The act allows a health-care provider to, under certain circumstances, adjust the dose or frequency of a chronic maintenance drug without needing prior authorization from an insurance carrier. (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 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 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 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.)
Under current law, there are 2 total program formulas to finance public schools. Absent the satisfaction of a statutorily specified condition, the first formula is scheduled to stop determining total program after the 2024-25 budget year (expiring formula), and the second formula is scheduled to determine total program beginning in the 2030-31 budget year (new formula). For the 2025-26 budget year through the 2029-30 budget year (transition period), total program is scheduled to be determined by using figures that were calculated under both the expiring formula and the new formula. The act: Extends the transition period by one year, so that it is from the 2025-26 budget year through the 2030-31 budget year; and Postpones the exclusive use of the new formula to determine total program until the 2031-32 budget year. The act changes how each school district's and institute charter school's annual total program is determined during the transition period. For the 2025-26 and 2026-27 budget years, each school district's and institute charter school's annual total program is the greater of the school district's or institute charter school's total program for the 2024-25 budget year or the amount calculated under the expiring formula plus an amount equal to 15% in 2025-26 and 30% in 2026-27 of the difference between the amounts calculated under the new formula and the expiring formula. For the 2027-28 budget year through the 2030-31 budget year, each school district's and institute charter school's annual total program is the greater of the district's or institute charter school's calculation under the expiring formula plus 1% of that calculation, or: For the 2027-28 budget year, the amount calculated under the expiring formula plus an amount equal to 45% of the difference between the amounts calculated under the new formula and the expiring formula; For the 2028-29 budget year, the amount calculated under the expiring formula plus an amount equal to 60% of the difference between the amounts calculated under the new formula and the expiring formula; For the 2029-30 budget year, the amount calculated under the expiring formula plus an amount equal to 75% of the difference between the amounts calculated under the new formula and the expiring formula; and For the 2030-31 budget year, the amount calculated under the expiring formula plus an amount equal to 90% of the difference between the amounts calculated under the new formula and the expiring formula. Under current law, there are specified conditions that apply to the transition period. If the joint budget committee determines that a specified condition occurs in a budget year during the transition period, then for the next budget year and each budget year thereafter, the transition is suspended, and each school district's total program is determined pursuant to the calculation and determination required for the budget year when the condition occurred. For one of the existing conditions, the act specifies that an income tax deposit to the state education fund that was made to correct an error does not count toward determining whether the condition has been satisfied. A school district's funded pupil count is a figure that is used as a part of determining a school district's total program. Under the expiring formula, a school district's funded pupil count is calculated by determining the greater of the school district's pupil enrollment for the applicable budget year or the average of the school district's pupil enrollment for the applicable budget year and the immediately preceding 4 budget years. Under current law, the new formula calculates a school district's funded pupil count by determining the greater of the school district's pupil enrollment for the applicable budget year or the average of the school district's pupil enrollment for the applicable budget year and the immediately preceding 3 budget years. The act changes the new formula so that: For the 2025-26 budget year, a school district's funded pupil count is calculated by determining the greater of the school district's pupil enrollment for the applicable budget year or the average of the school district's pupil enrollment for the applicable budget year and the immediately preceding 3 budget years; and For the 2026-27 budget year and each budget year thereafter, a school district's funded pupil count is calculated by determining the greater of the school district's pupil enrollment for the applicable budget year or the average of the district's pupil enrollment for the applicable budget year and the immediately preceding 2 budget years. However: If a statutorily specified condition is satisfied, and consequently for the 2026-27 budget year, a district's total program is not determined as scheduled under the transition period, then for the 2026-27 budget year, and each budget year thereafter, funded pupil count will continue to be determined by the greater of the school district's pupil enrollment for the applicable budget year or the average of the school district's pupil enrollment for the applicable budget year and the immediately preceding 3 budget years; and If, for the 2027-28 budget year, the state education fund balance is projected to be less than $200 million, then the general assembly is required to implement a smoothing factor or the funded pupil count will be determined by the greater of the school district's pupil enrollment for the applicable budget year or the average of the school district's pupil enrollment for the applicable budget year and the immediately preceding budget year for the 2027-28 budget year and each budget year thereafter. The act expiring formula is changed so that, starting in the 2027-28 budget year, the funded pupil count used in the expiring formula is the same funded pupil count that is used in the new formula to determine a district's total program during the transition period. The total program for the 2025-26 budget year is determined using the formula changes in the act. The act: Increases the statewide base per pupil funding for the 2025-26 budget year by $195.42 to account for inflation; Sets a new statewide base per pupil funding amount for the 2025-26 budget year at $8,691.80; and Sets the total program funding for the 2025-26 budget year for all school districts and institute charter schools to at least $10,036,070,748 or $10,031,606,090, depending upon whether Senate Bill 25-315 becomes law. Under current law, a new at-risk measure is required to be implemented in the 2025-26 budget year. The act repeals this requirement and requires the department of education (department) to collect data necessary to identify individual student census block groups to account for students who are at-risk of below-average academic performance and education outcomes because of socioeconomic disadvantages or poverty, but who may not qualify for free or reduced price lunch. Under current law, as a part of the charter contract, a district charter school and the school district, or the institute charter school and state charter school institute (institute), must agree on funding and services provided by the school district or institute to the charter school, subject to parameters. The act: Suspends the use of these provisions after the 2025-26 budget year; Repeals charter school at-risk supplemental aid after the 2026-27 budget year, following its gradual phase out during the 2025-26 and 2026-27 budget years; Creates incremental funding for charter schools for the 2025-26 budget year; and Requires the general assembly to consult with charter school representatives to ensure that charter schools are aligned with the implementation of the new formula. The act raises the limit from $750 million to $1 billion for the amount of money that the general assembly may appropriate to restore any or all qualified charter school debt reserve funds to their qualified charter school debt service fund requirements. Under current law, $41 million of interest and income earned on money in the public school fund is credited to certain purposes, and any remaining interest and income may be credited as specified by the general assembly or remain in the public school fund. The act requires that any remaining interest and income is credited to the public school capital construction assistance fund. The total annual amount of revenue credited to the public school capital construction fund is capped at $150 million, adjusted for inflation; except that money received from public school fund interest and income does not apply toward the cap. Any amount above the cap is credited to the state public school fund instead. The act creates the kids matter account within the state education fund. Beginning July 1, 2026, the state treasurer must deposit in the account all state revenues collected from an existing tax on 0.00065% on federal taxable income, as modified by law, of every individual, estate, trust, and corporation. The money in the account must only be used for district total program funding and total state funding for all categorical programs. Under current law, the department is required to contract with an entity to develop and implement a public information campaign to emphasize the importance of learning to read by third grade and highlight local education providers that are achieving high percentages of third-grade students who demonstrate reading competency. The act repeals the requirement that the department contract with an entity to develop and implement the information campaign. The act authorizes the department to use any unexpended money that was appropriated for the out-of-school time program grant program and is remaining at the end of the 2024-25 or 2025-26 state fiscal years in the 2025-26 or 2026-27 state fiscal years without further appropriation. The act creates and implements certain parameters for multifunction school activity buses. For the 2025-26 state fiscal year, the act: Appropriates $7,009,989 to the department from the state education fund for at-risk supplemental aid; Appropriates $7.6 million to the department from the public school capital construction assistance fund for public school capital construction assistance board cash grants; Appropriates $25 million to the department from the public school capital construction assistance fund for public school capital construction assistance board lease payments; and Adjusts the 2025-26 long bill by decreasing the cash funds appropriation from the state education fund for the state share of district's total program by $15,775,837; decreasing the cash funds appropriation from the state education fund for at-risk per pupil additional funding by $5 million; and decreasing the cash funds appropriation from the public school capital construction assistance fund for public school capital construction assistance board cash grants by $45,648,087.(Note: This summary applies to this bill as enacted.)
The act clarifies when a teacher may conclude that an early elementary school student has a significant reading deficiency requiring remediation through a specialized approach to instruction (READ plan) based on a body of evidence that includes information in addition to the student's scores on a reading assessment. Current law requires certain parental communications in connection with a student's READ plan. The act requires the addition of specific information regarding characteristics of dyslexia, if applicable, to the parental communications. Beginning no later than the 2027-28 school year, a local education provider must either develop its own screening process for identifying early elementary school students with characteristics of dyslexia or implement a universal dyslexia screener that conforms to certain new requirements. A local education provider that implements a screener may include the screener in an interim reading assessment or administer the screener separately from the interim assessment. Either way, the screener must accurately and reliably identify students at risk of reading difficulties. If an interim reading assessment includes a screener, the assessment must meet standards for validity and reliability, encourage data-driven instructional decision making, and promote efficient administration and effective follow-up. (Note: This summary applies to this bill as enacted.)
Current law includes a pilot program for complementary and alternative medicine in the department of health care policy and financing (department) for an eligible person with a disability. The act converts the pilot program into an ongoing program and changes the name of the program to the "complementary and integrative health program" (program). The act extends the program to September 1, 2030, and clarifies that the program covers persons with a primary condition of multiple sclerosis, a brain injury, spina bifida, muscular dystrophy, or cerebral palsy when one of these diagnoses directly results in a total inability for independent ambulation. For the 2025-26 state fiscal year, the act appropriates $66,637 to the department from the general fund. The department may use $65,487 for personal services and $1,150 for operating expenses. This appropriation is based on the assumption that the department will receive $66,637 in federal funds for these services. For the 2025-26 state fiscal year, the act appropriates an additional $1,214,019 to the department from the general fund. The department may use the appropriation for medical and long-term care services for medicaid eligible individuals. This appropriation is based on the assumption that the department will receive $1,214,019 in federal funds for these services. (Note: This summary applies to this bill as enacted.)
Beginning January 1, 2026, the act allows the department of health care policy and financing (department) to reimburse community health workers for services rendered to medicaid members after receiving any necessary federal authorization. Reimbursement for community health worker services is subject to available appropriations. The act postpones until January 31, 2027, the requirement for the department to report to the general assembly on community health worker utilization and costs in the medicaid program. The act reduces the appropriations to the department from the general fund for the 2025-26 fiscal year by $1,364,558 and the healthcare affordability and sustainability cash fund for the 2025-26 fiscal year by $342,750. (Note: This summary applies to this bill as enacted.)
