Bill Sponsor
Colorado House Bill 1325
Session 2022A
Primary Care Alternative Payment Models
Became Law
Became Law
Signed by Governor on May 18, 2022
Sponsors
Democrat
Chris Kennedy
Democrat
Yadira Caraveo
Democrat
Joann Ginal
First Action
Mar 24, 2022
Latest Action
May 18, 2022
Origin Chamber
House
Type
Bill
Bill Number
1325
State
Colorado
Session
2022A
Sponsorship by Party
Democrat
Primary
Democrat
Primary
Democrat
Primary
Summary
The act requires the division of insurance (division) to collaborate with the department of health care policy and financing, the department of personnel, the department of public health and environment, and the primary care payment reform collaborative (collaborative) to develop and promulgate rules for alternative payment model parameters for primary care services offered through health benefit plans. The alternative payment model parameters must: Include transparent risk adjustment parameters that ensure that primary care providers are not penalized for or disincentivized from accepting vulnerable, high-risk patients and are rewarded for caring for patients with more severe or complex health conditions and patients who have inadequate access to affordable housing, healthy food, or other social determinants of health; Utilize patient attribution methodologies that are transparent and reattribute patients on a regular basis, which must ensure that population-based payments are made to a patient's primary care provider rather than other providers who may only offer sporadic primary care services to the patient and include a process for correcting misattribution that minimizes the administrative burden on providers and patients; Include a set of core competencies around whole-person care delivery that primary care providers should incorporate in practice transformation efforts to take full advantage of various types of alternative payment models; and Require an aligned quality measure set that considers the quality measures and the types of quality reporting that carriers and providers are engaging in under current state and federal law and includes quality measures that are patient-centered and patient-informed and address: Pediatric, perinatal, and other critical populations; the prevention, treatment, and management of chronic diseases; and the screening for and treatment of behavioral health conditions. For health-care plans that are issued or renewed on or after January 1, 2025, each carrier must ensure that the carrier's alternative payment models for primary care incorporate the aligned alternative payment model parameters created by the division. By December 1, 2023, the commissioner of insurance must promulgate rules detailing the requirements for alternative payment model parameters alignment. The division shall allow carriers the flexibility to determine which network providers and products are best suited to achieve the goals and incentives set by the division. Once the division has 5 years of data, the division is required to analyze the data, produce a report on the data, and present the findings to the general assembly during the department of regulatory agencies' presentation to legislative committees at hearings held pursuant to the "SMART Act". To assist carriers with implementing primary care alternative payment models, the division is required to retain a third-party contractor to design an evaluation plan for such implementation and retain a third-party contractor to provide technical assistance to carriers. With regard to the collaborative, the act: Requires the collaborative to annually review the alternative payment models developed by the division and provide the division with recommendations on the models; and Adjusts the date on which the collaborative must deliver its annual reports. With regard to the all-payer health claims database, the act: Requires the administrator to include in the annual primary care spending report data related to the aligned quality measure set determined by the division; and Adjusts the date on which the annual reports are due. For the 2022-23 state fiscal year, $56,328 is appropriated to the department of personnel from the general fund for use by the division of human resources to implement the act. (Note: This summary applies to this bill as enacted.)
Actions (18)
05/18/2022
Office of the Governor
Governor Signed
05/18/2022
Office of the Governor
Sent to the Governor
05/18/2022
Senate
Signed by the President of the Senate
05/18/2022
House
Signed by the Speaker of the House
05/10/2022
House
House Considered Senate Amendments - Result was to Concur - Repass
05/09/2022
House
House Considered Senate Amendments - Result was to Laid Over Daily
05/05/2022
Senate
Senate Third Reading Passed - No Amendments
05/04/2022
Senate
Senate Second Reading Special Order - Passed with Amendments - Committee, Floor
05/03/2022
Senate
Senate Second Reading Laid Over Daily - No Amendments
05/03/2022
Senate
Senate Committee on Appropriations Refer Amended to Senate Committee of the Whole
04/28/2022
Senate
Senate Committee on Health & Human Services Refer Amended to Appropriations
04/25/2022
Senate
Introduced In Senate - Assigned to Health & Human Services
04/25/2022
House
House Third Reading Passed - No Amendments
04/22/2022
House
House Second Reading Special Order - Passed with Amendments - Committee, Floor
04/21/2022
House
House Second Reading Special Order - Laid Over Daily - No Amendments
04/21/2022
House
House Committee on Appropriations Refer Amended to House Committee of the Whole
04/13/2022
House
House Committee on Health & Insurance Refer Amended to Appropriations
03/24/2022
House
Introduced In House - Assigned to Health & Insurance
Sources
Record Created
Mar 25, 2022 12:38:06 AM
Record Updated
Aug 20, 2022 1:49:20 AM