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.
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
Page 3, Line 2allow the state to seek and accept gifts for the primary care fund that are
Page 3, Line 3designated for an FQHC in order to receive the federal match and allocate 115% of the total amount of gifts received to the designated FQHC.
Page 3, Line 4SECTION 2. In Colorado Revised Statutes, 24-22-117, amend (2) introductory portion and (2)(b)(I) as follows:
Page 3, Line 524-22-117. Tobacco tax cash fund - accounts - creation -
Page 3, Line 6legislative declaration. (2) There are
herebyPage 3, Line 7(b) (I) The primary care fund to be administered by the department
Page 3, Line 8of health care policy and financing. The state treasurer and the controller
Page 3, Line 9shall transfer an amount equal to nineteen percent of the
moneysPage 3, Line 10deposited into the cash fund, plus nineteen percent of the interest and
Page 3, Line 11income earned on the deposit and investment of
those moneysPage 3, Line 12money, to the primary care fund.
except that, for the 2008-09, 2009-10,Page 3, Line 13
2010-11, and 2011-12 fiscal years, the state treasurer and the controllerPage 3, Line 14
shall transfer to the primary care fund only an amount equal to nineteenPage 3, Line 15
percent of the moneys deposited into the cash fund.Page 3, Line 16money transferred from the cash fund, the primary care fund
Page 3, Line 17consists of gifts received pursuant to section 25.5-3-302 and any
Page 3, Line 18other money the general assembly may appropriate or transfer
Page 3, Line 19into the primary care fund. All interest and income derived from the
Page 3, Line 20deposit and investment of
moneysshallPage 3, Line 21
beexcept that all interest and incomePage 3, Line 22
derived from the deposit and investment of moneys in the primary carePage 3, Line 23
fund during the 2008-09, 2009-10, 2010-11, and 2011-12 fiscal yearsPage 4, Line 1
shall be credited to the general fund.Page 4, Line 2
moneysPage 4, Line 3year
shall remainshallbePage 4, Line 4SECTION 3. In Colorado Revised Statutes, 25.5-3-302, amend (1); and add (3.5) as follows:
Page 4, Line 525.5-3-302. Annual allocation - primary care services -
Page 4, Line 6qualified provider - rules. (1) The state department shall annually
Page 4, Line 7allocate the
moneysPage 4, Line 8primary care fund created in section 24-22-117 (2)(b)
C.R.S.,Page 4, Line 9eligible qualified providers in the state who comply with the requirements
Page 4, Line 10of subsection (2) of this section. Except as provided in subsection
Page 4, Line 11(3.5) of this section, the state department shall allocate the
moneysPage 4, Line 12money in amounts proportionate to the number of uninsured or medically
Page 4, Line 13indigent patients served by the qualified provider. For a qualified provider
Page 4, Line 14to be eligible for an allocation pursuant to this section, the qualified provider
shallPage 4, Line 15(a) The qualified provider is a community health center, as
Page 4, Line 16defined in section 330 of the federal "Public Health Service Act", 42 U.S.C. sec. 254b; or
Page 4, Line 17(b) At least fifty percent of the patients served by the qualified
Page 4, Line 18provider are uninsured or medically indigent patients, or patients who are
Page 4, Line 19enrolled in the medical assistance program, articles 4, 5, and 6 of this
Page 4, Line 20title, or the children's basic health plan, article 8 of this title, or any combination thereof.
Page 4, Line 21(3.5) (a) The state department may seek and accept gifts
Page 4, Line 22from private or public sources for the purposes of this section.
Page 5, Line 1The state department shall transmit all money received
Page 5, Line 2through gifts to the state treasurer, who shall credit the
Page 5, Line 3money to the primary care fund created in section 24-22-117(2)(b).
Page 5, Line 4(b) Upon receiving any necessary federal authorization,
Page 5, Line 5if the state department receives gifts pursuant to subsection
Page 5, Line 6(3.5)(a) of this section designated for a federally qualified
Page 5, Line 7health center, as defined in the federal "Social Security Act",
Page 5, Line 842 U.S.C. sec. 1395x (aa)(4), or a qualified provider, the state
Page 5, Line 9department shall allocate one hundred fifteen percent of the
Page 5, Line 10total amount of gifts received to the designated federally qualified health center or qualified provider.
Page 5, Line 11(c) Notwithstanding this subsection (3.5) to the contrary,
Page 5, Line 12the state department shall not allocate money to a federally
Page 5, Line 13qualified health center or qualified provider pursuant to
Page 5, Line 14subsection (3)(b) of this section if the donor is a federally
Page 5, Line 15qualified health center or a qualified provider that has a direct
Page 5, Line 16or indirect relationship to medicaid payments and the allocation amount is positively correlated to the donation.
Page 5, Line 17SECTION 4. In Colorado Revised Statutes, add 25.5-4-434 as follows:
Page 5, Line 1825.5-4-434. Federally qualified health center - subsidiary -
Page 5, Line 19fee-for-service reimbursement. (1) A federally qualified health
Page 5, Line 20center, as defined in the federal "Social Security Act", 42 U.S.C.
Page 5, Line 21sec. 1395x (aa)(4), may establish a separate subsidiary company
Page 5, Line 22for the purpose of providing fee-for-service services outside of
Page 5, Line 23the federally qualified health center's standard cost report if:
Page 6, Line 1(a) The subsidiary is providing fee-for-service services
Page 6, Line 2that have historically been provided and reimbursed on a fee-for-service basis; or
Page 6, Line 3(b) The state department determines that the subsidiary's reimbursements would be budget neutral.
Page 6, Line 4(2) Upon receiving any necessary federal authorization,
Page 6, Line 5the state department shall reimburse a subsidiary company, as
Page 6, Line 6described in subsection (1) of this section, on a fee-for-service
Page 6, Line 7basis for services that are eligible for fee-for-service reimbursement.
Page 6, Line 8(3) A subsidiary that receives reimbursement pursuant to
Page 6, Line 9this section may pass through money received from the
Page 6, Line 10reimbursement directly to the federally qualified health center operating as the subsidiary's parent corporation.
Page 6, Line 11(4) Services reimbursed pursuant to this section are
Page 6, Line 12excluded from the federally qualified health center's cost report.
Page 6, Line 13SECTION 5. Safety clause. The general assembly finds,
Page 6, Line 14determines, and declares that this act is necessary for the immediate
Page 6, Line 15preservation of the public peace, health, or safety or for appropriations for
Page 6, Line 16the support and maintenance of the departments of the state and state institutions.