Amendments for HB21-1276
House Journal, May 6
9 HB21-1276 be amended as follows, and as so amended, be referred to
10 the Committee on Appropriations with favorable
11 recommendation:
12
13 Amend printed bill, page 5, strike lines 13 through 15.
14
15 Reletter succeeding paragraphs accordingly.
16
17 Page 6, strike lines 4 and 5 and substitute "(a) A HEALTH BENEFIT PLAN
18 ISSUED OR RENEWED ON".
19
20 Page 6, line 6, strike "COVERAGE" and substitute "A COST-SHARING
21 BENEFIT".
22
23 Page 6, line 7, strike "AS AN ALTERNATIVE TO OPIOIDS." and substitute
24 "FOR A PATIENT WITH A PAIN DIAGNOSIS WHERE AN OPIOID MIGHT BE
25 PRESCRIBED.".
26
27 Page 6, strike lines 8 and 9, and substitute:
28
29 "(b) THE COST-SHARING BENEFIT MUST INCLUDE, AT A
30 COST-SHARING AMOUNT NOT TO EXCEED THE".
31
32 Page 6, line 13, strike "VISITS; AND" and substitute "VISITS.".
33
34 Page 6, strike lines 14 through 16.
35
36 Page 6, after line 21 insert:
37
38 "(d) (I) WITHIN ONE HUNDRED TWENTY DAYS AFTER THE
39 EFFECTIVE DATE OF THIS SUBSECTION (24), THE DIVISION SHALL SUBMIT
40 TO THE FEDERAL DEPARTMENT OF HEALTH AND HUMAN SERVICES:
41 (A) ITS DETERMINATION AS TO WHETHER THE COST-SHARING
42 BENEFIT SPECIFIED IN THIS SUBSECTION (24) IS IN ADDITION TO ESSENTIAL
43 HEALTH BENEFITS AND WOULD BE SUBJECT TO DEFRAYAL BY THE STATE
44 PURSUANT TO 42 U.S.C. SEC. 18031 (d)(3)(B); AND
45 (B) A REQUEST THAT THE FEDERAL DEPARTMENT CONFIRM THE
46 DIVISION'S DETERMINATION WITHIN SIXTY DAYS AFTER RECEIPT OF THE
47 DIVISION'S REQUEST AND SUBMISSION OF ITS DETERMINATION.
48 (II) THIS SUBSECTION (24) APPLIES TO LARGE EMPLOYER POLICIES
49 OR CONTRACTS ISSUED OR RENEWED ON OR AFTER JANUARY 1, 2022, AND
50 TO INDIVIDUAL AND SMALL GROUP POLICIES AND CONTRACTS ISSUED ON
51 OR AFTER JANUARY 1, 2023, AND THE DIVISION SHALL IMPLEMENT THE
52 REQUIREMENTS OF THIS SUBSECTION (24), IF:
53
1 (A) THE DIVISION RECEIVES CONFIRMATION FROM THE FEDERAL
2 DEPARTMENT OF HEALTH AND HUMAN SERVICES THAT THE COVERAGE
3 SPECIFIED IN THIS SUBSECTION (24) DOES NOT CONSTITUTE AN
4 ADDITIONAL BENEFIT THAT REQUIRES DEFRAYAL BY THE STATE PURSUANT
5 TO 42 U.S.C. SEC. 18031 (d)(3)(B); OR
6 (B) MORE THAN THREE HUNDRED SIXTY-FIVE DAYS HAVE PASSED
7 SINCE THE DIVISION SUBMITTED ITS DETERMINATION AND REQUEST FOR
8 CONFIRMATION THAT THE COVERAGE SPECIFIED IN THIS SUBSECTION (24)
9 IS NOT AN ADDITIONAL BENEFIT THAT REQUIRES STATE DEFRAYAL
10 PURSUANT TO 42 U.S.C. SEC. 18031 (d)(3)(B), AND THE FEDERAL
11 DEPARTMENT OF HEALTH AND HUMAN SERVICES HAS FAILED TO RESPOND
12 TO THE REQUEST WITHIN THAT PERIOD, IN WHICH CASE THE DIVISION
13 SHALL CONSIDER THE FEDERAL DEPARTMENT'S UNREASONABLE DELAY A
14 PRECLUSION FROM REQUIRING DEFRAYAL BY THE STATE.
15 (e) THE DIVISION SHALL CONDUCT AN ACTUARIAL STUDY TO
16 DETERMINE THE EFFECT, IF ANY, THE COST-SHARING BENEFIT REQUIRED BY
17 THIS SUBSECTION (24) HAS ON PREMIUMS.".
18
19 Page 8, line 27, strike "INSTITUTE" and substitute "REQUIRE THE CARRIER
20 TO DEVELOP AND PROVIDE TO THE DIVISION FOR APPROVAL".
21
22 Page 9, line 1, strike "FOR THE CARRIER TO FOLLOW".
23
24 Page 9, line 3, strike "OBTAIN" and substitute "ENSURE".
25
26 Page 10, line 7, strike "THE EXECUTIVE DIRECTOR" and substitute "ON OR
27 BEFORE NOVEMBER 1, 2021, THE APPLICABLE BOARD FOR EACH
28 PRESCRIBER".
29
30 Page 10, line 10, strike "MONTHS." and substitute "MONTHS; EXCEPT THAT
31 THE RULES MUST NOT LIMIT THE SUPPLY OF A BENZODIAZEPINE
32 PRESCRIBED TO TREAT A SEIZURE DISORDER, ALCOHOL WITHDRAWAL, OR
33 A NEUROLOGICAL EMERGENCY EVENT INCLUDING A POSTTRAUMATIC
34 BRAIN INJURY.".
35
36 Page 10, after line 20 insert:
37
38 "SECTION 8. In Colorado Revised Statutes, 12-30-114, amend
39 (1)(a) as follows:
40 12-30-114. Demonstrated competency - opiate prescribers -
41 rules - definition. (1) (a) The applicable licensing board for each
42 licensed health-care provider, IN CONSULTATION WITH THE CENTER FOR
43 RESEARCH INTO SUBSTANCE USE DISORDER PREVENTION, TREATMENT, AND
44 RECOVERY SUPPORT STRATEGIES CREATED IN SECTION 27-80-118, shall
45 promulgate rules that require each licensed health-care provider, as a
46 condition of renewing, reactivating, or reinstating a license on or after
47 October 1, 2019 2022, to complete up to four credit hours of training per
48 licensing cycle in order to demonstrate competency regarding: Best
49 practices for opioid prescribing, according to the most recent version of
50 the division's guidelines for the safe prescribing and dispensing of
51 opioids; THE POTENTIAL HARM OF INAPPROPRIATELY LIMITING
52 PRESCRIPTIONS TO CHRONIC PAIN PATIENTS; BEST PRACTICES FOR
53 PRESCRIBING BENZODIAZEPINES; recognition of substance use disorders;
54 referral of patients with substance use disorders for treatment; and the use
4 55 of the electronic prescription drug monitoring program created in part
1 of article 280 of this title 12.".
2
3 Renumber succeeding sections accordingly.
4
5 Page 12, strike lines 8 through 27.
6
7 Page 13, strike lines 1 and 2.
8
9 Renumber succeeding sections accordingly.
10
11 Page 14, line 11, before "WITH" insert "AND ELECTRONIC HEALTH
12 RECORDS THROUGH A BOARD-APPROVED VENDOR AND METHOD".
13
14 Page 14, line 24, strike "(4) (a) (I)" and substitute "(4) (a)".
15
16 Page 15, strike lines 8 through 12.
17
18 Page 17, line 26, strike "16" and substitute "15".
19
20
House Journal, May 14
29 HB21-1276 be amended as follows, and as so amended, be referred to
30 the Committee of the Whole with favorable
31 recommendation:
32
33 Amend printed bill, page 17, after line 22 insert:
34
35 "SECTION 19. Appropriation. (1) For the 2021-22 state fiscal
36 year, $382,908 is appropriated to the department of human services for
37 use by the office of behavioral health. This appropriation is from the
38 marijuana tax cash fund created in section 39-28.8-501 (1), C.R.S. To
39 implement this act, the office may use this appropriation as follows:
40 (a) $74,848 for personal services related to community behavioral
41 health administration, which amount is based on an assumption that the
42 office will require an additional 0.8 FTE;
43 (b) $8,060 for operating expenses related to community
44 behavioral health administration; and
45 (c) $300,000 for community prevention and treatment programs.
46 (2) For the 2021-22 state fiscal year, $13,000 is appropriated to
47 the department of regulatory agencies for use by the division of insurance.
48 This appropriation is from the division of insurance cash fund created in
49 section 10-1-103 (3), C.R.S. To implement this act, the division may use
50 this appropriation for personal services.".
51
52 Renumber succeeding sections accordingly.
53
54 Page 1, line 101, strike "DISORDERS." and substitute "DISORDERS, AND,
55 IN CONNECTION THEREWITH, MAKING AN APPROPRIATION.".
House Journal, May 20
41 Amendment No. 1, Appropriations Report, dated May 14, 2021, and
42 placed in member's bill file; Report also printed in House Journal,
43 May 14, 2021.
44
45 Amendment recommended by Health & Insurance Report, dated May 5,
46 2021, and placed in member's bill file; Report also printed in House
47 Journal, May 6, 2021.
48
49 Representative Hanks offered a substitute motion to rerefer the bill to the
50 Committee on Health & Insurance.
51
52 The motion was withdrawn.
53
54 Representative Hanks moved to rerefer the bill to the Committee on
55 Health & Insurance.
1 The motion was lost via viva voce vote.
2
3 On motion of Representative Esgar, the bill, as amended was laid over.
House Journal, May 22
32 Amendment No. 1, Appropriations Report, dated May 14, 2021, adopted
33 May 20, 2021, House Journal, page 1391.
34
35 Amendment No. 2, Health & Insurance Report, dated May 5, 2021, and
36 placed in member's bill file; Report also printed in House Journal, May 6,
37 2021.
38
39 Amendment No. 3, by Representative Kennedy.
40
41 Amend the Health and Insurance Committee Report, dated May 5, 2021,
42 page 1, strike lines 10 through 14 and substitute:
43
44 "Page 6 of the printed bill, strike lines 8 through 16 and substitute:
45
46 "(b) THE COST-SHARING BENEFIT MUST INCLUDE:
47 (I) A COST-SHARING AMOUNT FOR EACH VISIT NOT TO EXCEED THE
48 COST-SHARING AMOUNT FOR A PRIMARY CARE VISIT FOR NONPREVENTIVE
49 SERVICES; AND
50 (II) A MINIMUM OF SIX PHYSICAL THERAPY VISITS, SIX
51 OCCUPATIONAL THERAPY VISITS, SIX CHIROPRACTIC VISITS, AND SIX
52 ACUPUNCTURE VISITS.".".
53
54 Amendment No. 4, by Representative Kennedy.
55
1 Amend the Health and Insurance Committee Report, dated May 5, 2021,
2 page 2, line 20 strike "OR".
3
4 Page 2, after line 20 insert:
5
6 "(B) THE FEDERAL DEPARTMENT OF HEALTH AND HUMAN SERVICES
7 HAS OTHERWISE INFORMED THE DIVISION THAT THE COVERAGE DOES NOT
8 REQUIRE STATE DEFRAYAL PURSUANT TO 42 U.S.C. SEC. 18031 (d)(3)(B);
9 OR".
10
11 Reletter succeeding sub-subparagraph accordingly.
12
13 Amendment No. 5, by Representative Kennedy.
14
15 Amend the Health and Insurance Committee Report, dated May 5, 2021,
16 page 3, after line 3 insert:
17
18 "Page 10 of the printed bill, line 9, strike "THAT" and substitute "A".".
19
20 Page 3 of the committee report, strike lines 6 through 8 and substitute
21 "PRESCRIBED TO TREAT EPILEPSY, A SEIZURE OR SEIZURE DISORDER, A
22 SUSPECTED SEIZURE DISORDER, SPASTICITY, ALCOHOL WITHDRAWAL, OR
23 A NEUROLOGICAL CONDITION, INCLUDING A POSTTRAUMATIC BRAIN
24 INJURY OR CATATONIA. THE RULES MUST ALLOW FOR APPROPRIATE
25 TAPERING OFF OF BENZODIAZEPINES AND MUST NOT REQUIRE OR
26 ENCOURAGE ABRUPT DISCONTINUATION OR WITHDRAWAL OF
27 BENZODIAZEPINES.".".
28
29 Page 3 of the committee report, after line 32 insert:
30
31 "Page 13, line 22, after "TREAT" insert "EPILEPSY," and after "DISORDER,"
32 insert "A SUSPECTED SEIZURE DISORDER, SPASTICITY,".
33
34 Page 13, line 23, strike "EMERGENCY EVENT" and substitute
35 "CONDITION,".
36
37 Page 13, line 24, strike "INJURY." and substitute "INJURY OR
38 CATATONIA.".".
39
40 Amendment No. 6, by Representative Kennedy.
41
42 Amend the Health and Insurance Committee Report, dated May 5, 2021,
43 page 2, strike lines 1 and 2 and substitute:
44
45 ""(d) (I) THE DIVISION SHALL SUBMIT".
46
47 Page 2, line 4, strike "COST-SHARING".
48
49 Amendment No. 7, by Representative Kennedy.
50
51 Amend printed bill, page 7, strike line 27.
52
53 Page 8, strike line 1 and substitute "AN OPIOID AGONIST WITH A
54 DOCUMENTED SAFER SIDE-EFFECT PROFILE AND LESS RISK OF ADDICTION
55 THAN OLDER OPIUM-BASED MEDICATIONS.".
1 Amendment No. 8, by Representative Kennedy.
2
3 Amend printed bill, page 4, strike lines 2 through 14.
4
5 Reletter succeeding paragraphs accordingly.
6
7 Page 4, after line 18 insert:
8 "(e) There is growing evidence of the harms of inappropriately
9 prescribing benzodiazepines, especially long-term prescribing for acute
10 conditions, which contributes to physical dependence and potential for
11 misuse, drug interactions, or overdose;
12 (f) Although Colorado's opioid prescription limit explicitly
13 exempts certain diagnoses, including cancer and chronic pain, many
14 chronic pain patients have nonetheless found their prescriptions limited;
15 (g) There are many legitimate uses of opioids and
16 benzodiazepines, especially for patients with chronic conditions, and
17 limiting access for these patients can cause considerable harm, especially
18 when they are titrated too rapidly;".
19
20 Reletter succeeding paragraphs accordingly.
21
22 Page 4, line 19, strike "Chances" and substitute "Notwithstanding the
23 legitimate uses of these medications, chances".
24
25 Page 4, strike lines 20 through 27 and substitute "benzodiazepines; and".
26
27 Page 5, strike line 1.
28
29 Reletter succeeding paragraphs accordingly.
30
31 Page 5, line 2, strike "Medical education" and substitute "Education".
32
33 Page 5, strike line 7 through 12 and substitute:
34 "(a) Reduce out-of-pocket costs for physical therapy, occupational
35 therapy, chiropractic services, and acupuncture services;
36 (b) Remove barriers to coverage of atypical opioids, such as
37 buprenorphine, tramadol, and tapentadol;
38 (c) Continue to limit opioid prescriptions and require prescribers
39 to query the prescription drug monitoring program (PDMP);
40 (d) Establish limits on benzodiazepine prescriptions for certain
41 conditions and require prescribers to query the PDMP;
42 (e) Make it easier for providers to query the PDMP by integrating
43 it into electronic health records systems;".
44
45 Reletter succeeding paragraphs accordingly.
46
47 Page 5, strike lines 16 through 18.
48
49 Reletter succeeding paragraphs accordingly.
50
51 Representative Ransom moved to rerefer the bill to the Committee on
52 Health & Insurance.
53
54 The motion was lost via viva voce vote.
55
1 As amended, ordered engrossed and placed on the Calendar for Third
2 Reading and Final Passage.
3
Senate Journal, May 27
After consideration on the merits, the Committee recommends that HB21-1276 be
amended as follows, and as so amended, be referred to the Committee on Appropriations
with favorable recommendation.
Amend reengrossed bill, page 5, line 24, strike "PROVIDE A COST-SHARING
BENEFIT" and substitute "ALIGN COST-SHARING AMOUNTS".
Page 5, strike lines 26 and 27 and substitute "DIAGNOSIS WHERE AN OPIOID
MIGHT BE PRESCRIBED, WHICH MUST INCLUDE".
Page 6, line 1, strike "(I) A" and substitute "A".
Page 6, strike lines 3 and 4 and substitute "SERVICES FOR A MINIMUM OF SIX
PHYSICAL THERAPY VISITS, SIX".
Reletter succeeding paragraphs accordingly.
Page 14, after line 7 insert:
"SECTION 15. In Colorado Revised Statutes, 12-280-403, add (6) as
follows:
12-280-403. Prescription drug use monitoring program -
registration required. (6) ON OR BEFORE SEPTEMBER 1, 2021, THE DIVISION
SHALL FULLY ENABLE THE EXPANSION, UTILIZATION, AND ADOPTION OF THE
UNITED STATES BUREAU OF JUSTICE ASSISTANCE RXCHECK, BOTH FOR
INTERSTATE DATA SHARING AND FOR INTEGRATING THE PROGRAM INTO THE
ELECTRONIC MEDICAL RECORDS OF PRACTITIONERS AND HEALTH SYSTEMS
WITHIN THE STATE. PRACTITIONERS AND HEALTH SYSTEMS, THROUGH PUBLIC
AND PRIVATE INTEGRATION ORGANIZATIONS THAT COMPLY WITH THE BUSINESS
ASSOCIATE REQUIREMENTS OF THE FEDERAL "HEALTH INSURANCE PORTABILITY
AND ACCOUNTABILITY ACT OF 1996", AS AMENDED, 42 U.S.C. SEC. 1320d TO
1320d-9, AND ITS RELATED PRIVACY AND SECURITY REGULATIONS, ARE
AUTHORIZED TO DIRECTLY CONNECT TO THE PROGRAM THROUGH RXCHECK. IN
ORDER TO COMPLETE THE REQUIRED RXCHECK ENABLEMENT, THE DIVISION
MAY AUTHORIZE PUBLIC OR PRIVATE INTEGRATION ORGANIZATIONS TO PROVIDE
TO THE DIVISION REASONABLE AND NECESSARY PROGRAM QUERY AUDIT
REPORTS SHOULD AUDIT REPORTING FUNCTIONALITY NOT BE SUFFICIENT FOR
THE DIVISION THROUGH RXCHECK. NOTWITHSTANDING THE ENABLEMENT OF
RXCHECK DESCRIBED IN THIS SUBSECTION (6), THE PROGRAM, WHETHER
DEVELOPED BY THE BOARD OR PROCURED, MUST ALLOW DIRECT APPLICATION
PROGRAM INTERFACE CONNECTIONS TO THE PROGRAM THROUGH PUBLIC AND
PRIVATE INTEGRATION ORGANIZATIONS THAT COMPLY WITH THE BUSINESS
ASSOCIATE REQUIREMENTS OF THE "HEALTH INSURANCE PORTABILITY AND
ACCOUNTABILITY ACT OF 1996", AS AMENDED, 42 U.S.C. SEC. 1320d TO
1320d-9, AND ITS RELATED PRIVACY AND SECURITY REGULATIONS.
PRACTITIONERS AND HEALTH SYSTEMS, AND THE INTEGRATION ORGANIZATIONS
ACTING ON THEIR BEHALF, SHALL NOT BE ASSESSED ANY FEES FOR THE
INTEGRATION ACCESS TO THE PROGRAM DESCRIBED IN THIS SUBSECTION (6),
EITHER THROUGH RXCHECK OR THROUGH AN APPLICATION PROGRAM
INTERFACE CONNECTION.".
Renumber succeeding sections accordingly.
State,
Veterans, &
Military
Affairs
Senate Journal, June 4
HB21-1276 by Representative(s) Kennedy and Herod; also Senator(s) Pettersen and Priola--Concerning
the prevention of substance use disorders, and, in connection therewith, making an
appropriation.
A majority of those elected to the Senate having voted in the affirmative, Senator Pettersen
was given permission to offer a third reading amendment.
Third Reading Amendment No. 1(L.025), by Senator Pettersen.
Amend revised bill, page 14, line 9, strike "SEPTEMBER" and substitute
"DECEMBER".
Page 15, strike lines 7 through 11 and substitute "REGULATIONS.".
The amendment was passed on the following roll call vote:
YES 35 NO 0 EXCUSED 0 ABSENT 0
Bridges Y Gardner Y Lee Y Simpson Y
Buckner Y Ginal Y Liston Y Smallwood Y
Coleman Y Gonzales Y Lundeen Y Sonnenberg Y
Cooke Y Hansen Y Moreno Y Story Y
Coram Y Hisey Y Pettersen Y Winter Y
Danielson Y Holbert Y Priola Y Woodward Y
Donovan Y Jaquez Lewis Y Rankin Y Zenzinger Y
Fenberg Y Kirkmeyer Y Rodriguez Y President Y
Fields Y Kolker Y Scott Y
The question being "Shall the bill, as amended, pass?", the roll call was taken with the
following result:
YES 23 NO 12 EXCUSED 0 ABSENT 0
Bridges Y Gardner N Lee Y Simpson Y
Buckner Y Ginal Y Liston N Smallwood N
Coleman Y Gonzales Y Lundeen N Sonnenberg N
Cooke N Hansen Y Moreno Y Story Y
Coram Y Hisey N Pettersen Y Winter Y
Danielson Y Holbert N Priola Y Woodward N
Donovan Y Jaquez Lewis Y Rankin N Zenzinger Y
Fenberg Y Kirkmeyer N Rodriguez Y President Y
Fields Y Kolker Y Scott N