Sen. Jim Smallwood

The bill authorizes a fire station, hospital, or community clinic emergency center (authorized facility) to install a newborn safety device on its premises for parents who voluntarily relinquish their child who is 72 hours old or younger. A newborn safety device must be installed in a conspicuous location at the authorized facility and be equipped with a dual alarm system. An authorized facility that installs a newborn safety device is responsible for the cost of the installation and maintenance, shall ensure the dual alarm system is functioning, and shall make information available to the relinquishing parent. The bill makes conforming amendments. (Note: This summary applies to this bill as introduced.)

The act makes indecent exposure a class 6 felony if committed when the person who commits indecent exposure knew there was a child under 15 years of age in view of the exposure and the person is more than 18 years of age and more than 4 years older than the child. The act appropriates $54,797 to the judicial department from the general fund for the 2023-24 state fiscal year for probation programs and capital outlay. APPROVED by Governor June 7, 2023 EFFECTIVE June 7, 2023 (Note: This summary applies to this bill as enacted.)

The act changes how pass-through entities may elect to pay taxes, specifies how to report and account for adjustments to federal taxable income, and changes the due date for filing a C-corporation income tax return. Partnerships and S corporations (pass-through entities) have had 3 options for ensuring that the income taxes owed by nonresident owners will be paid. Pass-through entities have been able to file a composite return on behalf of these owners, withhold an estimated tax payment, or collect and file an agreement that the owner will file a separate return. For income tax years beginning on and after January 1, 2024, section 1 of the act consolidates the composite return and withholding options and clarifies the calculation of the required payment. Section 2 adopts the multistate tax commission's model statute for reporting adjustments to federal taxable income. When federal taxable income is adjusted by the internal revenue service, or by the taxpayer through an amended federal return, the taxpayer must also report that change to the state. Those changes have had to be reported within 30 days and new federal centralized partnership audit procedures have not been addressed. The act provides additional time for reporting adjustments and allows pass-through entities to handle adjustments at the entity level on behalf of their owners. Section 3 changes the due date for income tax returns by C corporations. State income tax returns have had to be filed by C corporations by April 15, and prior to 2017, the federal income tax return deadline for C corporations was March 15. This meant that the state's April 15 due date and October 15 extension deadline was one month after the federal due date. In 2017, congress moved the federal due date for C corporations to April 15. Section 3 restores the one-month lag by changing the state due date to May 15, with a November 15 extension deadline. APPROVED by Governor June 1, 2023 PORTIONS EFFECTIVE January 1, 2024 PORTIONS EFFECTIVE August 7, 2023 NOTE: This act was passed without a safety clause and portions of it take effect 90 days after sine die. (Note: This summary applies to this bill as enacted.)

The act adjusts the supplemental medicaid payment rates a qualifying nursing facility receives from the department of health care policy and financing (state department). Beginning July 1, 2024, the payment must not be less than 12% of total provider fee payments and must be adjusted for fiscal years 2024-25 and 2025-26. No later than July 1, 2026, the payment must not be less than 15% of total provider fee payments and must be annually adjusted thereafter. Current law limits the annual increase of the general fund share of the aggregate statewide average of the per diem rate to not more than 3%. The act removes this limitation and requires that the general fund share be calculated based on specific percentage increases. The act requires the state department to initiate a process no later than July 1, 2023, to remove the medicare costs from the provider rate setting by July 1, 2026. The act repeals the requirement that only such costs as are reasonable, necessary, and patient-related be reported for reimbursement purposes. The act authorizes the state department to require a nursing facility, as a condition of receiving medicaid funds, to submit any documentation necessary to ensure the state's interest in transparency, stability, and sound fiscal stewardship. As part of developing and implementing a transition plan to regulate nursing facility reimbursement, the act requires the state department to: No later than July 1, 2026, define "nursing home reimbursement" and provide payments to nursing facilities; Engage with stakeholders regularly to seek input on any proposed methodology changes; and From November 1, 2023, to November 1, 2026, submit an annual report to the joint budget committee of the general assembly regarding the implementation process. Each nursing facility that receives medicaid funds is required to submit a plan to the state department that demonstrates how the nursing facility will: Improve the health and safety of the nursing facility's residents, including infection control and staffing; Increase access to care; Improve financial sustainability, including opportunities for diversification of business lines and stabilization of revenue streams; and Promote innovation to meet the emerging needs of individuals with disabilities and aging and older adults. The act requires the state department to issue additional supplemental payments to nursing facility providers with disproportionately high medicaid utilization, to facilities that are geographically critical to ensuring access to care, and to facilities that admit compassionate release individuals from the department of corrections. The act requires each nursing facility that receives medicaid funds to develop and submit a plan to the state department that meets the state department's standards and demonstrates how the nursing facility will improve the health and safety of the nursing facility's residents, increase access to care, improve financial sustainability, and promote innovation to meet the emerging needs of individuals with disabilities and aging and older adults. Effective July 1, 2028, the act repeals the requirement that the state department exempt certain nursing facility providers from the provider fee. Effective July 1, 2026, the act repeals: The process for providing a wage enhancement supplemental payment to eligible nursing home providers that pay their employees a wage of at least $15 per hour; and Requirements for issuing additional supplemental payments to nursing facility providers that meet certain requirements. For the 2023-24 state fiscal year, the act appropriates $30,509,457 from the general fund to the state department for medical and long-term care services for medicaid eligible individuals. For the 2023-24 state fiscal year, the general assembly anticipates that the state department will receive $31,754,740 in federal funds for medical and long-term care services for medicaid eligible individuals to implement the act. APPROVED by Governor May 30, 2023 EFFECTIVE May 30, 2023 (Note: This summary applies to this bill as enacted.)

For a contract between a pharmacy benefit manager (PBM) or a health insurance carrier (carrier) and a certificate holder or policyholder, the act requires that the amount charged by the PBM or carrier to the certificate holder or policyholder for a prescription drug be equal to or less than the amount paid by the PBM or carrier to the contracted pharmacy for the drug. For group health benefit plans in effect during the 2025 calendar year and each calendar year thereafter, the act creates transparency requirements for PBMs and carriers regarding prescription drug benefits and grants audit authority to the commissioner of insurance (commissioner) for fully insured plans to ensure compliance with the requirements. The commissioner is authorized to promulgate rules to implement the act. A violation of the requirements of the act is a deceptive trade practice in the business of insurance, with regard to fully insured plans. For contracts between a PBM and the department of health care policy and financing (state department) or one of its affiliated managed care organizations offering a prescription benefit plan that is issued on or after January 1, 2025, the act requires the amount charged by the PBM to the state department or managed care organization for a prescription drug dispensed to an enrollee in the Colorado medical assistance program to be equal to or less than the amount paid by the PBM to a pharmacy for the prescription drug dispensed to the enrollee. The act directs the medical services board to adopt rules to implement and ensure compliance with this requirement. APPROVED by Governor May 10, 2023 EFFECTIVE August 7, 2023 NOTE: This act was passed without a safety clause and takes effect 90 days after sine die. (Note: This summary applies to this bill as enacted.)

The bill authorizes a physician, a physician assistant, and an advanced practice registered nurse licensed health-care professional who is authorized to prescribe drugs (prescriber) to prescribe and administer a drug approved by the federal food and drug administration (FDA) for an off-label use. if: The off-label use of the drug for the indication has longstanding, common use; There is medical evidence to support the off-label use and no known evidence contraindicating such off-label use; and The prescriber has provided the patient or a minor patient's parent or guardian with an informed consent form, and the patient or parent or guardian has signed the form. The bill applies the same standard of care for the off-label use of the drug as for the on-label use of the drug. The bill clarifies that: The prescription and administration of an FDA-approved drug for an off-label use is not, by itself, a grounds for discipline; and A pharmacist who fills a prescription for off-label use is not subject to discipline by the state board of pharmacy. (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.)

No later than June 30, 2023, the act requires the department of health care policy and financing (state department), in conjunction with the department of public health and environment, to develop a regulatory plan to establish formal oversight requirements for the program of all-inclusive care for the elderly (PACE). No later than March 1, 2024, the act requires the state department to establish, administer, and enforce minimum regulatory standards and rules for the PACE program. The act requires the state department to continually analyze the reimbursement methodology for PACE entities and provide an update to specified committees of the general assembly of any methodology requirements that incorporate encounter data and any associated costs to the state department in overseeing PACE entities. (Note: This summary applies to this bill as enacted.)

The act requires the division of insurance (division), on or before November 1, 2022, to retain by contract one or more entities that have experience in actuarial reviews, health-care policy, and health equity (contractors) for the purpose of performing actuarial reviews of legislative proposals that may impose a new health benefit coverage mandate on health benefit plans or reduce or eliminate coverage mandated under health benefit plans. The contractors, under the direction of the division, shall conduct an actuarial review of up to 6 such legislative proposals for each regular legislative session as follows: Up to 2 members of the majority party of the house of representatives may submit a request for an actuarial review; One member of the minority party of the house of representatives may submit up to one request for an actuarial review; Up to two members of the majority party of the senate may submit a request for an actuarial review; and One member of the minority party of the senate may submit up to one request for an actuarial review. Each actuarial review performed by the contractors must consider the predicted effects of the legislative proposal during the 5 and 10 years immediately following the effective date of the proposed legislation, or during another time period following the effective date if such consideration is more actuarially feasible, including specifically described considerations. A request for an actuarial review and the final report resulting from such a request must be treated as confidential except by the member of the general assembly who made the request until the legislative proposal that is the subject of the actuarial review is introduced in the regular legislative session following the submission of the request for the actuarial review or, if no such legislative proposal is introduced, until after the end of the legislative session following the submission of the request. The division may not engage any contractor to perform an actuarial review unless the division determines that there are adequate resources available within existing appropriations to compensate the contractor for the actuarial review. In preparing a fiscal note for any legislative proposal that may impose a new health benefit mandate on health benefit plans, the legislative service agency charged with preparing the fiscal note shall include a statement that a report has been prepared by the contractors for the legislative proposal and an indication of how the report may be obtained in its entirety. The act is repealed, effective November 1, 2027. For the 2022-23 state fiscal year, the act appropriates $100,000 from the division of insurance cash fund to the department of regulatory agencies for use by the division of insurance as follows: $50,000 for personal services; and $50,000 for operating expenses.(Note: This summary applies to this bill as enacted.)

The act removes telepharmacies from the definition of "other outlet" under current law and removes the geographic restriction requiring that a telepharmacy outlet be located more than 20 miles from the nearest prescription drug outlet or another telepharmacy. The act requires telepharmacies to be registered as "prescription drug outlets", instead of other outlets, and to be located in an area of need. An "area of need" is any health facility licensed or certified by the department of public health and environment or any area where a demonstration of need is approved by the state board of pharmacy (board). A telepharmacy outlet must have a pharmacist manager and must be under the direct charge or control of the pharmacist manager or licensed pharmacist delegate who provides remote supervision to the telepharmacy outlet. The act authorizes the board to adopt limited rules to specify additional enumerated criteria to facilitate the operation of telepharmacy outlets, including, in part, the number of telepharmacy outlets that may be operated by a central pharmacy. (Note: This summary applies to this bill as enacted.)

The act requires the board of directors (board) of the Colorado health benefit exchange (exchange) to create and implement a consumer outreach campaign (campaign) to educate consumers regarding options for health-care coverage. To pay for the campaign, the amount of the tax credits that the commissioner of insurance is allowed to allocate to insurers that contribute to the exchange increases from $5 million to $9 million for a 6-year period. The board is required to annually report its progress and accounting to the Colorado health insurance exchange oversight committee at the committee's first meeting of the calendar year starting in 2024. The requirements of the act repeal on December 31, 2028. (Note: This summary applies to this bill as enacted.)