HB 1377 — Managed Care Entity Payments

SecondHOUSE RegularBILL Session26-1377 Seventy-fifthBY GeneralREPRESENTATIVE(S) AssemblySirota STATEand OFTaggart, COLORADOBrown; REREVISED This Version Includes All Amendments Adopted in the Second House LLS NO.

26-0931.02also PierceSENATOR(S) Lively x2059 HOUSE BILL 26-1377 HOUSE SPONSORSHIP Sirota and Taggart, Brown, SENATE SPONSORSHIP Amabile and Kirkmeyer, BridgesBridges. d d n m 2 E n 2 A U , N n 1 S d r House Committees Senate Committees e A Appropriations Appropriations R r e A BILL FOR AN ACT n m 2 C ONCERNING A CLARIFICATION REGARDING THE TREATMENT OF T n 2 A U 5 FUNDS THAT ARE TRANSFERRED FROM THE DEPARTMENT OF E i i S a p HEALTH CARE POLICY AND FINANCING THROUGH TO THE R A d C OLORADO DEPARTMENT OF HUMAN SERVICES THAT PASS THROUGH A REGIONAL ACCOUNTABILITY ENTITY .

dCONCERNINGACLARIFICATIONREGARDINGTHETREATMENTOFFUNDSTHAT dARETRANSFERREDFROMTHEDEPARTMENTOFHEALTHCAREPOLICY BillAND SummaryFINANCING eTHROUGH 6TO ETHE aC 0OLORADO SDEPARTMENT UOF ,HUMAN (Note:SERVICES THAT PASS THROUGH A REGIONAL ACCOUNTABILITY ENTITY .

This summary applies to this bill as introduced and does U g 1 H d r notreflectanyamendmentsthatmaybesubsequentlyadopted.Ifthisbill e p passes third reading in the house of introduction, a bill summary that R A applies to the reengrossed version of this bill will be available at http://leg.colorado.gov/.) e Joint Budget Committee.

The department of human services n (CDHS) operates mental health transitional living homes (transitional e 6 E n 0 U U , O i r Shading denotes HOUSE amendment.

Double underlining denotes SENATE amendment.

H a A Capital letters or bold & italic numbers indicate new material to be added to existing law.e Dashes through the words or numbers indicate deletions from existing law.

d homes).

Part of the funding for transitional homes comes from patient revenues, including Medicaid-eligible patient revenues.

For Medicaid-eligible patients, the patient revenues originate in the departmentofhealthcarepolicyandfinancing(HCPF),HCPFdistributes this money to managed care entities (MCEs), and the MCEs then pay CDHSfortheservicesprovidedatthetransitionalhomes.Atleastinpart, theMCEsserveaspassthroughstransferringpatientrevenuesfromHCPF to CDHS for transitional homes.

Because MCEs are nonstate entities, the office of the state controller counts the payments from HCPF to MCEs for transitional homes as money leaving the state and then counts the payments from MCEs to CDHS for transitional homes as state fiscal year spending for purposes of section 20 of article X of the state constitution (TABOR).

Thebillestablishesthat,if anMCEreceivesfederal funds or state money from HCPF and pays those funds or that money to CDHS, the funds or money received by CDHS is not included in the calculation of state fiscal year spending for purposes of TABOR.

(1) IFIAMANAGEDCAREENTITYRECEIVESFEDERALFUNDSORSTATE A MANAGED CARE ENTITY RECEIVES FEDERAL FUNDS OR STATE MONEY FROM THE DEPARTMENT OF HEALTH CARE POLICY AND FINANCING AND PAYS THOSE FUNDS OR THAT MONEY TO THE STATE DEPARTMENT ,,THE THE FUNDS OR MONEY RECEIVED BY THE STATE DEPARTMENT IS NOT INCLUDED IN THE CALCULATION OF STATE FISCAL YEAR SPENDING .________ Capital letters or bold & italic numbers indicate new material added to existing law;

(2)dashes ASthrough USEDwords INor THISnumbers SECTION,UNLESSindicate THEdeletions CONTEXTfrom OTHERWISEexisting REQUIRES,"MANAGEDlaw CAREand ENTITYsuch "HASTHEmaterial SAMEis MEANINGnot ASpart "MCE"of INthe SECTION25.5-5-402act. (9)(b)(III)(B).

(2) AS USED IN THIS SECTIO,UNLESS THE CONTEXT OTHERWISE REQUIRES,"MANAGEDCAREENTITY " HASTHESAMEMEANINGAS "MCE" IN SECTION 25.5-5-402 (9)(b)(III)(B).

The general assembly finds, determines, and declares that this act is necessary for the immediate preservationofthepublicpeace,health,orsafetyorforappropriationsforpreservation -2-of 1377the public peace, health, or safety or for appropriations for the support and maintenance of the departments of the state and state institutions.

-3-____________________________ 1377____________________________ Julie McCluskie James Rashad Coleman, Sr.

SPEAKER OF THE HOUSE PRESIDENT OF OF REPRESENTATIVES THE SENATE ____________________________ ____________________________ Vanessa Reilly Esther van Mourik CHIEF CLERK OF THE HOUSE SECRETARY OF OF REPRESENTATIVES THE SENATE APPROVED________________________________________ (Date and Time) _________________________________________ Jared S.

Polis GOVERNOR OF THE STATE OF COLORADO PAGE 2-HOUSE BILL 26-1377