Healthcare (Substance Abuse)

The bill establishes the adult mental health services program (program) to facilitate access for adults to mental health services, including substance use disorder services, and to respond to identified mental health needs. The program reimburses providers for up to 6 mental health sessions with an adult and may provide additional reimbursement, subject to available money. The adult mental health program enterprise (enterprise), created in the bill, creates, operates, and funds the program. The enterprise is required to enter into an agreement with a vendor to create or use an existing website or web-based application as a portal that is available to adults and providers to facilitate the program. The department of human services is required to annually report to the general assembly about the program.The bill establishes the internet-enabled mental health access grant program (grant program) to award grants to entities that use the internet to facilitate mental health services. The enterprise administers the grant program. The enterprise shall annually report to the health and human services committees of the house of representatives and the senate about the grant program.The bill creates the mental health services enterprise as a government-owned business within the behavioral health administration for the business purpose of imposing and collecting a surcharge on internet service account holders in Colorado and to use the surcharge revenue to create, operate, and fund the adult mental health services program and internet-enabled mental health access grant program. Each internet service provider shall collect from its account holders located in Colorado the mental health services access surcharge and remit the surcharge to the enterprise.(Note: This summary applies to this bill as introduced.)

The act requires the department of health care policy and financing and the behavioral health administration to publish on each department's website an easily accessible list of secure transportation providers that have contracts with managed care entities and behavioral health administrative services organizations, as applicable.(Note: This summary applies to this bill as enacted.)

The act requires a health insurance carrier that provides prescription drug benefits to require that:The utilization review requirements, including prior authorization and step therapy, for a non-opioid drug prescribed and approved by the federal food and drug administration (FDA) for the treatment or management of chronic or acute pain (non-opioid pain management drug) are no more restrictive than the least restrictive utilization review requirements for opioid drugs prescribed for the treatment or management of chronic or acute pain; andThe cost-sharing, copayment, or deductible for a non-opioid pain management drug is not greater than the cost-sharing, copayment, or deductible for an opioid drug prescribed for the treatment or management of chronic or acute pain.     The act requires each individual and small group health benefit plan issued or renewed on or after January 1, 2027, and each large employer health benefit plan issued or renewed on and after January 1, 2028, to ensure there is at least one non-opioid pain management drug available as a clinically appropriate alternative for an opioid pain management drug. If the division of insurance determines that coverage for a non-opioid pain management drug offered by individual and small group health benefit plans requires state defrayal of the cost of coverage, the requirement to make a non-opioid pain management drug available is inoperative.     The state employee health benefit plan is excluded from the requirements of the act.     The act appropriates $15,415 to the department of regulatory agencies for use by the division of insurance to implement the act.(Note: This summary applies to this bill as enacted.)