federal authorization under the Medicaid program for the treatment of individuals with substance use disorders in jails.
The bill is a result of the 2018 Interim Study Committee on Opioid and other Substance
HB19-1009 Substance Use Disorders Recovery
The 2018 General Assembly worked tirelessly to pass a suite of opioid legislation aimed at prevention, treatment and harm reduction. House Bill 1009 seeks to build on that foundation and expand the housing voucher program to include individuals with substance use disorders. The bill would also establish a licensing system for recovery residences to standardize treatment.
This is another bill originating from the study committee, CMS is encouraged to see more being done for individuals in recovery.
SB19-079 Electronic Prescribing Controlled Substances
The CMS Prescription Drug Abuse Committee worked closely with the sponsors of SB 79 to ensure the bill included exceptions to the electronic prescribing mandate that reasonably accommodated system limitations and the nature of providing care in Colorado.
The bill requires podiatrists, physicians, PAs, APNs, optometrists, and dentists to prescribe schedule II, III and IV controlled substances electronically. The CMS lobby team continues to work closely with sponsors to ensure no unintended consequences or hardship result from this bill.
Health care coverage and access, costs and transparency
HB19-1004 Proposal for Affordable Health Coverage Option
This bill concerns a proposal for implementing a state option for health coverage. The bill directs the Department of Health Care Policy and Financing and the Division of insurance, with a robust stakeholder process, to study the costs, benefits and implementation logistics for a state option.
CMS is pleased to see a reaction to the inordinately high cost of health care in Colorado. The CMS Work Group on Health Care Costs and Quality is watching this legislation closely.
SB19-134 and HB19-1174 Out-of-Network
CMS has been focused on the issue of unanticipated treatment by out-of-network providers and surprise billing for the past five years and is pleased to see political momentum on the state and federal level to find a solution. Both bills seek to end the practice of balance billing and take the patient out of the middle. CMS is working with stakeholders and the bill sponsors to establish a clear system for notifying patients and to standardize fair compensation for providers.
The CMS lobby team is confident an agreement can be reached between the two bills that effectively protects patients while maintaining physician negotiating power.
HB19-1211 Prior Authorization Requirements Health Care Service
CMS was behind this legislation introduced in the House of Representatives at the end of February. The bill seeks to ease the administrative burden on physicians and streamline patient access to care by promoting safe, timely access to evidence-based care. The bill will standardize prior authorization among payers and utilization management organizations. Providers with 80 percent or higher approval rating on prior authorizations in the last 12 months will be exempt from further prior authorization requests. If a carrier or organization fails to make a timely determination on a request, the request is deemed approved.
Scope of practice
HB19-1095 Physician Assistants Supervision and Liability
COL and the Scope of Practice subcommittee are working closely with PAs on this bill, which addresses supervision requirements and the number of PAs on the Colorado Medical Board.
CMS is confident that a compromise can be found on this bill that suits both physician and PAs while improving patient access to care.
The CMS lobby team expects many more bills relating to health care and physician practice in the state before the session adjourns May 3. Watch for a legislative wrap-up in the next issue for an update of this and other legislation.