The bill states that the Colorado prescription drug affordability review board has no authority to perform an affordability review of, or to establish an upper payment limit for, a prescription drug that is:Designated as a drug for a rare disease or condition by the food and drug administration (FDA) of the federal department of health and human services; orA licensed biological product that is derived from human whole blood or plasma as indicated on product labeling approved by the FDA.(Note: This summary applies to the reengrossed version of this bill as introduced in the second house.)
Section 2 of the act repeals a requirement that health-care profession regulators adopt rules that require each licensed health-care provider, as a condition of renewing, reactivating, or reinstating a license, to complete up to 4 credit hours of training per licensing cycle in order to demonstrate competency regarding topics related to prescribing drugs and treatment. Section 3 authorizes the Colorado dental board to adopt rules that require every dentist, dental therapist, and dental hygienist, as a condition of renewing, reactivating, or reinstating a license, to complete up to 4 credit hours of training per licensing cycle regarding topics related to prescribing drugs and treatment. Section 4 requires a licensed veterinarian to complete at least 1 hour of training per renewal period regarding topics related to prescribing drugs and treatment. Section 5 changes the frequency at which specific health-care facilities are required to apply for a license issued by the department of public health and environment from annually to every 2 years. Under current law, a health-care facility is required to screen each uninsured patient for eligibility for public health insurance programs and discounted care (screening) utilizing a single uniform application developed by the department of health care policy and financing (state department). Sections 6 through 11 change this requirement by:Changing the method used to conduct the screening from a uniform application to use of a third-party resource, such as a major credit bureau, or use of a uniform screening questionnaire (questionnaire) developed by the state department;Allowing a health-care facility the option of screening a patient for eligibility for the health-care facility's financial assistance program;Requiring a health-care facility to provide specified notifications upon completion of the screening;Creating an application for discounted care (application) for use by a health-care facility upon completion of the screening through which additional information is requested from a patient to determine whether the patient qualifies or is likely to qualify for public health-care coverage or discounted care;Requiring a health-care facility to provide specified notice and appeal rights to a patient upon completion and review of the application; andRequiring the state department to adopt rules regarding the questionnaire and application. Section 11 also narrows state department review requirements of health-care facilities' and licensed health-care professionals' billing for patients who are indigent. The act prohibits the state department from making changes to regulatory documents or imposing new requirements unless the changes or new requirements are adopted by rule by specified dates and are subject to stakeholder engagement. Section 12 requires the state department to establish by rule the content and format of the information each hospital must provide to the state department for a hospital transparency report at least 30 days prior to the hospital's fiscal year. The act changes the deadline for a hospital to submit to the state department an annual audited financial statement from 120 days to 150 days after the end of the hospital's fiscal year. Current law requires that each hospital has a minimum of 15 days to review the hospital transparency report; the act specifies that the review period is 15 business days and requires that a statewide hospital association must also have a minimum of 15 business days to review the report.(Note: This summary applies to this bill as enacted.)
If certain conditions are met, the act requires health benefit plans that provide hospital, surgical, or medical expense insurance to provide reimbursement for health-care services provided by a pharmacist that are within the pharmacist's scope of practice without entering into a collaborative pharmacy practice agreement. Similarly, under the medical assistance program (medicaid), the act authorizes reimbursement for services that are within a pharmacist's scope of practice and not duplicative of other pharmacist services or programs reimbursed by medicaid. Further, solely on the basis of the type of license or certification, a health benefit plan or health insurance company (carrier) shall not discriminate against a pharmacist who is acting within the scope of the pharmacist's license or certification under state law, with respect to participation, referral, reimbursement of covered services, or indemnification, or prohibit a pharmacist from membership in a provider network; except that, in selecting pharmacist providers, the act does not:Prohibit a health benefit plan or carrier from including providers in its provider network only to the extent necessary to meet the needs of the plan or from limiting referrals or establishing quality control measures;Require a health benefit plan or carrier to contract with any provider willing to abide by the terms and conditions for participation established by the health benefit plan or carrier; orRequire coverage for any health-care service that is not otherwise covered. The act makes changes to the definitions in the pharmacy practice statutes to include a definition for 'final product verification'. For drug, device, or product orders that are not for controlled substances, final product verification may be delegated by a supervising pharmacist to a certified pharmacy technician or pharmacy intern. A pharmacy or other outlet shall have a continuous quality assessment system in place to periodically verify the accuracy of the final drug, device, or product and must create a plan for final product verification, including how pharmacists' hours will be maintained to provide direct patient care. The state board of pharmacy is required to adopt rules relating to final product verification no later than December 31, 2026. Under current law, a pharmacist may administer certain tests to patients who are 12 years old or older for certain conditions and prescribe drugs to treat the tested conditions. The act adds to the definition of the 'practice of pharmacy' independent prescriptive authority for drugs that are not controlled substances, drug categories, or devices that are prescribed to patients who are 5 years old or older but under 12 years old for conditions that do not require a new diagnosis, that are minor and self-limiting, or that have a test that guides diagnosis and are not medications that may only be prescribed pursuant to a certified education program and a limited distribution network. If a pharmacist tests or treats any patient who is under 18 years old, the act requires a pharmacist to notify the patient's primary care provider consistent with health-care privacy laws or, if the patient does not have or disclose a primary care provider, refer the patient to a primary care provider for further care.(Note: This summary applies to this bill as enacted.)
The act requires the nonemergency medical transportation broker (broker) to establish the transportation community advisory board (TCAB) and requires the state department of health care policy and financing (state department) to collaborate with the TCAB prior to establishing rules and processes for the safety and oversight of nonmedical transportation services and nonemergency medical transportation (NEMT) services. The act requires, in collaboration with the TCAB, certain rules for NEMT the state department must adopt. The state department may impose trip caps or market-share restrictions on a transportation provider (provider) as part of corrective action plan. The act requires providers to use vehicles equipped with 2-way video cameras and a video recording system when transporting members. The act establishes how the broker must roll out their implementation and requires the broker to provide all providers with software, a communication toolkit, training, and technical assistance to facilitate NEMT services. The broker may encourage medicaid members (members) to book transportation services at least 2 days before their requested transportation date, and the broker shall accept and make reasonable efforts to fulfill same-day and next-day transportation requests. The act requires providers, only after all service regions have been implemented, to accommodate member requests for preferred or alternate drivers when operationally feasible. The act requires the broker, and, if there is no broker, the providers to verify that individuals using the transportation services are eligible members during the scheduling of transportation services. The act prohibits the broker from operating, owning, or controlling a provider in Colorado. The act requires the broker to provide their trip assignment rules and procedures to the state department for approval and for publication on the state department's website. The act allows a transportation network company to provide NEMT services when a provider is unavailable. The state department shall ensure all transportation providers, drivers, and vehicles are credentialed, and services provided by noncredentialed drivers or in noncredentialed vehicles are not eligible for reimbursement. The act prohibits the state department from denying payment of services to providers if the provider provides scheduled transportation services in good faith based on the information provided by the broker or if the provider had no knowledge of an inaccuracy and the provider followed all applicable rules and procedures. Subject to available appropriations, the act requires the state department to audit providers and audit the broker annually. The act requires the state department to categorize all NEMT expenditures as medical services and make changes to the NEMT program as necessary to obtain medical services federal match rates for NEMT services. The act also eliminates the requirement that the state department provide transportation services as an administrative cost. The act reduces appropriations to the state department from the general fund by $76,639 and from the healthcare affordability and sustainability hospital provider fee cash fund by $20,941,853.(Note: This summary applies to this bill as enacted.)
The act requires an institution of higher education (institution) that operates a student health center to provide abortion medication to all students enrolled at the institution. The act requires an institution that has an on-site prescription drug outlet or other outlet to maintain a stock of and provide access to abortion medication to students enrolled at the institution. The act requires an institution that does not have an on-site prescription drug outlet or other outlet to either submit a prescription for abortion medication to an off-campus prescription drug outlet or other outlet or dispense abortion medication through the institution's student health center if permitted by the student health center's licensure. The act prohibits an institution from knowingly providing personally identifiable information contained in a student's patient records, billing records, or precise location data related to accessing abortion medication in response to a request from another state seeking to impose liability for accessing abortion medication. An institution is not required to provide access to or stock abortion medication if doing so would jeopardize an institution's federal grant participation, require the institution to deviate from generally accepted billing practices, modify the generally accepted standards of medical practice, or conflict with the institution's sincerely held religious beliefs or practices.(Note: This summary applies to this bill as enacted.)
The bill creates the large employer health-care support enterprise (enterprise) to impose, assess, and collect the large employer health-care support fee (enterprise fee) in the amount of $2,300 for each supported worker for the calendar year in an amount determined by the enterprise board (enterprise board) that reflects the costs of the services provided by the enterprise . A worker who is receiving medical assistance benefits under the state medical assistance program, except for a worker eligible for medical assistance benefits based on disability, is a supported worker (supported worker). An employer is subject to the enterprise fee if the employer is a large employer, which is defined in the bill as an employer that has 500 or more supported workers (large employer). An employer is exempted from paying the enterprise fee if the employer:Provides affordable health coverage to all workers working 20 or more hours per week or 80 or more hours per month;Is a franchisee of the employer;Is a nonprofit employer;Is a public employer; orHas a collective bargaining agreement with its employees that includes health-care coverage. The business purpose s of the enterprise are to use enterprise fee revenue to help large employers retain supported workers who are not provided employer-sponsored affordable health coverage by using enterprise fee revenue to:Help finance the costs for medical assistance benefits for large employers' supported workers ; and Provide reimbursement grants to large employers for some or all of an employer's costs incurred for allowing a worker to buy into an employer-sponsored health benefit plan, should the employer choose to participate in the worker buy-in program created in the bill.This These business service s reduce s lost productivity due to worker illness and training costs to replace workers who may otherwise seek employment that provides affordable health coverage. Starting with a review of the 2027 calendar year, the department of health care policy and financing (HCPF) every employer that employed 500 or more workers in the state shall prepare an annual employer report on or before January 31, 2028, and on or before the same date each year thereafter, that includes information about the employer's employees, including the employee's name, date of birth, hours worked, and dates of employment for the preceding calendar year. An employer may seek an exemption from the requirement to file the annual employer report by demonstrating that it provides affordable health coverage to all workers working 20 or more hours per week or 80 or more hours per month. Upon receipt of the annual employer report, the enterprise shall determine whether an employer is a large employer and shall issue a report by March of the following same calendar year that identifies large employers by their number of supported workers for the preceding calendar year and impose the enterprise fee on each large employer . An employer may contest the employer's identification as a large employer. Once identified, a large employer shall either pay the enterprise fee for each of the large employer's supported workers or demonstrate that it provides will offer affordable health coverage to all workers working 20 or more hours per week or 80 or more hours per month. The enterprise may adjust the amount of the enterprise fee to reflect the cost of the services, for inflation, or for other reasons. A large employer commits a petty offense and is subject to a civil penalty for The enterprise shall contract with the department of revenue to collect and enforce the payment of the enterprise fee on behalf of the enterprise, including the failure to provide information necessary to calculate the enterprise fee or to either timely pay the enterprise fee or demonstrate that the large employer offers affordable health coverage as specified in the bill. The department of revenue may collect interest and penalties and institute collection actions on behalf of the enterprise. Enterprise revenue is used to support the pay for payment of medical assistance benefits for working-age adults under the state medical assistance program, and to increase reimbursement rates for ensure access to health-care providers providing medical assistance program services, to ensure worker access to medical services and to pay for large employer reimbursement grants under the worker buy-in program for large employers that pay the enterprise fee. The enterprise is governed by the enterprise board, and the enterprise board shall report annually to the general assembly on the enterprise revenue and the enterprise's use of the enterprise revenue in support of large employers. If the enterprise determines that the enterprise to would receive more than $100 million dollars in its first 5 fiscal years, the state treasurer shall credit the additional fee revenue to the large employer fee cash fund created in the state treasury for administration by HCPF, and that fee revenue is subject to the state fiscal year spending limit imposed by section 20 of article X of the state constitution and the excess revenues cap. The money in the large employer fee cash fund shall be used by HCPF to pay for costs for medical assistance benefits to support large employers' supported workers enterprise shall reduce the amount of the enterprise fee.(Note: Italicized words indicate new material added to the original summary; dashes through words indicate deletions from the original summary.)(Note: This summary applies to the reengrossed version of this bill as introduced in the second house.)
The act allows an injured person to bring a cause of action for claims of injury caused by sexual orientation or gender identity change efforts (efforts) against a licensed mental health professional and allows the cause of action to be commenced at any time without limitation. Specifically, the act applies to a civil cause of action brought against a licensed mental health professional who seeks to direct a patient toward a predetermined sexual orientation or gender identity outcome or eliminate or reduce sexual or romantic attractions or feelings toward individuals of a particular sex or gender. The act permits the injured individual, or the individual's personal representative or estate if the individual is deceased, to recover economic, noneconomic, and exemplary damages, and any other damages deemed appropriate by the court. A cause of action may be brought as a survival action within 5 years after the death of the person who underwent efforts.(Note: This summary applies to this bill as enacted.)
On and after July 1, 2027, a manufacturer of a hair relaxer product or a hairpiece product (covered hair product) is prohibited from selling or distributing a covered hair product in the state that contains an intentionally added carcinogen or reproductive toxicant unless the covered hair product has a warning label that notifies the consumer that the covered hair product contains an intentionally added carcinogen or reproductive toxicant, which warning label must comply with certain requirements depending on whether the covered hair product contains an intentionally added carcinogen, an intentionally added reproductive toxicant, or both (warning label requirement). The warning label requirement does not apply to a covered hair product that is sold or distributed to a commercial entity for professional use. On and after July 1, 2028, the attorney general may adopt rules updating the warning label requirement. A violation of the warning label requirement constitutes a deceptive trade practice.(Note: This summary applies to this bill as enacted.)
The bill makes it an unfair or deceptive trade practice under the "Colorado Consumer Protection Act" for a facility or medical practice providing cosmetic, aesthetic, wellness, longevity, or lifestyle treatments involving the administration or use of prescription drugs, including injectable and sterile drug products (medical spa), to:Acquire or receive a prescription drug from a person not legally authorized to distribute or transfer the prescription drug;Fail to store, handle, prepare, or administer a prescription drug in accordance with manufacturer requirements, applicable federal and state law, or generally accepted standards of medical practice;Permit an individual to prescribe or administer prescription drugs outside the scope of the individual's state-issued credential;Fail to maintain reasonable safeguards to prevent contamination, diversion, theft, or misuse of prescription drugs;Represent that a prescription drug is safe or effective in a manner inconsistent with federal law or federal food and drug administration-approved labeling; has sponsorship, approval, characteristics, ingredients, uses, or benefits that it does not have; or is approved by the federal food and drug administration when it is not;Fail to designate a licensed health-care provider with prescriptive authority to provide clinical oversight of prescription drugs used at the medical spa; orFail to create, maintain, or produce to the attorney general or a district attorney records of serious adverse events involving patients.The attorney general or a district attorney may enforce a violation of a prohibited action specified in the bill. The attorney general may adopt rules to implement the bill.(Note: This summary applies to this bill as introduced.)
The act provides that, if the action is undertaken in accordance with applicable federal and state law:A licensed person may compound a drug or device in the state;A state-licensed pharmacy or a distribution facility registered with the federal food and drug administration (licensed 503B outsourcing facility) may supply a compounded drug or device to a licensed health-care provider, pharmacy, facility, or organization; andA licensed health-care provider, pharmacy, facility, or organization may obtain, dispense, or administer a compounded drug or device supplied by a state-licensed pharmacy or a licensed 503B outsourcing facility. In addition, the act prohibits the state board of pharmacy from adopting rules that are more restrictive than federal or state law regarding the compounding of drugs or devices by licensed 503B outsourcing facilities. Current law exempts drugs that are intended solely for investigational use by experts qualified by scientific training and experience and that are plainly labeled for investigational use only from the sales and delivery prohibition for new drugs. The act also exempts from the prohibition:Drugs that are reviewed by an institutional review board and plainly labeled for investigational use only; andCompounded drugs and devices if the compounding of the drug or device is undertaken in accordance with applicable federal and state law.(Note: This summary applies to this bill as enacted.)
