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Bill Detail: HB22-1325

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Title Primary Care Alternative Payment Models
Status Signed by the Speaker of the House (05/18/2022)
Bill Subjects
  • Health Care & Health Insurance
  • Insurance
House Sponsors C. Kennedy (D)
Y. Caraveo (D)
Senate Sponsors J. Ginal (D)
House Committee Health and Insurance
Senate Committee Health and Human Services
Date Introduced 03/24/2022
Summary

The bill requires the division of insurance (division) to collaborate
with the department of health care policy and financing, the department
of personnel, and the primary care payment reform collaborative to
develop and promulgate rules for alternative payment model parameters
for primary care in the commercial health insurance market.
For health-care plans that are issued or renewed on or after January

1, 2025, the bill requires each carrier to ensure that the carrier's
alternative payment models for primary care incorporate the aligned
alternative payment model parameters created by the division.
The division is also required to develop and periodically update a
set of core competencies around whole-person care delivery that primary
care providers must meet in order to be eligible to receive practice
support provided by the division and other value-based payments
provided by a carrier. In updating the core competencies, the division
shall consider recommendations provided by the primary care payment
reform collaborative.
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
State Measurement for Accountable, Responsive, and Transparent
(SMART) Government Act.
With regard to the primary care payment reform collaborative
(collaborative), the bill:
  • Requires the collaborative to annually review the
alternative payment models developed by the division and
provide the division with recommendations on the models;
  • Requires the collaborative to provide the division with
recommendations on the core competencies developed by
the division; and
  • Adjusts the date on which the collaborative must deliver its
annual reports.
With regard to the all-payer health claims database, the bill:
  • Requires the administrator to include in the 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.

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