Rep. Gretchen Rydin

The act makes changes to requirements for preventive care coverage by health insurers for breast cancer screening, including: Relocating in statute the high-risk breast cancer screening requirements; Defining and specifying criteria for the use of diagnostic breast examinations and supplemental breast examinations; and Clarifying that, in addition to regular breast cancer screening, diagnostic and supplemental breast examinations that are medically necessary and conducted within nationally recognized screening guidelines do not require cost sharing by the patient.(Note: This summary applies to this bill as enacted.)

The act creates the provider stabilization fund for use by Colorado department of health care policy and financing (department) to distribute provider stabilization payments to safety net providers who provide services to low-income, uninsured individuals on a sliding-fee schedule or at no cost. Provider stabilization payments will be distributed to eligible safety net providers based on the proportion of low-income, uninsured individuals that an individual provider serves in comparison to the total number of low-income, uninsured individuals served by all eligible safety net providers. The state treasurer is directed to make an interest-free loan of interest earnings on the principal in the unclaimed property trust fund (UPTF) and, if the interest earnings are insufficient, from the principal of the UPTF as well, to the provider stabilization fund as follows: $25 million for the 2025-26 state fiscal year; $20 million for the 2026-27 state fiscal year; and $15 million for each of the 2027-28, 2028-29, and 2029-30 state fiscal years. The act specifies that the loan from the UPTF to the provider stabilization fund is an interfund loan that is not classified as revenue, is booked as an interfund receivable or payable, is not state fiscal year spending or state revenues, and does not count against the state fiscal year spending limit or the excess state revenues cap. The department is directed to repay the loan by January 1, 2045, but in any year in which state revenues do not exceed the limit on state fiscal year spending, the department must present to the joint budget committee a proposal to repay all or a portion of the loan at an earlier time, and to the extent possible, the general assembly must prioritize repaying the loan starting in the 2030-31 state fiscal year or sooner if funds are available. The provider stabilization fund also consists of any money the general assembly appropriates, transfers, or credits to the fund and any gifts, grants, or donations the department may receive for the fund. The act directs the department to leverage money in the provider stabilization fund to obtain federal matching money. The act establishes a provider stabilization fund advisory board (advisory board) to assist the department in implementing and administering the provider stabilization fund. The department, with assistance from the advisory board, is required to submit an annual report on the provider stabilization fund to specified committees, the governor, and the medical services board in the department. The advisory board is scheduled for repeal on September 1, 2031, and is subject to a sunset review by the department of regulatory agencies before the repeal. The act appropriates $25,000,000 from the provider stabilization fund to the department to implement the act, allocated as follows: $138,505 for personal services to administer the act, including 2.0 FTE; $15,900 for operating expenses; and $24,845,595 for provider stabilization payments to eligible safety net providers.(Note: This summary applies to this bill as enacted.)

No later than October 1, 2025, the act requires the department of human services (state department), in consultation with the works allocation committee, to: Develop a standardized process for each county to collect and report to the state department on a monthly basis certain information about the Colorado works program; Develop recommendations that include a menu of standardized outcome measures and required levels of evidence for third-party contracted services funded with Colorado's temporary assistance for needy families (TANF) allocation; and Submit a report to the joint budget committee (JBC) that includes a description of the standardized process and recommendations. Beginning January 1, 2026, and each January thereafter, the act requires the state department to submit a report to the JBC that includes the information collected and reported through the standardized process and the total dollar amount of Colorado's TANF allocation that is redistributed through the state budget or other programs and services and publish the information on a monthly basis on the state department's website in a publicly accessible format. No later than July 1, 2026, the act requires the state department to submit a report to the JBC that includes certain information related to the standard of need for eligibility for basic cash assistance. For the 2025-26 state fiscal year, the act appropriates $154,000 to the department of human services for use by the office of economic security to conduct the works program evaluation. (Note: This summary applies to this bill as enacted.)

Infusion pharmacies supply medicaid members with parenteral nutrition, which provides patients with essential nutrients through an intravenous infusion. The act requires the state department of health care policy and financing (state department) to create specific professional dispensing fees for the preparation and dispensing of parenteral nutrition (fees) to encourage an adequate level of market participation among infusion pharmacies that serve medicaid members. During the year beginning January 1, 2026, the fees must not exceed 30% of infusion pharmacy administrative costs for the preparation and dispensing of parenteral nutrition. The state department shall seek federal authorization, as necessary, to implement the fees. The act requires the state department to annually report on the adequacy of the infusion pharmacy network that supplies parenteral nutrition to medicaid members. For the 2025-26 state fiscal year, the act appropriates $54,832 to the state department from the general fund. The state department may use the appropriation for medical and long-term care services for medicaid-eligible individuals. The general assembly anticipates that the state department will receive an equal amount in federal funds to implement the act. (Note: This summary applies to this bill as enacted.)

The act amends statutory provisions relating to unused medication in facilities, including correctional facilities, nursing care facilities, assisted living residences, hospice, and other facilities, to change the defined term "medication" to "medicine" and specifies the types of unused medicines that may be redispensed to patients or donated to another entity that has legal authority to possess the medicine. The act creates the Colorado drug donation program (donation program). The donation program allows a person legally authorized to possess medicine, including an individual donor who is a member of the public and other donors, including a pharmacy, a long-term care facility, a surgical center, a prescriber or other health-care professional or facility, a wholesaler, a distributor, a third-party logistics provider, and others (donor), to donate certain unused medicine (donated medicine), as specified in the act. The act prohibits the donation of prescription drugs that are subject to risk evaluation and mitigation strategies (REMS), unless all of the required guidelines are followed, or REMS drugs that were initially dispensed by a pharmacy pursuant to a restricted distribution channel. A donor or an individual donor may donate unused medicine to a donation recipient that is authorized to possess medicine and that has a credential in good standing in the state in which the donation recipient is located. A donation recipient includes a hospital, pharmacy, clinic, health-care provider, or prescriber office, and may include a wholesaler, distributor, third-party logistics provider, reverse distributor, or repackager if the entity is a nonprofit entity or is directly or indirectly owned, controlled, or could be controlled by a nonprofit entity. The act requires the donation recipient to keep a record of the donated medicine, separate the donated medicine from regular stock, and have donated medicine inspected by a licensed pharmacist. The donation recipient may transfer the donated medicine to another donation recipient or entity, repackage the donated medicine, or, if the donation recipient is a prescription drug outlet or other outlet, replace medicine of the same drug name and strength. The act requires donated medicine to first be dispensed to an eligible patient who is an individual who is indigent, uninsured, or underinsured. Donated medicine must not be resold; except that a donation recipient may charge a handling or dispensing fee for the donated medicine. When acting in good faith, the participants in the donation program are not subject to civil or criminal liability or professional disciplinary action. The act also shields drug manufacturers from liability for donated medicine that is subject to REMS under federal law. (Note: This summary applies to this bill as enacted.)

The act authorizes the department of health care policy and financing (HCPF) to seek and accept gifts from private or public sources for the primary care fund. The act authorizes a federally qualified health center (FQHC) to establish a separate subsidiary company for the purpose of providing fee-for-service services outside of the FQHC's standard cost report if the subsidiary is providing fee-for-service services that have historically been provided and reimbursed on a fee-for-service basis and if HCPF determines that the subsidiary's reimbursements would be budget neutral. Upon receiving any necessary federal authorization, HCPF is required to reimburse a subsidiary of an FQHC on a fee-for-service basis for services that are eligible for fee-for-service reimbursement. A subsidiary that receives reimbursement is authorized to pass through money received from the reimbursement directly to the FQHC operating as the subsidiary's parent corporation. Services reimbursed to an FQHC's subsidiary are excluded from the FQHC's cost report. The act requires HCPF to exclude all costs associated with a subsidiary company from the calculation of a FQHC's reimbursement rates and requires a FQHC that establishes a separate subsidiary company to include the costs associated with the subsidiary in its cost report that is necessary to calculate reimbursement rates. (Note: This summary applies to this bill as enacted.)

On or after July 1, 2025, the act requires a person, before commencing a project to install or substantially repair a contiguous fence of at least a specified certain size in the Sangre de Cristo land grant lands (covered fencing project), to submit an application for the covered fencing project to the local government with jurisdiction over the covered fencing project (application) if the local government has opted into the act's requirements. No later than 14 days after the local government's receipt of an application, the local government must publish notice of the application on the local government's website. No later than 60 days after the local government's receipt of an application, the local government must either approve or reject the application based on certain criteria; except that, despite the criteria, a local government may approve an application if it determines that the benefits of the covered fencing project outweigh the harms. If the local government finds that a covered fencing project presents no significant environmental impacts, then the local government shall not require a person commencing the covered fencing project to submit an application or pay a fee. The act does not apply to a covered fencing project that is necessary for a public utility or department of transportation project, an energy sector public works project, the safety or security of a public school or prison, or fences provided by the division of parks and wildlife. (Note: This summary applies to this bill as enacted.)

The Tony Grampsas youth services grant program (grant program) provides grants to community-based programs to reduce incidents of youth crime and violence. The youth mentoring program, the student dropout prevention and intervention program, and the student before-and-after school project (collectively, the "programs") were created within the grant program. The act repeals the individual programs and instead lists the programs as allowable uses for grant money under the grant program. The act transfers certain responsibilities from the Tony Grampsas youth services board (board) to the department of human services (department). The act repeals local public-to-private funding match requirements. The act requires each entity that receives a grant to annually report certain information to the department; except that an entity that has an operating budget of less than $1.5 million, or that receives a grant in the amount of not more than $25,000, is not required to report on the outcomes achieved by the services provided and the methods used to track the outcomes. The act decreases the appropriation from the marijuana tax cash fund to the youth mentoring services cash fund by $500,000 and reappropriates the money to the grant program by $500,000. The act decreases the appropriation from the youth mentoring services cash fund to the grant program by $504,120. (Note: This summary applies to this bill as enacted.)

The statewide welcome, reception, and integration grant program provides grants to community-based organizations that provide culturally and linguistically appropriate navigation of services to migrants who have arrived in the United States within the past year and do not qualify for federal support services or refugee resettlement assistance benefits. The act removes the requirement that a migrant must have arrived in the United States within the past year and instead requires community-based organizations to prioritize assisting migrants who have arrived in the United States within the past 3 years. (Note: This summary applies to this bill as enacted.)

The act implements the recommendation of the department of regulatory agencies in the department's 2024 sunset report that the title insurance commission be repealed. The act also requires the commissioner of insurance to hold twice each year a meeting of representatives of the title insurance industry, who are referred to as the "title insurance advisory group" (advisory group). The commissioner or the commissioner's designee must attend each of the 2 meetings, and the commissioner must respond in writing to formal, written proposals or recommendations presented to the commissioner by the advisory group at a meeting. The advisory group is repealed, effective September 1, 2029, subject to a sunset review. (Note: This summary applies to this bill as enacted.)