Healthy Concern, Pt. 1

HB13-1068

On Site Inspections of Medicaid Providers

By Rep. Young and Sen. Roberts

Close Inspection

Compliance bills are ones advocated for by state departments that keep Colorado law aligned with federal law. 1068 is one of those. 

Inside the 2010 federal Affordable Care Act is a bit that gives state agencies that administer Medicaid the authority to check in on their providers without giving advance notice of the inspection visit. The Department of Health Care Policy and Finance is responsible for delivering Medicaid to Coloradoans, and they are the major actors behind 1068 and its intent to comply with federal law. 

Under current law the Department must provide 10 day advance notice of any inspection, audit, or on-site visits to a Medicaid provider. 

In Committee

1068 was routed to the House Public Health Care and Human Services Committee chaired by Rep. Primavera and vice chaired by Rep. Young (the sponsor of the bill). As Young explained, after the bill was introduced many stakeholders took issue with the language not being tight enough and having the potential to negatively affect them. Together, the Department and concerned parties worked together to re-draft the bill to a state agreeable to all. Completely altering a bill is called a strike below because it wipes clean everything below the enacting clause portion. 

The enacting clause

The introduced version of the bill can be found here, and the engrossed version can be found here.   

Witnesses lined up to testify in support of the bill as amended (the new version) included the Colorado Hospital Association, the Colorado Association of Medical Equipment Suppliers, former Representative Young (not to be confused with current Representative Young), and of course the Department of Health Care Policy and Financing. All of them were involved in remaking the bill. 

Although no party was terribly specific about the changes that were made, Rep. Young explained that most of the new language was borrowed from the federal version of the law. It includes specifics on categories of risk for providers, pre-enrollment and post enrollment site visits, and an important section that ensures inspectors will not be paid on commission for violations they uncover. 

Everyone harmonized on the bill. With few questions from committee members the strike below amendment passed unanimously, the bill passed to the committee of the whole unanimously which sent it to third readings, and earlier today 1068 passed the House third reading vote unanimously too. It's now off to the Senate where I predict smooth sailing clear to Hickenlooper's hands. 

More Ahead

1068 is not the only health care related bill this session. Among many more that I plan to keep track of are 

• 1115 which repeals the outdated program CoverColorado
• 008 which eliminates a waiting period in the CHP+ program
• 026 which updates the Michael Skolnik Medical Transparency Act
• 044 which deals with prepaid inpatient health plans
• 1175 which limits Medicaid expansion -- Postponed Indefinitely on 2/19/13 --
• 1196 which requires enhanced reporting by the Department
• 1199 regarding fee collection for nursing home providers -- Passed thirds in the House, now in the Senate --