Senate Health & Human Services [Mar 19, 2026]

Senators Bright here.

Doherty. Here.

Weissman. Good afternoon.

Mr. Chair Malika. Here.

The appointees for the day are Lindsay Spraker, come on up, and Antonia Chiesa, with Aaron Miller, with the Family Strengthening Director for the Colorado Department of Human Services, here to introduce them.

THANK YOU, MR. CHAIR. FIRST I'LL INTRODUCE LINDSAY SPRAKER. LINDSAY IS THE DIRECTOR OF OPERATIONS AT LIFELONG AND AN ADJUCT FACULTY MEMBER AT THE UNIVERSITY OF DENVER AND BRINGS OVER 25 YEARS OF EXPERTISE IN CLINICAL SOCIAL WORK AND AND DOMESTIC VIOLENCE TREATMENT. HER EXTENSIVE BACKGROUND INCLUDES LEADERSHIP IN RESIDENTIAL TREATMENT CENTERS AND COMMUNITY PROGRAMS WITH A SPECIALIZED FOCUS ON SERVING INDIVIDUALS WITH DIVERSE ABILITIES AND COMPLEX NEEDS. SHE CURRENTLY SERVES ON THE COLORADO DOMESTIC VIOLENCE FATALITY REVIEW BOARD AND THE DOMESTIC VIOLENCE OFFENSIVE MANAGEMENT BOARD, DEMONSTRATING A DEEP COMMITMENT TO STATEWIDE SAFETY AND OVERSIGHT. HER OVER 25 YEARS OF EXPERTISE IN CLINICAL SOCIAL WORK AND HER SUBJECT MATTER EXPERTISE IN DOMESTIC VIOLENCE TREATMENT BRING A UNIQUE PERSPECTIVE TO THE BOARD THAT IS UNMATCHED. HER PROFESSIONAL EXPERTISE AND TRAINING UNIQUELY QUALIFY HER TO SERVE ON THE COLORADO CHILD ABUSE PREVENTION TRUST FUND BOARD.

SURE. THANK YOU FOR HAVING ME. Mr. Chair and everybody on this committee. My name is Lindsay Spraker, and I have been in the field of mental health, behavioral health services for over 25 years, starting from a line staff all the way up to the owner of a treatment agency specializing in work with clients with disabilities. And we have contracts with a majority of probation, judicial districts, as well as the local human service agencies providing any range of mental health and behavioral health evaluation and parenting and family time support services and I am eager and excited to be a part of this board because I've seen through the work directly myself about the power of prevention and the connection to families communities in the improvement as opposed to the other side of intervention and how that's received and responded to and I believe THERE'S A LOT OF GOOD WORK TO DO ON THE FRONT END, AND I'M HAPPY TO BE A PART OF IT.

SHOOT, THANK YOU. I'D LIKE TO INTRODUCE TO YOU ANTONIA CAIZA, IS A PROFESSOR OF PEDIATRICS AT THE UNIVERSITY OF COLORADO AND THE DIRECTOR OF HEALTH CARE SERVICES AT THE KEMP CENTER, SPECIALIZING IN CHILD ABUSE PEDIATRICS. SHE'S BOARD CERTIFIED IN GENERAL AND CHILD ABUSE PREVENTION PEDIATRICS. She serves as the medical director of the Children's Hospital Colorado Child Protection Team and has been a faculty member since 2007. Dr. Caiza has pioneered critical statewide initiatives, including the Kemp Care Network for provider education and Colorado's only pediatric sexual assault nurse examiner, SANE program. Her leadership in developing comprehensive clinical programs for child maltreatment providers is unparalleled WITHIN THE MEDICAL AND IS A BENEFIT TO OUR TRUST FUND BOARD SYSTEM.

YES, THANK YOU SO MUCH. ANTONIA CAISA. AND I'VE REALLY WORKED IN CHILD ABUSE THROUGHOUT MY ENTIRE CAREER. I am really eager to join the board to help influence broader systems change including prevention efforts beyond working on the front line I have developed larger scale programs such as the Kemp care network and also helped to develop multidisciplinary type clinics however I know that for sustainability purposes and to really impact larger populations we have to focus on those BIGGER SYSTEMIC PIECES AND ALSO ON PREVENTION. SO I'M REALLY EAGER TO WORK WITH THE BOARD AROUND THESE EFFORTS AND TO PROVIDE BOTH MY CLINICAL EXPERTISE BUT ALSO THE ACADEMIC PERSPECTIVE.

Senator Frizzell. Thank you, Mr. Chair. Members, this is undoubtedly going to be the best bill you hear today.

I was kind of serious about that, and you laugh. So we're here to talk about House Bill 1070 today. And just as some background, under current law, an insurance carrier can contract with a dentist and then turn around and sell that dentist's services to another separate insurance carrier. This can be done without the dentist having full knowledge of the agreement between the carriers and can be done with different terms and conditions in place than what the dentist agreed to in their contract with the original carrier. So this practice is called network leasing by insurance companies, and it creates all sorts of issues for dentists and their patients both. So when a dentist is not informed about dental benefit plans that they've been added to, that dentists can't educate their patients about the benefits either, and they can't provide accurate cost estimates. And so this policy of network leasing leaves it up to dentists, many of whom are in private practice, small business owners and patients, and their patients then trying to work through this mess of figuring out when dental benefits apply or when they don't, and who's left holding the bag at the end of the day. So House Bill 1070 is pretty simple. It's a simple and clear solution to this issue. An insurance carrier needs to ask a dentist if they want to be leased before leasing them out. It's really kind of as simple as that, and anyone would expect that a normal contract process should happen this way. And, you know, asking the questions, do you agree to these terms or don't you? The bill provisions also require clear communication and updates from carriers to dentists so that if a dentist does agree to leasing, they still get the information they need to educate their parents and make informed care plans together with their patients. And with that, I'm going to turn it over to my co-pring.

Madam Vice Chair.

So the crux of this bill is really about full engagement clarity and transparency in the contracting process for dental services The bill doesn prohibit leasing from happening at all It just acknowledges and affirms a dental provider's right to contract with full knowledge and consent of their contract terms. While the bill addresses contracts between dental providers and insurance carriers, many of the impacts are on dental patients. If a dental office isn't aware of a benefit plan that they've been enrolled in, it's incumbent on the patient to try and figure out the complexities of their dental insurance plan themselves. Even if a patient is able to find information in their dental benefit plan, there is still abundant confusion because the dental office does not have the information they also need to assess how benefits apply to services and procedures and provide accurate cost estimates. When patients encounter financial uncertainty, they may be reluctant to move forward with prescribed and necessary dental care. Sometimes urgent and emergent care may even be delayed when patients are faced with ambiguity and what the costs will be. There's also no situations where patients move forward with treatment. Sorry, there are also situations where patients move forward with treatment only to later find out that their dentist was removed from their dental benefit network without the dentist being informed of the change and the patient is left with out-of-pocket costs they didn't anticipate. This kind of uncertainty and financial strain can be avoided by simply ensuring dentists are agreeing to be a part of the dental benefit network and ensuring they are informed about the terms and conditions of those benefit networks, which is what House Bill 1070 achieves. When the dentist is aware, they can make sure those patients are also aware and informed about their options. Addressing this practice of network leasing minimizes confusion for both dentists and patients and ensures that contracts and costs for services are clear, transparent, and fair, and I ask for an vote thank you does the committee have any questions for these sponsors seeing

GOOD AFTERNOON, CHAIR MELLICA AND MEMBERS OF THE COMMITTEE. MY NAME IS MELISSA YOUNG, AND I AM THE REGIONAL VICE PRESIDENT FOR STATE RELATIONS FOR THE AMERICAN COUNCIL OF LIFE INSURERS. I APPRECIATE THE OPPORTUNITY TO TESTIFY IN AN IMPOSE POSITION FOR HOUSE BILL 1070 THE THIRD-PARTY NETWORK LEASE AGREEMENTS FOR DENTAL SERVICES. ACLI REPRESENTS 270 MEMBER COMPANIES WHO ARE DEDICATED TO PROTECTING CONSUMERS' FINANCIAL WELL-BEING THROUGH LIFE INSURANCE, ANNUITIES, RETIREMENT PLANS, LONG-TERM CARE INSURANCE, DISABILITY INCOME INSURANCE, REINSURANCE, AS WELL AS SUPPLEMENTAL BENEFITS, INCLUDING DENTAL AND VISION PLANS. WE BELIEVE THIS BILL WILL HAVE UNINTENDED CONSEQUENCES FOR CONSUMERS. By allowing dentists to essentially drop out of networks will lead to more patients paying for care directly or being out of network and not having the benefit of a negotiated rate. For demonstrative purposes, let's say a dental cleaning costs $100 and the patient assumes that the dental insurance carrier will pay 100% of the cost. But because the dentist did not opt in to that least network, the dentist does not take the patient's insurance and so the cleaning is out of network and the patient will have to pay the entire cost of that cleaning. A dentist may be in-network with Plan A, but has not opted into a lease version used by Plan B. This would lead to unexpected out-of-network charges, balanced billing, and claim denials. The benefit of network leasing is that it allows consumers to quickly access large discounted networks. As House Bill 1070 requires dentists to opt in to a dental network, dental networks will shrink, as we have seen in Oregon, which thereby limit access to care for patients and could be a concern in rural and underserved areas of our state. A smaller network inevitably leads to higher out-of-pocket costs for patients because they do not have the added benefit of a negotiated rate by the insurer. If this bill passes in its current format, House Bill 1070 is a large operational change for our members, AND AS SUCH, WE ASK THAT THE COMMITTEE DELAY THE EFFECTIVE DATE OF THIS BILL FOR A YEAR TO AUGUST OF 2027 IN ORDER TO ALLOW OUR COMPANIES, OUR MEMBERS, TO CHANGE AND UPDATE THEIR OPERATING SYSTEMS TO BE IN COMPLIANCE WITH THIS NEW LEGISLATION. THANK YOU FOR YOUR TIME TODAY AND I'D BE HAPPY TO ANSWER ANY QUESTIONS.

Thank you so much, Chairman and members of the committee. My name is Bianca Baloli, and I am here on behalf of the National Association of Dental Plans. Our members provide dental coverage to more than 200 million Americans, including thousands of Colorado families. We support transparency in dental contracting. However, we respectfully oppose House Bill 1070 because, as written, this bill would reduce access to care, increase costs, and create instability that ultimately harms consumers. Network leasing is a longstanding practice that allows one dental plan to lease another plan's provider network, which benefits everyone. Providers gain additional patience, employers can offer more affordable dental benefits, and consumers receive broader access to in-network care, as my colleague indicated from ACLI, with predictable out-of-pocket costs. The opt-in framework in this bill may sound simple, but in practice, it creates serious consumer-facing problems and real operational challenges. Under this framework, if a provider does not affirmatively respond in time because a form was missed, delayed, or routed incorrectly, that provider could fall unintentionally out of network. That may not reflect a decision to actually opt out, yet patients bear the consequences through disrupted care or unexpected out-of-network charges. This also creates significant operational burdens, as outlined, for dental plans. Carriers would be required to repeatedly follow up with providers, track individual responses, update systems, and manage network eligibility across multiple arrangements. These are unknown and potentially significant costs that create barriers to effective implementation. Importantly, no other state has adopted this type of affirmative consent requirement for network leasing. It is an untested approach that introduces unnecessary risks into a system that works today to keep dental coverage both affordable and accessible. Colorado families rely on stable provider networks, predictable costs, and access to care. House Bill 1070 places all three of these at risk. For these reasons, we respectfully urge the committee to oppose House Bill 1070. Thank you so much for your time and consideration, and I'd be happy to answer any questions.

Hi, good morning or good afternoon. Mr. Chair and committee, I'm Dr. Sarah Parsons. I'm a second generation general dentist for over 16 years and I practice in Highlands Ranch. I'm here today to ask for your support of House Bill 1070. Network leasing as it currently practiced undermines the dentist ability to provide quality care by introducing hidden contracts reduced reimbursements and confusion that harms both providers and more importantly our patients Numerous issues arise when a dentist is committed to a binding contract without their knowledge or consent. Just one of these issues is the terms and fees are set in a unilateral decision without consulting the dentist. It is wrong that both parties are not individually consenting to the contract, but the dentist is obligated to adhere to the terms. The fees the carrier elects to pay for services in many cases do not cover the overhead and cost in providing the necessary dental services. Ultimately, this directly affects patients and their access to care. Network leasing creates a widespread confusion for patients and introduces barriers that negatively affect the patient's access to dental care. Patients are frequently told by insurers or benefit administrators that a dental practice is in-network only later to discover discrepancies in coverage, reimbursement levels, or unplanned out-of-pocket costs. When a dental office is unaware of umbrella policies, they unknowingly provide a patient with inaccurate estimate of benefits and out-of-pocket expenses to no fault of the dentist. The impact of this confusion harms the patient, delaying their ability to make informed decisions about their long-term health care, creates a real probability that patients will incur greater expenses than they were expecting, and erodes the doctor-patient relationship. The reforms laid out in House Bill 1070 will protect patients, support small health care businesses like my family's second generation dental practice, and preserve access to quality care. Dentists want and need to focus on patient care, not hidden contracts, not confusion insurance practices. I appreciate Senator Judot and Senator Frizzell for bringing this bill forward, and I ask that you please vote in support of House Bill 1070. Thank you.

Thank you. Good afternoon, Chair and Committee members. My name is Dr. Lindsay Compton, and I'm a general dentist and a dental practice owner in Arvada. I'm here to support House Bill 1070 and I'm grateful for Senators Judah and Frizzell for sponsoring this important bill. As a private practice owner, I can tell you that network leasing leads to endless hours spent by my staff and I having to fix billing issues when benefits change without notice and when we struggle to keep my patients and help them understand the cost of their dental care when we don't have the full information that we need. I want to share a couple of key provisions of the bill and why they're important. This bill has an opt-in policy for network leasing. This is the affirmative consent. This means that a dentist must agree to being leased before the leasing actually happens. This is opposed to an opt-out policy where a dentist would be automatically added to a leased network and would have to find a way to opt-out. So as you can see, they're forced into a contract and then it's the burden of the small business owner to find a way out. That's what opt-out means. In states with opt-out network leasing laws, many dentists remain unaware that a lease is occurring and may not even know that they can opt out on details, and they're often buried in contracts and fine print. As small business owners, we don't have tons of administrative staff, and we don't have legal teams to comb through this and to look at contract details. Oregon did pass a network leasing law in 2023 with an opt-in policy. Despite veiled threats of negative impacts, Oregon has not seen negative impacts to dental network stability, nor have they seen dental insurance premiums rise drastically. In fact, dental premiums in Oregon have grown at a slower pace than those in Colorado. This bill also has an exemption for same-brand license programs at the bottom of page 6. This is intended for entities who operate under the same-brand license and the same name and the same policies. This is in contrast to the affiliate exemption, which has been requested. The affiliate exemption would be a much broader loophole and would allow for insurance carriers with different names, Denver contract policies to ignore the provisions of the bill. This is why there is not an affiliate exemption in this bill. To support small business dental offices and their patients, it is important that the contract process between the carrier and the dentist starts with transparency, clarity and consent from all contracting parties and that's why House Bill 1070 is so important.

three minutes to testify. Start when you're ready. Thank you so much Senator. My apologies for the tardiness. I hope it doesn't reflect badly on the bill that we're proposing. Let me start obviously by thanking all of your presence today. My name is Dr. Gaurich Kapodi. I am a nonprofit dentist. I work with a PACE organization in Colorado Springs and also serve on the board of another nonprofit that cares to veterans, individuals with disabilities, and seniors. I'm here to ask for your support for House Bill 1070. Excuse me. One factor that drove me towards non-profit work among many things were the policies of commercial insurance companies. They made it challenging to focus on dental care for my patients while I was also dealing with the complex world of insurance including issues like network leasing. Under the current status quo where network leasing is allowed without dentist consent, without giving dentist information, the burden falls on dentists and their patients to navigate it complex and unclear dental benefits. The confusion, the frustration, cost burden these leasing agreements create can erode the trust between patients and their dentist. Rather than putting the burden on dentists and patients to track down information on leasing agreements, the insurance carrier should do the work to have the contract stand on their own merits, provide direct with clear terms to the dentist that they contract with. When dentists affirmatively consent to dental insurance contracts and are fully informed about dental benefit plans, their patients have better access to clear and accurate cost and billing information, reducing the likelihood of unexpected out-of-pocket costs. House Bill 1070 is a common sense measure that minimizes confusion for both dentists and patients and ensures that contracts and costs for services are clear, transparent, and fair. I'd like to thank Senator Frizzle and Senator Joda for sponsoring this bill and I ask that you support House Bill 1070. Thank you.

Thank you. Good morning, Mr. Chair and members of committee. My name is Dr. Jillian Horkin. I'm a general dentist in Mantras and I appreciate you allowing me to testify remotely today from Western Slope, a rural and sometimes referred to as underserved area. I'm here in support of House Bill 1070. At my private practice, I experienced the complexity and lack of transparency currently created by network leasing agreements. We had an experience where the same insurance plans were covered under two different leased network agreements. Despite them being the same insurance plans, there were different contract terms and different fees depending on which leased network it was under. This was incredibly confusing and also problematic to have complete uncertainty as to which benefit coverage applied when patients had these insurance plans since the benefit coverage depended only on what leased network it was, not the difference in care and services. And this left patients confused and with unexpected bills despite being in network through network leasing. These challenges and the confusion and burden for billing made it unattainable for me to stay in network. I then sent official communication to the insurance carriers and informed my patients that I would no longer be in network so that I can make appropriate plans. I wanted to be sure that I gave my patients adequate notice and information about my decision. Yet by following the current opt-out model of network leasing, the insurance carrier that used my services through a network lease failed to process my legal request to remove myself from the network on time. This resulted in my patients being confused and frustrated as they had heard from me that I was not in network but the insurance companies continue to tell them I was in network And unfortunately that then created distrust and it was difficult for me to explain why these issues were happening The leasing network failure to acknowledge and process my request to opt out then also created a huge financial strain and burden for my small dental practice. The cost was over $30,000 to my small business and because the carrier disregarded my legal request to leave their network and provide transparency to my patients. This then created further distrust with my patients and I. The policies in this bill would prevent these unforeseen issues from happening and help prevent and protect and inform decision-making between patients and their dental provider. It would also protect small business like mine from these predatory policies. I want to thank Senator Judah and Senator Frizzell for sponsoring the bill, and I ask that you please support House Bill 1070. Thank you for your time.

Hello, I'm Dr. Jeff Lodl. Thank you. Hello, members of the committee and Mr. Chair. Thank you very much for your time today. I am a private practice dentist owner in Arvada, Colorado. I am also the president-elect of the Colorado Dental Association. I'm here today in support of House Bill 1070, and I want to thank Senator Frizzell and Senator Judah for sponsoring this bill. When the Colorado Dentist Association surveyed its members about network leasing, they were flooded with comments and specific examples, all of which had similar themes. Confusion for the dentist and patients alike, lack of transparency, lack of communication from insurance carriers, and impact of patient care when insurance benefits are not clear or changed without notice. Many dentists report that they were unaware of their contracted fees would be leased to third-party networks. When disclosure does exist, it is often buried in contracts or amendments to contracts and does not provide a clear, affirmative opt-in opportunity to the dentist. I would also like to confirm what Dr. Lindsay Compton reported on, that Oregon has already passed an opt-in bill. I know one of our opposition people said that no state has passed it, but Oregon has already passed an opt-in bill. As a result, many dentists may unknowingly become in-network with entities that they never agreed to contract with. This lack of transparency undermines fair contracting practices and deprives small business dental providers of the ability to make informed business decisions. This also undermines our ability to provide accurate treatment plan estimates to our patients. When we don't have updated insurance information and estimates are wrong, it can cause patients to not get the treatment that they actually need. While that may help insurers with their bottom line, it doesn't help our patients who need dental care. I have experienced these issues myself with multiple carriers in my office. Dental offices spend countless hours trying to identify leased networks, correcting billing errors, disputing payments. All this adds to increased costs and complexity that takes away from patient care time for ourselves and our staff. It places an undue burden and strain on small health care practices. When dentists have control over their network participation, they can focus on patient care rather than managing unauthorized access to their practice agreements. I appreciate your time today, and I ask you to support House Bill 1070. Thank you.

Thank you, Mr. Chair. Dr. Compton, you mentioned Oregon. um i heard oregon twice and apparently they've put some policies in place here regarding network leasing um and so that makes me wonder if there's more of a national effort underway on this if you've seen sort of a national trend here dr compton exactly uh so you

senator bright okay thank you mr chair um so this would colorado would be the second state

witnesses seeing none thank you so much for being here members that exhausts the list uh before me

Senator Frizzell. Thank you. Thank you, Mr. Chair and committee members, and thank you for your time this afternoon. I'd like to definitely extend my appreciation or our appreciation to those witnesses who took time out of their day to come and talk about this bill. House Bill 1070 is going to add some much-needed clarity and transparency to insurance contracting for dental services. I think you heard just a few examples here today of why this is a problem. This is really important for dentists to have a say in what dental benefit plans they will be part of. and really important for patients to know that they're getting accurate and reliable cost estimates for dental services based on their benefit plans. And I did hand out a fact sheet, and my apologies for not getting it to you at the beginning of our time together today, but there have been 32 states that have passed network leasing legislation. Oregon's is just the one that is most similar to what we're talking about here with the, because the others, generally speaking, have the opt-out language. This is kind of the opposite of that, where dentists have that affirmative language that is part of the spell. So I'd be very grateful for your yes vote today, and thank you for your time.

Madam Vice Chair. Thank you, Mr. Chair. I also want to echo my co-primes sentiments. One thing that I would like to say is this bill is about patient protection and making sure that they have transparency and clarity about what they are covered, how they're covered, and who they're covered by. And so I passed a bill similar to this a few years ago, and I couldn't believe the stories that came out of, I made an appointment, and I went to this appointment only to find out my dentist was not in my network anymore. Sorry, my provider was not in my network anymore. I certainly don't want to see this happen here, and I don't want that to happen to dentists, and I want to make sure patients understand when they go into their dentist's office, they are covered, and that they can get the procedure that they need. And again, we all know that sometimes ignoring your dental care can lead to much bigger things, and we don't want our chair to be seeing them in the emergency room. Thank you for that. With that, I ask for an aye vote.

Senator Frizzell. Thank you, Mr. Chair. I move House Bill 1070 to the Committee of the Whole with a favorable recommendation, an ecstatically favorable recommendation.

Senators Bright. Aye.

Frizzell. Aye.

Judah. Aye.

Senator Frizzell. Thank you, Mr. Chair. I recommend this bill be placed on the consent calendar.