Sen. Janice Marchman

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.)

Current Colorado laws do not always expressly provide whether the laws apply to the Southern Ute Indian Tribe or the Ute Mountain Ute Tribe (Tribes). The act creates a rule of construction that a law does not apply to the Tribes unless the law clearly and expressly states that the law applies to the Tribes. The act further clarifies that if the general assembly enacts a new law or materially amends an existing law that is silent as to its application to the Tribes or to tribally controlled entities; purports to apply statewide; or grants a governmental agency or entity civil, criminal, or regulatory authority, it is presumed that the law does not apply within the exterior boundaries of the reservations to the Tribes, including the Tribes' officials and employees acting in their official capacities, to a tribally controlled entity, or to Tribal lands. The act reinforces that these rules of construction do not: Preclude or limit the authority of the Tribes' governing bodies from requesting inclusion in legislation pending before the general assembly; Abrogate the sovereign immunity of the state or the Tribes; or Affect the rights of the state, the Tribes, or other persons to pursue legal remedies that may be available to contest the application of laws passed by the general assembly.(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.)

The act implements recommendations made by the direct care workforce stabilization board (board) by: Requiring the board to investigate health-care benefits for the direct care workforce; Requiring the department of labor and employment (department) to collaborate with the board and other entities to establish a comprehensive "know your rights" training for direct care workers; Requiring the department to ensure that the "know your rights" training is available to direct care workers, to allow worker organizations to participate in the training free of charge, and to report direct care worker training completion information to the board; and Requiring direct care employers to document each direct care worker's completion of the "know your rights" training. The act also requires the director of the division of labor standards and statistics (director) in the department to provide compliance assistance to direct care employers and investigate possible violations by the direct care employers. The director is also required to enforce compliance with the requirements in the act. To implement the board's recommendations, the act also requires the department of health care policy and financing to: In collaboration with the board, establish a website and communication platform for direct care workers and develop a direct care worker-specific notice of rights for direct care employers; Collaborate with direct care employers to inform direct care workers about the website and communication platform; and Allow specified entities access to the contact information of each direct care worker enrolled in the communication platform. For the 2025-26 state fiscal year, the act appropriates $120,105 to the department of health care policy and financing based on an assumption that the department of health care policy and financing will receive certain federal funding. Also for the 2025-26 state fiscal year, the act appropriates $168,459 to the department of labor and employment for use by the division of labor standards and statistics. (Note: This summary applies to this bill as enacted.)

The act prevents a pharmacy benefit manager (PBM) from prohibiting a rural independent pharmacy from using a private courier or a delivery service to deliver a prescription drug to a patient. A PBM is required to reimburse a rural independent pharmacy for a prescription drug in an amount not less than the national average drug acquisition cost for the dispensed prescription drug ingredients, plus pay a dispensing fee. When a PBM conducts an audit of a rural independent pharmacy and the audit results in a recoupment of more than $1,000 or a penalty of more than $1,000, the PBM must: Electronically notify the rural independent pharmacy of the rural independent pharmacy's rights to appeal at least 30 days before the recoupment of funds; If the rural independent pharmacy does not respond to the electronic notification within 30 days after the electronic notification, again electronically notify the rural independent pharmacy of the rural independent pharmacy's rights to appeal at least 30 days before the recoupment of funds; and If the rural independent pharmacy does not respond to the second electronic notification within 30 days after the second electronic notification, serve process on the rural independent pharmacy notifying of the rural independent pharmacy's rights to appeal at least 30 days before the recoupment of funds. The act allows a rural independent pharmacy to operate without being under the direct charge of a pharmacist if the initial interpretation and final evaluation of the prescription is done by a state-licensed pharmacist in person or remotely. (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.)

The act extends the achieving a better life experience state income tax deduction (ABLE deduction) until December 31, 2030. The act specifies that the purposes of the ABLE deduction are to provide support to individuals with disabilities and their families and to provide an incentive for individuals with disabilities and their families to set aside money in an account to cover future disability-related expenses. (Note: This summary applies to this bill as enacted.)

Under current law, certain provisions are required in a public school contract (contract), and if the provisions are omitted from a contract, the law deems that the provisions are automatically included in the contract. The act clarifies that the list includes that a contractor is required to comply with accessibility standards adopted by the office of information technology for an individual with a disability. The act adds a provision to the list to require a contractor to indemnify, hold harmless, and assume liability on behalf of a public school contracting entity, the public school, and the public school's employees and agents, for all remedies for noncompliance with standards that ensure technology accessibility to persons with disabilities. The act requires that a contract or agreement entered into between a state agency or public entity and a contractor must require a contractor to comply with accessibility standards adopted by the office of information technology for an individual with a disability. Additionally, the contractor must indemnify, hold harmless, and assume liability on behalf of a state agency or public entity's officers, employees, and agents for all remedies for noncompliance with standards that ensure technology accessibility to persons with disabilities. If the provisions are omitted from a contract, the law deems that the provisions are automatically included in the contract. (Note: This summary applies to this bill as enacted.)

For alternative education campuses (AECs), the act: Directs the department of education (department), when administering state education grants, to allocate priority points to AECs; Authorizes AECs to include certain high-risk students in the AEC's pupil count who are 21 years of age or younger during the budget year; Requires the department to prepare and post an annual report on enrollment trends, student demographics, and student mobility in AECs; and Exempts an AEC from losing its designation due to a fluctuation in enrollment for one school year. The act appropriates $9,613 from the general fund to the department for accountability and improvement planning. (Note: This summary applies to this bill as enacted.)

The act implements the recommendation of the department of regulatory agencies in its 2024 sunset review and report on the rural alcohol and substance abuse prevention and treatment program by continuing the program until September 1, 2030. (Note: This summary applies to this bill as enacted.)