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D4227C5F2FA2B53B87258AF4006DA241 Hearing Summary




PUBLIC
BILL SUMMARY For HB24-1149

SENATE COMMITTEE ON HEALTH & HUMAN SERVICES
Date Apr 3, 2024      
Location SCR 357



HB24-1149 - Referred to Senate Appropriations


01:57:33 PM  
Senators Kirkmeyer
and Roberts presented House Bill 24-1149, which establishes prior authorization
requirements for certain health care services and prescription drug benefits
covered under a health benefit plan. Specifically, carriers, private utilization
review organizations, and pharmacy benefit managers must:



·        
develop
and adopt a program that eliminates or substantially modifies the prior
authorization administrative process for qualified health care providers
who meet certain criteria;


·        
establish
a binding arbitration process for a carrier’s failure to include a provider
in the program;


·        
publicly
disclose information on prior authorization requirements and restrictions
including a list of drugs that require prior authorization, clinical criteria
for reauthorization, standard forms, data on prior authorization request
determinations, exemptions, and prescription drug formularies;



·        
annually
review and eliminate prior authorization requirements for services and
drugs that do not promote health care quality or equity, nor reduce health
care spending;


·        
upon
denial of a prior authorization, provide relevant alternative services
or treatments that may be covered;



·        
use
an application programming interface that automates the prior authorization
process for providers to access certain information; and



·        
accept
and respond to prior authorization requests through the secure electronic
transmission system through which the request was submitted.

02:00:55 PM  
Ms. Saskia Young, representing Colorado Association of Health Plans, testified in opposition to the bill.
02:13:04 PM  
Karlee Tebbutt, representing America's Health Insurance Plans (AHIP), testified in opposition to the bill.
02:13:15 PM  
Mr. Jonathan Buxton,
representing PCMA, testified in opposition to the bill.

02:14:23 PM  
Ms. Rebecca Gillett,
representing themself, testified in support of the bill.
02:21:35 PM  
Hope Stonner, representing Colorado Consumer Health Initiative, testified in support of the bill.
02:23:56 PM  
Mr. Ryan Biehle,
representing Colorado Academy of Family Physicians, testified in support
of the bill.
02:24:12 PM  
Kelly Erb, representing Colorado Rural Health Center, testified in support of the bill.
02:32:49 PM  
Dr. Rhonda Parker, representing Colorado Medical Society, testified in support of the bill.
02:35:53 PM  
Dr. Nolan Wessell, representing University of Colorado School of Medicine Department of Orthopedic Surgery, testified in support of the bill.


02:48:08 PM
Motion Refer House Bill 24-1149 to the Committee on Appropriations.
Moved Ginal
Seconded
Cutter Yes
Jaquez Lewis No
Michaelson Jenet Yes
Mullica Yes
Rich Yes
Smallwood Excused
Will Yes
Ginal Yes
Fields Yes
Final YES: 7   NO: 1   EXC: 1   ABS:  0   FINAL ACTION:  PASS