House Bill 25-1288 Preamended

A Bill for an Act

• Page 1, Line 101Concerning financial support for federally qualified health

• Page 1, Line 102centers.

Bill Summary

(Note: This summary applies to this bill as introduced and does not reflect any amendments that may be subsequently adopted. If this bill passes third reading in the house of introduction, a bill summary that applies to the reengrossed version of this bill will be available at http://leg.colorado.gov.)

The bill authorizes the department of health care policy and financing (state department) to seek and accept gifts from private or public sources for the primary care fund. Upon receiving federal authorization, if the state department receives gifts designated for a federally qualified health center (FQHC) or a qualified provider, the state department is required to allocate 115% of the total amount of gifts received to the designated FQHC or qualified provider. The bill prohibits the state department from allocating money to a qualified provider if the donor is an FQHC or a qualified provider that has a direct or indirect relationship to medicaid payments and the allocation amount is positively correlated to the donation.

The bill authorizes an FQHC to establish a separate subsidiary company for the purpose of providing fee-for-service services outside of the FQHC's standard cost report if the subsidiary is providing fee-for-service services that have historically been provided and reimbursed on a fee-for-service basis, or if the state department determines that the subsidiary's reimbursements would be budget neutral. Upon receiving any necessary federal authorization, the state department is required to reimburse a subsidiary of an FQHC on a fee-for-service basis for services that are eligible for fee-for-service reimbursement. A subsidiary that receives reimbursement is authorized to pass through money received from the reimbursement directly to the FQHC operating as the subsidiary's parent corporation. Services reimbursed to an FQHC's subsidiary are excluded from the FQHC's cost report.

• This Unofficial Version Includes Committee

• Amendments Not Yet Adopted on Second Reading

• Page 2, Line 1Be it enacted by the General Assembly of the State of Colorado:

• Page 2, Line 2SECTION 1.  Legislative declaration. (1)  The general assembly finds that:

• Page 2, Line 3(a)  Federally qualified health centers (FQHC) play an important

• Page 2, Line 4role in the safety net system by serving roughly 30% of medicaid patients

• Page 2, Line 5in Colorado; however, FQHCs receive less than 2% of the state's medicaid provider reimbursement;

• Page 2, Line 6(b)  The primary care fund (fund) was created to allocate money

• Page 2, Line 7to qualified providers who provide comprehensive primary care services

• Page 2, Line 8in an outpatient setting to uninsured and medically indigent patients, or individuals enrolled in medicaid;

• Page 2, Line 9(c)  Each dollar in the fund receives a one-for-one match by the federal centers for medicare and medicaid (CMS); and

• Page 2, Line 10(d)  CMS adopted rules that prohibit qualified providers who

• Page 2, Line 11would benefit from the federal match from donating to the fund, but the rules do not prohibit other gifts from being made to the fund.

• Page 3, Line 1(2)  Therefore, the general assembly declares that it is necessary to allow the state to seek and accept gifts for the primary care fund.

• Page 3, Line 2SECTION 2.  In Colorado Revised Statutes, 24-22-117, amend (2) introductory portion and (2)(b)(I); and add (2)(b)(VI) as follows:

• Page 3, Line 324-22-117.  Tobacco tax cash fund - accounts - creation -

• Page 3, Line 4legislative declaration. (2)  There are hereby created in the state treasury the following funds:

• Page 3, Line 5(b) (I)  The primary care fund to be administered by the department

• Page 3, Line 6of health care policy and financing. The state treasurer and the controller

• Page 3, Line 7shall transfer an amount equal to nineteen percent of the moneys money

• Page 3, Line 8deposited into the cash fund, plus nineteen percent of the interest and

• Page 3, Line 9income earned on the deposit and investment of those moneys the

• Page 3, Line 10money, to the primary care fund. except that, for the 2008-09, 2009-10,

• Page 3, Line 112010-11, and 2011-12 fiscal years, the state treasurer and the controller

• Page 3, Line 12shall transfer to the primary care fund only an amount equal to nineteen

• Page 3, Line 13percent of the moneys deposited into the cash fund. In addition to the

• Page 3, Line 14money transferred from the cash fund, the primary care fund

• Page 3, Line 15consists of gifts received pursuant to subsection (2)(b)(VI) of

• Page 3, Line 16this section and any other money the general assembly may

• Page 3, Line 17appropriate or transfer into the primary care fund. All interest

• Page 3, Line 18and income derived from the deposit and investment of moneys money

• Page 3, Line 19in the primary care fund shall be is credited to the primary care fund.

• Page 3, Line 20except that all interest and income derived from the deposit and

• Page 3, Line 21investment of moneys in the primary care fund during the 2008-09,

• Page 3, Line 222009-10, 2010-11, and 2011-12 fiscal years shall be credited to the

• Page 3, Line 23general fund. Any unexpended and unencumbered moneys money

• Page 4, Line 1remaining in the primary care fund at the end of a fiscal year shall remain

• Page 4, Line 2remains in the fund and shall is not be credited or transferred to the general fund or any other fund.

• Page 4, Line 3(VI)  The state department may seek and accept gifts from

• Page 4, Line 4private or public sources for the purposes of this subsection(2)(b).

• Page 4, Line 6SECTION 3.  In Colorado Revised Statutes, amend 25.5-5-331 as follows:

• Page 4, Line 725.5-5-331.  Federally qualified health center - reimbursement

• Page 4, Line 8- rules. (1)  Costs associated with services provided by clinical

• Page 4, Line 9pharmacists through a federally qualified health center, as defined in the

• Page 4, Line 10federal "Social Security Act", 42 U.S.C. sec. 1395x (aa)(4), are

• Page 4, Line 11considered allowable costs for the purpose of a federally qualified health

• Page 4, Line 12center's cost report and must be included in the calculation of the reimbursement rate for a patient visit at a federally qualified health center.

• Page 4, Line 13(2) (a)  A federally qualified health center, as defined in

• Page 4, Line 14the federal "Social Security Act", 42 U.S.C. sec. 1395x (aa)(4),

• Page 4, Line 15may establish a separate subsidiary company for the purpose of

• Page 4, Line 16providing fee-for-service services outside of the federally qualified health center's standard cost report if:

• Page 4, Line 17(I)  The subsidiary is providing fee-for-service services

• Page 4, Line 18that have historically been provided and reimbursed on a fee-for-service basis; and

• Page 4, Line 19(II)  The state department determines that the subsidiary's reimbursements would be budget neutral.

• Page 4, Line 20(b)  Upon receiving any necessary federal authorization,

• Page 5, Line 1the state department shall reimburse a subsidiary company, as

• Page 5, Line 2described in subsection (2)(a) of this section, on a fee-for-service

• Page 5, Line 3basis for services that are eligible for fee-for-service reimbursement.

• Page 5, Line 4(c)  A subsidiary that receives reimbursement pursuant to

• Page 5, Line 5this section may pass through money received from the

• Page 5, Line 6reimbursement directly to the federally qualified health center operating as the subsidiary's parent corporation.

• Page 5, Line 7(d) (I)  The state department shall exclude all costs

• Page 5, Line 8associated with a subsidiary company established pursuant to

• Page 5, Line 9this subsection (2) from the calculation of a federally qualified health center's reimbursement rates.

• Page 5, Line 10(II)  The state department shall require a federally

• Page 5, Line 11qualified health center that establishes a separate subsidiary

• Page 5, Line 12company pursuant to this subsection (2) to include the costs

• Page 5, Line 13associated with the subsidiary in its cost report that is necessary to calculate reimbursement rates.

• Page 5, Line 14(2)  (3)  The state department shall promulgate rules to implement the provisions of this section.

• Page 5, Line 15SECTION 4.  Safety clause. The general assembly finds,

• Page 5, Line 16determines, and declares that this act is necessary for the immediate

• Page 5, Line 17preservation of the public peace, health, or safety or for appropriations for

• Page 5, Line 18the support and maintenance of the departments of the state and state institutions.