The House Committee on Health Care indicated support for Senate amendments to H.80 on April 11, agreeing by straw poll to a package of technical and substantive edits that narrow the Office of the Health Care Advocate's participation in certificate-of-need proceedings and clarify consent and consultation requirements.

Committee staff presented the Senate's edits as a strike-all markup for ease of review and noted the changes to three areas: the certificate-of-need process, the office's authority to obtain provider and insurer records, and the expectation that state agencies seek input from the Office of the Health Care Advocate on major policy matters affecting access and affordability.

Under the Senate language, the committee was told, the office and the long-term care ombudsman would be treated as interested parties in certificate-of-need proceedings but would no longer have the authority to question employees of the review board. Committee counsel said the board and the Office of the Health Care Advocate agreed that allowing interested parties to directly question board employees was not appropriate.

"We agreed with the board that it didn't make sense for us," said Mike Fisher, Healthcare Advocate, indicating his office was comfortable with removing the direct questioning language.

The draft also makes permissive adjustments to records requests: a provider or insurer may require written consent from the individual (or the individual's guardian or legal representative) before furnishing records to the office. Committee counsel explained this language reflects stakeholders' desire for clarity that a written authorization might be necessary rather than a verbal consent.

Finally, the bill's language asking state agencies to "seek input" from the Office of the Health Care Advocate was narrowed to specify the General Assembly's intent that agencies seek input when developing or revising "significant matters" of state policy affecting health care access and affordability, addressing agency concerns that the original phrasing could be read to require input on routine decisions.

Action and vote: The committee took a straw poll to support H.80 as amended by the Senate; committee counsel reported the straw poll result as 9-0-2 (9 in favor, 0 opposed, 2 not present). The committee plans to report concurrence to the floor with the Senate proposal of amendment.

Next steps: Committee staff will carry the committee's concurrence to the floor; counsel indicated Wendy would report the committee's action on Tuesday.