HB 22-1325 Summary

• Requires the Division of Insurance to develop alternative payment model parameters for primary care services by rule, including transparent risk adjustment and an aligned quality measure set, effective for health benefit plans issued or renewed on or after January 1, 2025

• Establishes minimum requirements for alternative payment models including prospective payments, patient attribution methodologies, core competencies for whole-person care, and quality measures addressing pediatric, perinatal, chronic disease, and behavioral health services

• Mandates the Primary Care Payment Reform Collaborative annually review and provide recommendations on the Division's alternative payment models, with expanded membership to include health insurers and providers using various alternative payment models

• Requires a third-party contractor to design an evaluation plan assessing effects on historically disadvantaged populations, primary care providers, practice independence, and administrative burdens, with data disaggregated by race, ethnicity, sex, gender, and age

• Appropriates $56,328 to the Department of Personnel for fiscal year 2022-23 to support implementation, including 0.7 FTE and operating expenses