Committee hears competing views on letting Medicaid members buy primary care from direct‑primary‑care practices; amendments pass but bill later postponed

Sponsors Senators Rich and Kipp introduced HB1096 to let Medicaid members voluntarily contract with direct primary care (DPC) providers and to create guardrails: required written disclosures, information‑sharing with the member’s managed care entity, limits on targeted marketing, and a fee cap for DPC services for Medicaid members. Sponsors emphasized rural access and the opportunity for longer, relationship‑based primary care.

Opponents’ concerns: safety‑net providers, health plans and disability advocates warned the bill could fragment care, create predatory marketing and shift providers out of Medicaid networks. Aubrey Wilde (Colorado Coalition for the Homeless) and Kevin McFatridge (Colorado Association of Health Plans) said the bill risked confusing members and could shift scarce primary‑care capacity away from FQHCs and Medicaid networks unless safeguards were adopted. Multiple witnesses asked for strong disclosure, marketing limits, care coordination and caps on member fees.

Proponents: direct‑care providers and patients testified they often keep longstanding relationships and that DPC can offer timely access and longer visits that prevent ER utilization. Several rural and private DPC practitioners said the model helps patients who otherwise face weeks‑long waits.

Amendments and committee action: The committee considered an unusually large package of sponsor and committee amendments adding disclosures, cooperation requirements with managed care entities, five‑day notification rules, marketing prohibitions, a fee cap (the lesser of $80 or the non‑Medicaid price), and enforcement via consumer protection statutes. Multiple amendments were adopted by roll call. After extended debate and votes, the motion to move the bill failed in final committee voting and sponsors requested postponement; the measure was postponed indefinitely with a reverse roll call at the sponsors’ request.

Outcome: HB1096 was not advanced to the floor and is being held for further work; sponsors and stakeholders signaled continued willingness to negotiate tighter protections and clarifications.