2019 Bill List

Colorado Pharmacists Society

HB19-1004 Proposal For Affordable Health Coverage Option 
Comment:
Position: Monitor
Calendar Notification: NOT ON CALENDAR
Short Title: Proposal For Affordable Health Coverage Option
Sponsors: D. Roberts (D) | M. Catlin (R) / K. Donovan (D)
Summary:

Proposal for a state option for health care coverage - creation - division of insurance - appropriation. The act requires the department of health care policy and financing and the division of insurance in the department of regulatory agencies (departments) to develop and submit a proposal (proposal) to certain committees of the general assembly concerning the design, costs, benefits, and implementation of a state option for health care coverage. Additionally, the departments shall present a summary of the proposal at the annual joint hearings with the legislative committees of reference during the interim before the 2020 legislative session.

The proposal must contain a detailed description of a state option and must identify the most effective implementation of a state option based on affordability to consumers at different income levels, administrative and financial burden to the state, ease of implementation, and likelihood of success in meeting the objectives described in the act. The proposal must also identify any necessary changes to state law to implement the proposal.

In developing the proposal, the departments shall engage in a stakeholder process that includes public and private health insurance experts, consumers, consumer advocates, employers, providers, and carriers. Further, the departments shall review any information relating to a pilot program operated by the state personnel director as a result of legislation that may be enacted during the 2019 legislative session.

The departments shall prepare and submit any necessary federal waivers or state plan amendments to implement the proposal, unless a bill is filed within the filing deadlines for the 2020 legislative session that substantially alters the federal authorization required for the proposal and the bill is not postponed indefinitely in the first committee.

For the 2018-19 state fiscal year, the act appropriates $75,000 from the general fund to the department of health care policy and financing for professional services, and $115,500 from the general fund to the department of regulatory agencies for the division of insurance for personal services.

For the 2019-20 state fiscal year, the act appropriates $150,000 from the general fund to the department of health care policy and financing for professional services, and $231,000 from the general fund to the department of regulatory agencies for the division of insurance for personal services.


(Note: This summary applies to this bill as enacted.)

Status: 5/17/2019 Governor Signed
Fiscal Notes:

Fiscal Note


HB19-1009 Substance Use Disorders Recovery 
Comment:
Position: Monitor
Calendar Notification: Friday, May 3 2019
THIRD READING OF BILLS - FINAL PASSAGE (CONTINUED)
(1) in senate calendar.
Short Title: Substance Use Disorders Recovery
Sponsors: C. Kennedy (D) | J. Singer (D) / K. Priola (R) | B. Pettersen (D)
Summary:

Recovery from substance use disorders - housing vouchers - recovery residence standards and requirements - recovery residence certification grant program - creation of the opioid crisis recovery funds advisory committee - appropriation. The act:

  • Expands the housing voucher program currently within the department of local affairs to include individuals with a substance use disorder;
  • Establishes standards for recovery residences for purposes of referrals and title protection and prohibits a facility from using the terms "recovery residence", "sober living facility", or "sober home" unless the facility meets specified conditions;
  • Creates the recovery residence certification grant program; and
  • Creates the opioid crisis recovery funds advisory committee to advise and collaborate with the department of law on uses of any custodial funds the state receives as settlement or damage awards resulting from opioid-related litigation.

To implement the act:

  • $1,000,000 is appropriated to the department of local affairs;
  • $2,620 is appropriated to the office of the governor for use by the office of information technology; and
  • $50,000 is appropriated to the department of human services for use by the office of behavioral health.
    (Note: This summary applies to this bill as enacted.)

Status: 5/23/2019 Governor Signed
Fiscal Notes:

Fiscal Note


HB19-1122 Colorado Department Of Public Health And Environment Maternal Mortality Review Committee 
Comment:
Position: Amend
Calendar Notification: NOT ON CALENDAR
Short Title: Colorado Department Of Public Health And Environment Maternal Mortality Review Committee
Sponsors: J. Buckner (D) | L. Landgraf (R) / R. Fields (D) | B. Gardner (R)
Summary:

Maternal mortality review committee - creation - appointments - duties - sunset review - appropriation. The act creates the Colorado maternal mortality review committee (committee), which is required to review maternal deaths, identify the causes of maternal mortality, and develop recommendations to address preventable maternal deaths, including legislation, policies, rules, and best practices that will support the health and safety of the pregnant and postpartum population in Colorado and prevent maternal deaths. The executive director of the department of public health and environment (department) is directed to appoint at least 11 members to serve on the committee.

The act requires certain health care providers and law enforcement officials to provide medical records to the department concerning each maternal death for access by the members of the committee. The records, notes, information, and activities of the committee are confidential.

The committee is repealed, effective September 1, 2029, and is subject to sunset review by the department of regulatory agencies prior to its repeal.

$145,167 is appropriated to the department for implementation of the act.


(Note: This summary applies to this bill as enacted.)

Status: 5/16/2019 Governor Signed
Fiscal Notes:

Fiscal Note


HB19-1131 Prescription Drug Cost Education 
Comment:
Position: Support
Calendar Notification: NOT ON CALENDAR
Short Title: Prescription Drug Cost Education
Sponsors: S. Jaquez Lewis (D) / F. Winter (D)
Summary:

Drug manufacturer, representative, agent, or employee - prescription drug marketing - disclosure of drug information required. The act requires a drug manufacturer, or a representative, agent, or employee of the manufacturer, who while employed by or under contract to represent a manufacturer engages in prescription drug marketing, to provide to a prescriber, in writing, the wholesale acquisition cost of a prescription drug when, in the course of conducting business, the manufacturer, representative, agent, or employee provides information concerning the drug to the prescriber.

The act also requires the drug manufacturer, or a representative, agent, or employee of the manufacturer, to also disseminate the names of at least 3 generic prescription drugs from the same therapeutic class, or if 3 are not available, as many as are available for prescriptive use.

Specified provisions of the act are contingent upon House Bill 19-1172 becoming law.


(Note: This summary applies to this bill as enacted.)

Status: 5/16/2019 Governor Signed
Fiscal Notes:

Fiscal Note


HB19-1172 Title 12 Recodification And Reorganization 
Comment:
Position: Monitor
Calendar Notification: NOT ON CALENDAR
Short Title: Title 12 Recodification And Reorganization
Sponsors: M. Weissman (D) / B. Gardner (R) | J. Cooke (R)
Summary:

Professions and occupations - organizational recodification of laws. Title 12 of the Colorado Revised Statutes relates primarily to the regulation of professions and occupations. In 2016, the general assembly enacted Senate Bill 16-163, which authorized a multi-year project to recodify title 12. In 2017 and 2018, the General Assembly enacted numerous bills to relocate from title 12 to other titles in the Colorado Revised Statutes all laws that do not relate to the regulation of professions and occupations. After the passage of those relocation bills, title 12 generally contains only laws administered by the department of regulatory agencies (DORA) that regulate a profession or occupation.

Section 1 of the act recodifies title 12, as contemplated by Senate Bill 16-163, by:

  • Reorganizing and renumbering articles and parts within the title, all of which are administered by the division of real estate, the division of conservation, or the division of professions and occupations (DPO) within DORA;
  • Relocating into title 12 statutes in part 1 of article 34 of title 24 of the Colorado Revised Statutes relating to the creation, powers, and duties of DPO in administering the laws regulating professions and occupations (practice acts);
  • Creating common provisions that are generally applicable to all practice acts administered by DPO, except as otherwise specified, and modifying the various practice acts to eliminate redundancies with the common provisions; and
  • Eliminating provisions in title 12 that are archaic or obsolete.

Article 1 of the recodified title 12 contains provisions that apply to the entire title. Article 10 includes the laws governing real estate, including the division of real estate within DORA, while article 15 includes laws governing conservation easements, including the division of conservation within DORA.

The remainder of the title relates to professions and occupations regulated by DPO within DORA. Article 20 includes laws relocated from title 24 relating to the creation of DPO and DPO's powers and duties and consolidated common provisions derived from the practice acts that relate to procedures, immunity, disciplinary and enforcement authority, and judicial review of final orders of DPO and the regulatory boards within DPO. Article 30 includes common provisions governing health care professions and occupations regulated by DPO, including the "Michael Skolnik Medical Transparency Act of 2010", health care work force data collection requirements, and opioid prescribing limitations. Articles 100 to 315 contain the practice acts governing individual professions and occupations regulated by DPO.

The comparative tables detailing how the act reorganized and renumbered specific provisions in title 12 is located at

.

Section 2 of the act relocates a law that prohibits the mandatory donation of services from title 12 to the "Administrative Organization Act of 1968" in title 24. Section 3 repeals relocated provisions from titles 24 and 25. To give agencies time to make necessary adjustments to their rules and forms, section 265 delays the effective date of the act until October 1, 2019.


(Note: This summary applies to this bill as enacted.)

Status: 4/25/2019 Governor Signed
Fiscal Notes:

Fiscal Note


HB19-1174 Out-of-network Health Care Services 
Comment:
Position: Monitor
Calendar Notification: NOT ON CALENDAR
Short Title: Out-of-network Health Care Services
Sponsors: D. Esgar (D) | M. Catlin (R) / B. Gardner (R) | B. Pettersen (D)
Summary:

Health insurance - out-of-network health care services - disclosures - claims - reimbursement rates - deceptive trade practice - rules - appropriation. The act:

  • Requires health insurance carriers, health care providers, and health care facilities to provide patients covered by health benefit plans with information concerning the provision of services by out-of-network providers and in-network and out-of-network facilities;
  • Outlines the disclosure requirements and the claims and payment process for the provision of out-of-network services;
  • Requires the commissioner of insurance, the state board of health, and the director of the division of professions and occupations in the department of regulatory agencies to promulgate rules that specify the requirements for disclosures to consumers, including the timing, the format, and the contents and language in the disclosures;
  • Establishes the reimbursement amount for out-of-network providers that provide health care services to covered persons at an in-network facility and for out-of-network providers or facilities that provide emergency services to covered persons; and
  • Creates a penalty for failure to comply with the payment requirements for out-of-network health care services.

The act appropriates $33,884 from the general fund to the department of public health and environment and $63,924 from the division of insurance cash fund to the division of insurance to implement the act.

Specified provisions of the act are contingent upon House Bill 19-1172 becoming law.


(Note: This summary applies to this bill as enacted.)

Status: 5/15/2019 Sent to the Governor
Fiscal Notes:

Fiscal Note


HB19-1176 Health Care Cost Savings Act of 2019 
Comment:
Position: Monitor
Calendar Notification: Friday, May 3 2019
THIRD READING OF BILLS - FINAL PASSAGE (CONTINUED)
(1) in senate calendar.
Short Title: Health Care Cost Savings Act of 2019
Sponsors: E. Sirota (D) | S. Jaquez Lewis (D) / M. Foote (D)
Summary:

Health care cost analysis task force - creation - analysis of health care financing systems - report - gifts, grants, and donations - repeal - appropriation. The act creates the health care cost analysis task force (task force). The president of the senate, the minority leader of the senate, the speaker of the house of representatives, and the minority leader of the house of representatives shall each appoint one legislative member to the task force. The governor shall appoint 4 members to the task force. The executive directors of the departments of human services, public health and environment, and health care policy and financing, or their designees, also serve on the task force.

The task force is required to issue a competitive solicitation in order to select an analyst to provide a detailed analysis of fiscal costs and other impacts to 3 health care financing systems. The health care financing systems to be analyzed are:

  • The current health care financing system, in which residents receive health care coverage from private and public insurance carriers or are uninsured;
  • A multi-payer universal health care system, in which all residents of Colorado are covered under a plan with a mandated set of benefits that is publicly funded and paid for by employer and employee contributions; and
  • A publicly financed and privately delivered universal health care system that directly compensates providers.

The analyst may use the same specified criteria when conducting the analysis of each health care financing system.

The task force is required to report the findings of the analyst to the general assembly.

The task force may seek, accept, and expend gifts, grants, and donations for the analysis. The general assembly may appropriate money to the health care cost analysis cash fund for the purposes of the task force, the analysis, and reporting requirements.

The act appropriates $92,649 to the department of health care policy and financing from the general fund to implement the act.


(Note: This summary applies to this bill as enacted.)

Status: 5/31/2019 Governor Signed
Fiscal Notes:

Fiscal Note


HB19-1211 Prior Authorization Requirements Health Care Service 
Comment:
Position: Neutral
Calendar Notification: NOT ON CALENDAR
Short Title: Prior Authorization Requirements Health Care Service
Sponsors: D. Michaelson Jenet (D) | Y. Caraveo (D) / A. Williams (D)
Summary:

Health care coverage - prior authorization for health care services - publication of requirements and restrictions - deadline for making determination - required criteria - exceptions for compliant providers - duration of prior authorization - rules. With regard to the prior authorization process used by carriers or private utilization review organizations (organizations) acting on behalf of carriers to review and determine whether a particular health care service prescribed by a health care provider is approved as a covered benefit under the patient's health benefit plan, the act requires carriers and organizations to:

  • Publish and update their prior authorization requirements and restrictions;
  • Comply with specified deadlines for making a determination on a prior authorization request;
  • Use current, clinically based prior authorization criteria that are aligned with other quality initiatives of the carrier or organization and with other carriers' and organizations' prior authorization criteria for the same health care service; and
  • Consider limiting the use of prior authorization to providers whose prescribing or ordering patterns differ significantly from the patterns of their peers after adjusting for patient mix and other relevant factors.

The act authorizes a carrier or organization to offer providers with a history of adherence to the carrier's or organization's prior authorization requirements an alternative to prior authorization, including an exemption from prior authorization for providers with an 80% approval rate of prior authorization requests over the previous 12 months. Carriers and organizations are to annually reevaluate a provider's eligibility for exemption from or other alternative to prior authorization requirements.

If a carrier or organization fails to make a determination within the time required, the request is deemed approved.

An approved prior authorization request is valid for at least 180 days, with some exceptions, and continues for the duration of the authorized course of treatment.

The commissioner of insurance is authorized to adopt rules as necessary to implement the act.


(Note: This summary applies to this bill as enacted.)

Status: 5/13/2019 Governor Signed
Fiscal Notes:

Fiscal Note


HB19-1216 Reduce Insulin Prices 
Comment:
Position: Support
Calendar Notification: NOT ON CALENDAR
Short Title: Reduce Insulin Prices
Sponsors: D. Roberts (D) / K. Donovan (D) | K. Priola (R)
Summary:

Prescription insulin drugs - 30-day supply - cost-sharing cap - appropriation. Effective January 1, 2020, the act caps the cost sharing a covered person is required to pay for prescription insulin drugs at $100 per 30-day supply of insulin.

The act requires the department of law to investigate the pricing of prescription insulin drugs and submit a report of its findings to the governor, the commissioner of insurance, and the judiciary committees of the senate and house of representatives.

$26,054 is appropriated to the department of regulatory agencies for use by the division of insurance to implement the act.


(Note: This summary applies to this bill as enacted.)

Status: 5/22/2019 Governor Signed
Fiscal Notes:

Fiscal Note


HB19-1233 Investments In Primary Care To Reduce Health Costs 
Comment:
Position: Support
Calendar Notification: NOT ON CALENDAR
Short Title: Investments In Primary Care To Reduce Health Costs
Sponsors: M. Froelich (D) | Y. Caraveo (D) / J. Ginal (D) | D. Moreno (D)
Summary:

Primary care - collaborative created - affordability standards - targets - payment reform recommendations. The act:

  • Establishes a primary care payment reform collaborative in the division of insurance in the department of regulatory agencies;
  • Requires the commissioner of insurance to establish affordability standards for premiums, including adding targets for carrier investments in primary care; and
  • Requires the department of health care policy and financing and carriers who offer health benefit plans to state employees to set targets for investment in primary care.
    (Note: This summary applies to this bill as enacted.)

Status: 5/16/2019 Governor Signed
Fiscal Notes:

Fiscal Note


HB19-1242 Board Of Pharmacy Regulate Pharmacy Technicians 
Comment:
Position: Strongly Support
Calendar Notification: NOT ON CALENDAR
Short Title: Board Of Pharmacy Regulate Pharmacy Technicians
Sponsors: D. Jackson (D) | S. Jaquez Lewis (D) / F. Winter (D) | J. Tate (R)
Summary:

Pharmacy technicians - regulation by state board of pharmacy - certification - provisional certification - criminal history record checks - renewal - continuing education - unprofessional conduct - discipline - supervision by pharmacist - authorized activities - sunset review - appropriation. The act requires pharmacy technicians practicing in Colorado on or after March 30, 2020, to obtain a certification from the state board of pharmacy (board). An applicant for certification by the board must provide proof of certification by a board-approved, nationally recognized organization that certifies pharmacy technicians and must either submit to a criminal history record check in the form and manner determined by the board by rule or provide evidence of submitting to a criminal history record check at the time of hire or as a condition of national certification as a pharmacy technician. If an applicant is not certified by a national certifying organization at the time of application for state certification, the board may grant a provisional certification to the applicant to allow the applicant up to 18 months or, if granted a hardship extension, an additional period determined by the board, to obtain national certification. A provisional certification is not renewable, and if the provisional certificant fails to obtain the national certification within the 18-month period or extended period granted by the board, the provisional certification expires and the person cannot practice as a pharmacy technician until the person satisfies all requirements for certification by the board.

To renew a certification, in addition to board requirements for renewal, a pharmacy technician must satisfy renewal and continuing education requirements of the national accrediting organization that certified the pharmacy technician.

Similar to pharmacists and interns, a pharmacy technician certified by the board is subject to the jurisdiction of the board and to discipline by the board for engaging in unprofessional conduct.

The act maintains the limitation on the number of interns and pharmacy technicians that a pharmacist may supervise but specifies that if the pharmacist is supervising 3 or more pharmacy technicians, a majority of the pharmacy technicians must be certified and all others must hold a provisional certification.

The regulation of pharmacy technicians by the board is subject to the same sunset review that applies to the board and its functions in regulating the practice of pharmacy.

$183,063 is appropriated from the division of professions and occupations cash fund to the department of regulatory agencies (DORA) to implement the act, of which $15,545 is reappropriated to the department of law for legal services for DORA. Additionally, $128,188 is appropriated from the Colorado bureau of investigation identification unit fund to the department of public safety for use by the biometric identification and records unit to perform criminal history record checks.

Specified provisions of the act are contingent upon House Bill 19-1172 becoming law.


(Note: This summary applies to this bill as enacted.)

Status: 6/3/2019 Governor Signed
Fiscal Notes:

Fiscal Note


HB19-1287 Treatment For Opioids And Substance Use Disorders 
Comment:
Position: Support
Calendar Notification: Friday, May 3 2019
THIRD READING OF BILLS - FINAL PASSAGE - CONSENT CALENDAR
(1) in senate calendar.
Short Title: Treatment For Opioids And Substance Use Disorders
Sponsors: D. Esgar (D) | J. Wilson (R) / B. Pettersen (D) | K. Priola (R)
Summary:

Access to behavioral health treatment - capacity tracking system - care navigation program - building substance use disorder treatment capacity in underserved communities grant program - appropriation. The act:

  • Directs the department of human services to implement a centralized, web-based behavioral health capacity tracking system to track available treatment capacity at behavioral health facilities and at programs for medication-assisted treatment and withdrawal management for substance use disorders, as well as other types of treatment;
  • Directs the department of human services to implement a care navigation program to assist individuals in obtaining access to treatment for substance use disorders, including medical detoxification and residential and inpatient treatment; and
  • Creates the building substance use disorder treatment capacity in underserved communities grant program to provide services in rural and frontier communities, prioritizing areas of the state that are unserved or underserved.

For the 2019-20 state fiscal year, the act appropriates:

  • $31,961 and 0.8 FTE to the department of health care policy and financing, executive director's office for personal services and operating expenses, with the expectation that the department will receive additional federal funding;
  • $5,589,344 and 2.5 FTE from the marijuana tax cash fund to the department of human services, office of behavioral health, for community behavioral health administration, the behavioral health capacity tracking system, the care navigation program, and the building substance use disorder treatment capacity in underserved communities grant program; and
  • $160,206 and 1.4 FTE from reappropriated funds received from the department of human services to the office of the governor for use by the office of information technology.
    (Note: This summary applies to this bill as enacted.)

Status: 5/14/2019 Governor Signed
Fiscal Notes:

Fiscal Note


HB19-1296 Prescription Drug Cost Reduction Measures 
Comment:
Position: Support
Calendar Notification: NOT ON CALENDAR
Short Title: Prescription Drug Cost Reduction Measures
Sponsors: D. Jackson (D) | S. Jaquez Lewis (D) / J. Ginal (D) | K. Donovan (D)
Summary:

Section 1 of the bill enacts the "Colorado Prescription Drug Cost Reduction Act of 2019", which requires:

  • Health insurers, starting in 2020, to submit to the commissioner of insurance (commissioner) information regarding prescription drugs covered under their health insurance plans that the plan paid for in the preceding calendar year, including information about rebates received from prescription drug manufacturers, a certification regarding how rebates were accounted for in insurance premiums, and a list of all pharmacy benefit management firms (PBMs) with whom they contract;
  • Prescription drug manufacturers to notify the commissioner, state purchasers, health insurers, and PBMs when the manufacturer, on or after January 1, 2020, increases the price of certain prescription drugs by more than specified amounts or introduces a new specialty drug in the commercial market;
  • Prescription drug manufacturers, within 15 days after the end of each calendar quarter that starts on or after January 1, 2020, to provide specified information to the commissioner regarding the drugs about which the manufacturer notified purchasers;
  • Health insurers or, if applicable, PBMs to annually report specified information to the commissioner regarding rebates and administrative fees received from manufacturers for prescription drugs for which they received the required notice from a manufacturer; and
  • Certain nonprofit organizations to compile and submit to the commissioner an annual report indicating the amount of each payment, donation, subsidy, or thing of value received by the nonprofit organization or its executive director, chief operating officer, board of directors, or any member of the board of directors from a prescription drug manufacturer, PBM, or health insurer and the percentage of the nonprofit organization's total gross income that is attributable to those payments, donations, subsidies, or things of value.

The commissioner is required to post the information received from health insurers, prescription drug manufacturers, PBMs, and nonprofit organizations on the division of insurance's website, excluding any information that is proprietary. Additionally, the commissioner, or a disinterested third-party contractor, is to analyze the data reported by health insurers, prescription drug manufacturers, PBMs, and nonprofit organizations and other relevant information to determine the effect of prescription drug costs on health insurance premiums. The commissioner is to publish a report each year, submit the report to the governor and specified legislative committees, and present the report during annual "State Measurement for Accountable, Responsive, and Transparent (SMART) Government Act" hearings. The commissioner is authorized to adopt rules as necessary to implement the requirements of the bill.

Section 2 prohibits PBMs from retroactively reducing payment on a clean claim submitted by a pharmacy unless the PBM determines, through an audit conducted in accordance with state law, that the claim was not a clean claim. Health insurers that contract with PBMs must ensure that the PBMs are complying with this prohibition and the reporting requirements and are subject to penalties for failure to do so.

Section 3 requires a carrier to reduce the cost sharing a covered person is required to pay for prescription drugs by an amount equal to the greater of 51% of the average aggregate rebates received by the carrier for all prescription drugs, including price protection rebates, or an amount that ensures cost sharing will not exceed 125% of the carrier's cost for the prescription drug.

Under sections 5 and 6 , a prescription drug manufacturer that fails to notify purchasers or fails to report required data to the commissioner is subject to discipline by the state board of pharmacy, including a penalty of up to $10,000 per day for each day the manufacturer fails to comply with the notice or reporting requirements. The commissioner is to report manufacturer violations to the state board of pharmacy. Additionally, health insurers that fail to report the required data are subject to a fine of up to $10,000 per day.

Sections 7 and 8 of the bill make conforming amendments necessary to harmonize the bill with the title 12 recodification bill, House Bill 19-1172.
(Note: This summary applies to this bill as introduced.)

Status: 5/9/2019 House Committee on Appropriations Lay Over Unamended - Amendment(s) Failed
Fiscal Notes:

Fiscal Note


HB19-1312 School Immunization Requirements 
Comment:
Position: Support
Calendar Notification: NOT ON CALENDAR
Short Title: School Immunization Requirements
Sponsors: K. Mullica (D) / J. Gonzales (D) | K. Priola (R)
Summary:

The bill requires the department of public health and environment (department) to:

  • Develop a standardized form and submission process to claim a medical exemption to an immunization; and
  • Develop a standardized form and submission process to claim a religious or personal belief exemption to an immunization.

The department is:

  • Required to develop educational materials regarding immunizations to distribute to health care providers and facilities;
  • Required to present immunization exemption information during its annual SMART Act hearing; and
  • Required to use the existing immunization tracking system.

The state board of health is:

  • Required to promulgate rules adopting the medical exemption recommendations from the advisory committee on immunization practices of the centers for disease control and prevention in the federal department of health and human services, or any successor entity (ACIP);
  • Required to promulgate rules adopting the the hepatitis A, rotavirus, and meningococcal immunizations; and
  • Allowed to promulgate rules establishing the timing by which schools, parents, legal guardians, and students must demonstrate compliance with immunization requirements.

Concerning the immunization tracking system, the bill:

  • Requires a licensed physician, physician assistant, or advanced practice nurse to inform a parent or legal guardian who is claiming a medical exemption that he or she may choose to exclude the student's immunization information from the immunization tracking system before the student's immunization data is sent to the immunization tracking system;
  • Requires the department or local or county, district, or municipal public health agency to inform a parent, legal guardian, or student who is claiming a religious or personal belief exemption that he or she may choose to exclude the student's immunization information from the immunization tracking system before the student's immunization data is sent to the immunization tracking system; and
  • Requires a practitioner who is a licensed physician, physician assistant, or advanced practice nurse to submit immunization and medical exemption data to the immunization tracking system. However, the practitioner is not subject to a regulatory sanction for noncompliance.
    (Note: This summary applies to the reengrossed version of this bill as introduced in the second house.)

Status: 5/2/2019 Senate Second Reading Special Order - Laid Over Daily - No Amendments
Fiscal Notes:

Fiscal Note


SB19-001 Expand Medication-assisted Treatment Pilot Program 
Comment:
Position: Support
Calendar Notification: NOT ON CALENDAR
Short Title: Expand Medication-assisted Treatment Pilot Program
Sponsors: L. Garcia (D) / B. Buentello (D)
Summary:

Medication-assisted treatment expansion pilot program - extension - administration - additional counties to participate - funding increase - appropriation. In 2017, the general assembly enacted Senate Bill 17-074, concerning the creation of a pilot program in certain areas of the state experiencing high levels of opioid addiction to award grants to increase access to addiction treatment, which created a 2-year medication-assisted treatment (MAT) expansion pilot program, administered by the university of Colorado college of nursing, to expand access to medication-assisted treatment to opioid-dependent patients in Pueblo and Routt counties and directed the general assembly to appropriate $500,000 per year for the 2017-18 and 2018-19 fiscal years from the marijuana tax cash fund to the university of Colorado board of regents for allocation to the college of nursing to implement the pilot program. The 2017 act also scheduled the pilot program for repeal on June 30, 2020.

The act:

  • Expands the pilot program to the counties in the San Luis valley and 2 additional counties in which a need is demonstrated;
  • Shifts responsibility to administer the pilot program from the college of nursing to the center for research into substance use disorder prevention, treatment, and recovery support strategies;
  • Adds representatives from the San Luis valley and any other counties selected to participate in the pilot program and members from the boards of county commissioners from participating counties to the advisory board that assists in administering the program;
  • Increases the annual appropriation for the pilot program to $2.5 million for the 2019-20 and 2020-21 fiscal years; and
  • Extends the program an additional 2 years.

The act appropriates $2.5 million from the marijuana tax cash fund to the department of higher education for use by the board of regents of the university of Colorado to allocate to the center for research into substance use disorder prevention, treatment, and recovery support strategies for the MAT expansion pilot program.


(Note: This summary applies to this bill as enacted.)

Status: 5/14/2019 Governor Signed
Fiscal Notes:

Fiscal Note


SB19-004 Address High-cost Health Insurance Pilot Program 
Comment:
Position: Monitor
Calendar Notification: NOT ON CALENDAR
Short Title: Address High-cost Health Insurance Pilot Program
Sponsors: K. Donovan (D) / D. Roberts (D) | J. McCluskie (D)
Summary:

Health care cooperatives - consumer protections - consumers negotiating rates.

The act modernizes laws authorizing health care cooperatives in the state to incorporate consumer protections such as coverage for preexisting conditions and to encourage consumers to help control health care costs by negotiating rates on a collective basis directly with providers. The act authorizes the commissioner of insurance to apply for a federal waiver as necessary to implement the act.


(Note: This summary applies to this bill as enacted.)

Status: 5/17/2019 Governor Signed
Fiscal Notes:

Fiscal Note


SB19-005 Import Prescription Drugs From Canada 
Comment:
Position: Neutral
Calendar Notification: NOT ON CALENDAR
Short Title: Import Prescription Drugs From Canada
Sponsors: R. Rodriguez (D) | J. Ginal (D) / S. Jaquez Lewis (D)
Summary:

Prescription drugs - Canadian prescription drug importation program - federal approval - eligible importers and suppliers - eligible prescription drugs - distribution requirements - reports - rules - appropriations. The act creates the "Canadian Prescription Drug Importation Program" (program) in the department of health care policy and financing (department). On or before September 1, 2020, the department shall submit a request to the United States secretary of health and human services for approval of the program. The department shall begin operating the program not later than 6 months after receiving such approval. The department may expend money for the purpose of requesting approval of the program, but the department cannot spend any other money to implement the program until the department receives approval of the program.

Upon receiving approval of the program, the department shall contract with 1 or more vendors to provide services under the program. Each vendor, in consultation with the department and any other vendors, shall establish a wholesale prescription drug importation list (importation list) that identifies the prescription drugs that have the highest potential for cost savings to the state. Each vendor shall revise the list at least annually and at the direction of the department. The department shall review the importation list at least every 3 months to ensure that it continues to meet the requirements of the program. The department may direct a vendor to revise the list, as necessary.

Each vendor shall:

  • Identify, in consultation with the department, Canadian suppliers who are in full compliance with relevant Canadian federal and provincial laws and regulations and who have agreed to export prescription drugs identified on the importation list;
  • Verify that such Canadian suppliers meet the requirements of the program and will export prescription drugs at prices that provide cost savings to the state;
  • Contract with such eligible Canadian suppliers, or facilitate contracts between eligible importers and Canadian suppliers, to import prescription drugs under the program;
  • Assist the department in developing and administering a distribution program within the program;
  • Assist the department with the preparation of an annual report and provide any information requested by the department for the report;
  • Ensure the safety and quality of drugs imported under the program;
  • Maintain a list of all eligible importers that participate in the program;
  • Ensure compliance with the federal "Drug Quality and Security Act" by all Canadian suppliers, eligible importers, distributors, and other participants in the program;
  • Provide an annual financial audit of its operations to the department;
  • Provide to the department quarterly financial reports specific to the program, which reports must include information concerning the performance of the vendor's subcontractors and vendors;
  • Submit evidence of a surety bond in an amount of at least $25,000 with any bid or initial contract negotiation documents and maintain documentation of evidence of the surety bond with the department throughout the contract term; and
  • Maintain the information and documentation submitted to the department for at least 7 years.

The act imposes certain requirements for drugs that are imported under the program, and the act prohibits certain drugs from being imported under the program.

The act states that the following entities are eligible importers under the program:

  • A pharmacist or wholesaler employed by or under contract with a medicaid pharmacy, for dispensing to the pharmacy's medicaid recipients;
  • A pharmacist or wholesaler employed by or under contract with the department of corrections, for dispensing to inmates in the custody of the department of corrections;
  • Commercial plans, as defined by rules promulgated by the medical services board and as approved by the federal government; and
  • A licensed Colorado pharmacist or wholesaler approved by the department.

An eligible importer may import a prescription drug from a Canadian supplier if:

  • The drug meets federal food and drug administration standards and is not a controlled substance, biological product, infused or intravenously injected drug, a drug that is inhaled during surgery, or a parenteral drug deemed a threat to public health; and
  • Importing the drug is expected to generate cost savings and would not violate federal patent laws.

The act requires the department to designate an office or division that must be a licensed pharmaceutical wholesaler or that shall contract with a licensed pharmaceutical wholesaler. The designated office shall:

  • Set a maximum profit margin so that a wholesaler, distributor, pharmacy, or other licensed provider participating in the program maintains a profit margin that is no greater than the profit margin that the wholesaler, distributor, pharmacy, or other licensed provider would have earned on the equivalent nonimported drug;
  • Exclude generic products if the importation of the products would violate United States patent laws applicable to United States-branded products;
  • Comply with certain federal requirements concerning drug quality and security; and
  • Determine a method for covering the administrative costs of the program.

Each participating eligible importer and Canadian supplier shall submit to the vendor specified information about each drug to be acquired by the importer or to be supplied by the Canadian supplier under the program.

The department shall immediately suspend the importation of a specific drug or the importation of drugs by a specific eligible importer if it discovers that any drug or activity is in violation of the act or any federal or state law or regulation. The department may revoke the suspension if, after conducting an investigation, it determines that the public is adequately protected from counterfeit or unsafe drugs being imported into this state.

The executive director of the department shall promulgate rules as necessary for the administration of the program. The department shall approve a method of financing the administrative costs of the program, which method may include imposing a fee on each prescription pharmaceutical product sold through the program or any other appropriate method determined by the department to finance administrative costs. The department shall not require a fee in an amount that the department determines would significantly reduce consumer savings.

On or before December 1, 2021, and on or before December 1 each year thereafter, the department shall submit a report to the governor, the president of the senate, and the speaker of the house of representatives concerning the operation of the program during the previous fiscal year.

For the 2019-20 fiscal year, the act appropriates $1,041,802 to the department to implement the act, $134,719 of which is reappropriated to the department of law to provide legal services to the department.


(Note: This summary applies to this bill as enacted.)

Status: 5/15/2019 Signed by Governor
Fiscal Notes:

Fiscal Note


SB19-013 Medical Marijuana Condition Opiates Prescribed For 
Comment:
Position: Monitor
Calendar Notification: NOT ON CALENDAR
Short Title: Medical Marijuana Condition Opiates Prescribed For
Sponsors: V. Marble (R) | J. Ginal (D) / E. Hooton (D) | K. Ransom (R)
Summary:

Medical marijuana - disabling medical conditions - conditions for which a physician could prescribe an opioid. The act adds a condition for which a physician could prescribe an opioid to the list of disabling medical conditions that authorize a person to use medical marijuana for his or her condition. Under current law, a child under 18 years of age who wants to be added to the medical marijuana registry for a disabling medical condition must be diagnosed as having a disabling medical condition by 2 physicians, one of whom must be a board-certified pediatrician, a board-certified family physician, or a board-certified child and adolescent psychiatrist who attests that he or she is part of the patient's primary care provider team. The act removes the additional requirements on specific physicians to align with the constitutional provisions for a debilitating medical condition. The act states if the recommending physician is not the patient's primary care physician, the recommending physician shall review the records of a diagnosing physician or a licensed mental health provider acting within its scope of practice. The act limits a patient with a disabling medical condition who is under eighteen years of age to using medical marijuana only in a nonsmokeable form when using medical marijuana upon the grounds of the preschool or primary or secondary school in which the student is enrolled, or upon a school bus or at a school-sponsored event.
(Note: This summary applies to this bill as enacted.)

Status: 5/23/2019 Governor Signed
Fiscal Notes:

Fiscal Note


SB19-015 Create Statewide Health Care Review Committee 
Comment:
Position: Monitor
Calendar Notification: NOT ON CALENDAR
Short Title: Create Statewide Health Care Review Committee
Sponsors: J. Ginal (D) / S. Beckman (R) | C. Kipp (D)
Summary:

Statewide health care review committee - creation - membership - duties - appropriation. The act recreates the former health care task force, renamed as the statewide health care review committee, to study health care issues that affect Colorado residents. The committee consists of no more than 10 of the members from the house of representatives committees on health and insurance and public health care and human services and the senate committee on health and human services. The committee may hold 2 meetings during the interim between legislative sessions, each of which may be a field trip.

$16,062 is appropriated from the general fund to the legislative department to implement the act.


(Note: This summary applies to this bill as enacted.)

Status: 5/30/2019 Governor Signed
Fiscal Notes:

Fiscal Note


SB19-134 Out-of-network Health Care Disclosures And Charges 
Comment:
Position: Monitor
Calendar Notification: NOT ON CALENDAR
Short Title: Out-of-network Health Care Disclosures And Charges
Sponsors: R. Fields (D) | J. Tate (R) / M. Soper (R)
Summary:

The bill:

  • Sets the reimbursement rate that a health insurance carrier must pay a health care facility if a covered person is treated for emergency services;
  • Requires in-network health care facilities and health care providers to make disclosures to patients covered by a health benefit plan concerning the provision of services by an out-of-network provider;
  • Outlines the claims and payment process, including reimbursement rates for the provision of out-of-network services for health care facilities and health care providers; and
  • Authorizes arbitration for the payment of health care claims that are in dispute if certain criteria are met.

The commissioner of insurance is required to submit a report annually to the general assembly concerning unanticipated out-of-network services.


(Note: This summary applies to this bill as introduced.)

Status: 4/25/2019 Senate Committee on Health & Human Services Postpone Indefinitely
Fiscal Notes:

Fiscal Note


SB19-217 Healthcare Provider Liens 
Comment:
Position: Monitor
Calendar Notification: Thursday, May 2 2019
CONFERENCE COMMITTEES TO REPORT
(1) in senate calendar.
Friday, May 3 2019
CONSIDERATION OF CONFERENCE COMMITTEE
(1) in house calendar.
Short Title: Healthcare Provider Liens
Sponsors: M. Foote (D) | J. Tate (R) / M. Snyder (D) | R. Bockenfeld (R)
Summary:

The bill establishes requirements for the creation of a healthcare provider lien. A healthcare provider lien is a lien related to charges for medical care provided to a person injured by the negligence or wrongful act of another person, which is asserted against money the injured person may receive from a personal injury claim or uninsured motorist claim. A healthcare provider or healthcare provider's assignee creating a lien must advise the injured person of their options for payment, including the use of benefits from an insurance plan or other payer of benefits, before or at the time of creating the lien. Before a person signs an agreement creating a healthcare provider lien, the healthcare provider or its assignee is required to disclose to the injured party that the healthcare provider is not a health insurer or payer of benefits, that unlike a health insurer or payer of benefits the lienholder is entitled to receive the full amount of the lien even if the injured party is not fully compensated from a settlement or judgment, that the lienholder is not required to contribute to the injured party's legal fees or costs, that the lienholder's compensation is based on the difference between the total amount of the medical bills and the negotiated amount, and of any business interests between the lienholder and the injured party's legal counsel or healthcare providers.

The lienholder is required to provide notice to the injured party of the amounts billed under the lien as they are accrued, to the extent practicable, and to provide a final itemized statement that includes a summary of treatment provided, the amounts billed, and the total amount due and owing.

The lien amount cannot include any additional amounts over the amount of the charges for services provided, billed at the provider's usual and customary rates. Except in the event of fraud by the injured party, the lienholder may only assign to a collection agency or debt collector an amount equal to the total amount actually paid to healthcare providers.

A healthcare provider may assign a lien to another person or entity. The fact of the assignment, its terms, and the amount paid by the assignee is not discoverable or admissible as evidence in any third-party or first-party action, except in an action under the "Uniform Consumer Credit Code".

The provisions of the bill do not apply to hospital liens.


(Note: This summary applies to the reengrossed version of this bill as introduced in the second house.)

Status: 5/2/2019 First Conference Committee Result was to Adopt Rerevised w/ Amendments
Fiscal Notes:

Fiscal Note


SB19-219 Sunset Continue Licensing Of Controlled Substances 
Comment:
Position: Monitor
Calendar Notification: NOT ON CALENDAR
Short Title: Sunset Continue Licensing Of Controlled Substances
Sponsors: B. Pettersen (D) / S. Gonzales-Gutierrez (D)
Summary:

Licensing of controlled substances act - continuation under sunset law. The act implements the recommendations of the department of regulatory agencies in its sunset review and report on the "Colorado Licensing of Controlled Substances Act" (controlled substances licensing act) by:

  • Continuing the controlled substances licensing act for 7 years and subjecting it to sunset review prior to its repeal on September 1, 2026;
  • Repealing references to research as a regulated activity in the controlled substances licensing act;
  • Requiring the department of human services (department) to develop and implement a formal, simple, accurate, and objective system to track and categorize complaints made against a licensee and disciplinary actions taken pursuant to the controlled substances licensing act; and
  • Directing the department to develop a secure online central registry for licensed opioid treatment programs to submit information to the department.

The department is required to develop a policy that separates the administration of the controlled substances licensing act from the performance of its duties relating to approved treatment facilities that receive public funds.


(Note: This summary applies to this bill as enacted.)

Status: 5/30/2019 Governor Signed
Fiscal Notes:

Fiscal Note


SB19-227 Harm Reduction Substance Use Disorders 
Comment:
Position: Support
Calendar Notification: NOT ON CALENDAR
Short Title: Harm Reduction Substance Use Disorders
Sponsors: B. Pettersen (D) | J. Gonzales (D) / C. Kennedy (D) | L. Herod (D)
Summary:

Substance use disorders - school districts, nonpublic schools, and specified public persons may obtain and administer opiate antagonists - definition of drug paraphernalia - hospitals as clean syringe exchange sites - opiate antagonist bulk purchase fund - household medication take-back program - identity verification for individuals initiating into treatment - appropriation. The act:

  • Allows school districts and nonpublic schools to develop policies by which schools are authorized to obtain a supply of opiate antagonists and school employees are trained to administer opiate antagonists to individuals at risk of experiencing a drug overdose;
  • Allows a prescriber to prescribe or dispense and a pharmacist to dispense an opiate antagonist to law enforcement agencies, schools, or specified public persons;
  • Removes from the definition of "drug paraphernalia" equipment, products, and materials used in testing or analyzing a controlled substance;
  • Specifies that a licensed or certified hospital may be used as a clean syringe exchange site;
  • Creates the opiate antagonist bulk purchase fund to facilitate bulk purchasing of opiate antagonists at a discounted price;
  • Expands the household medication take-back program in the department of public health and environment (department) for the purpose of allowing the safe collection and disposal of needles, syringes, and other devices used to inject medication;
  • Authorizes a public person or entity that makes an automated external defibrilator available to the public to also make an opiate antagonist available to the public; and
  • Requires the department of health care policy and financing to establish a policy on how a substance use disorder treatment program must verify the identity of individuals initiating into detoxification, withdrawal, or maintenance treatment for a substance use disorder.

$659,472 is appropriated to the department to implement the act.

Specified provisions of the act are contingent upon House Bill 19-1172 becoming law.


(Note: This summary applies to this bill as enacted.)

Status: 5/23/2019 Governor Signed
Fiscal Notes:

Fiscal Note


SB19-228 Substance Use Disorders Prevention Measures 
Comment:
Position: Amend
Calendar Notification: NOT ON CALENDAR
Short Title: Substance Use Disorders Prevention Measures
Sponsors: F. Winter (D) | D. Moreno (D) / B. Buentello (D) | J. Singer (D)
Summary:

Substance abuse prevention - pharmacy enhanced dispensing fee - health care providers with prescriptive authority - required training - receipt of benefits for prescriptions prohibited - access to prescription drug monitoring program - appropriation to address opioid and other substance use disorder priorities - office of behavioral health grant programs created - center for research into substance use disorder prevention, treatment, and recovery support strategies program created - perinatal substance use date linkage project created - report - appropriations. The act:

  • Allows a pharmacy that dispenses an opioid to receive an enhanced dispensing fee if the pharmacy provides counseling concerning the risk of opioids to the patient;
  • Prohibits a physician, physician assistant, or an advanced practice nurse from accepting any direct or indirect benefits for prescribing a specific medication;
  • Requires the state board of pharmacy to promulgate rules that require a prescription for an opioid for outpatient use to bear a warning label;
  • Allows medical examiners and coroners access to the prescription drug monitoring program under specified circumstances;
  • Authorizes the department of human services to conduct research that relates to the definition of "abuse" concerning the incidence of prenatal substance exposure and related newborn and family health and human services outcomes as the result of a mother's lawful and unlawful intake of controlled substances;
  • Requires specified state departments to report to the health committees of the general assembly by December 31, 2019, the amount of federal funds that each is receiving or is eligible to receive for use in testing for hepatitis and HIV and the number of individuals currently and anticipated to be tested. The departments are also required to share eligibility standards for treatment with primary care providers.
  • Creates the Charlie Hughes and Nathan Gauna opioid prevention grant program to improve young lives in the office of behavioral health in the department of human services (office) for the purpose preventing opioid use among the state's youth population.
  • Requires the center for research into substance use disorder prevention, treatment, and recovery support strategies (center) to develop and implement a program to increase public awareness about the safe use, storage, and disposal of opioids, and about the availability of antagonist drugs. The general assembly is required to annually appropriate until the 2023-24 fiscal year $750,000 to the center from the marijuana tax cash fund to implement the program.
  • Allows the center, in partnership with an institution of higher education and the state substance abuse trend and response task force to conduct a statewide perinatal substance use data linkage project;
  • Requires the center to hire additional staff to assist local communities in applying for grants;
  • Creates the maternal and child health pilot program in the office to provide grants to obstetric and gynecological health care clinics and to treatment facilities that provide substance use disorder or medication-assisted treatment; and
  • Requires podiatrists, dentists, advanced practice nurses, optometrists, and veterinarians to complete substance use disorder training as part of continuing education required to renew the provider's license if the health care provider has prescriptive authority.

$1,192, 367 is appropriated to the department of human services, $1,100,000 is appropriated to the department of higher education, and $2 million is appropriated department of public health and environment, all from the marijuana tax cash fund, to implement the act.

Specified provisions of the act are contingent upon House Bill 19-1172 becoming law.


(Note: This summary applies to this bill as enacted.)

Status: 5/23/2019 Governor Signed
Fiscal Notes:

Fiscal Note