Effective January 1, 2024, the bill creates an epinephrine auto-injector affordability program (program) to provide low-cost epinephrine auto-injectors to individuals who:

• Are residents of this state;
• Are not enrolled in the state medicaid program or the federal medicare program;
• Have a prescription for an epinephrine auto-injector; and
• Are not enrolled in prescription drug coverage that limits the total amount of cost sharing that the enrollee is required to pay for an epinephrine auto-injector.

The bill requires the division of insurance in the department of regulatory agencies (division) to create an application for the program and requires the division and the department of health care policy and financing to make the application available on their websites and to promote the availability of the program.

The bill requires a carrier that provides coverage for prescription epinephrine auto-injectors to cap the total amount that a covered person is required to pay for all covered prescription epinephrine auto-injectors at an amount not to exceed $60 for a 2-pack of epinephrine auto-injectors.

A pharmacy that dispenses epinephrine auto-injectors is authorized to collect a copayment not to exceed $60 from the individual to cover the pharmacy's costs of processing and dispensing a 2-pack of epinephrine auto-injectors.

A manufacturer of epinephrine auto-injectors:

• Is required to make epinephrine auto-injectors available to individuals through the program; and
• May be required to reimburse the dispensing pharmacy an amount that covers the difference between the pharmacy's wholesale acquisition cost for the number of epinephrine auto-injectors dispensed through the program and the amount the recipients of the epinephrine auto-injectors paid for the same number of epinephrine auto-injectors or send the pharmacy a replacement supply of the same number of epinephrine auto-injectors.

If a manufacturer fails to comply with the requirements of the bill, the manufacturer may be subject to a fine.

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

The bill prohibits a supplemental health-care staffing agency (staffing agency) from including in a contract or agreement with a health-care worker, nursing care facility, or assisted living residence a provision for liquidated damages, employment fees, or other compensation to be paid to the staffing agency if the nursing care facility or assisted living residence hires the health-care worker as a permanent employee either prior to or after the termination of the contract or agreement.

A staffing agency that violates the prohibition commits a civil infraction and is subject to a monetary penalty. Further, for repeated or willful violations, the executive director of the department of labor and employment may impose monetary or administrative penalties against the staffing agency.

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

The bill updates information associated with Prader-Willi syndrome to conform to current laws and regulations.

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

The bill creates the family and community intervener program (program) to support children who are deafblind and their families. The program provides deafblind children the services of an intervener who is specifically trained in deafblindness, building language and communication skills, and intervention strategies with children who are deafblind and their community, families, and environment. The Colorado commission for the deaf, hard of hearing, and deafblind (commission) shall contract with an intervener program manager (manager) who has oversight over the program, the intervener activities, and the outcomes for children who are deafblind.

Starting in 2025, and upon the approval of the department of health care policy and financing, the commission shall have the manager direct eligible children to receive intervener services through the home- and community-based services provided by the community first choice option of the federal "Social Security Act".

The program is funded through the Colorado telephone users with disabilities fund.

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

The bill requires all individual and group health benefit plans to provide coverage for biomarker testing if the testing is supported by medical and scientific evidence. Biomarker testing is defined as an analysis of a patient's tissue, blood, or other biospecimen for the presence of an indicator of normal biological processes, pathogenic processes, or pharmacologic responses to a specific therapeutic intervention.

The bill requires the commissioner of insurance to implement biomarker testing coverage for all individual and group health benefit plans issued or renewed on or after January 1, 2025.

Biomarker testing is subject to the health benefit plan's annual deductibles, copayment, or coinsurance but is not subject to any annual or lifetime maximum benefit limit.

If a carrier requires prior authorization for biomarker testing, the bill requires the carrier to use an expedited prior authorization process.

Subject to federal authorization and federal financial participation, beginning July 1, 2024, the bill includes coverage for biomarker testing as part of the state medical assistance program if the testing is supported by medical and scientific evidence.

Under the state medical assistance program, the bill requires an expedited utilization review and prior authorization process, as well as an appeal process if biomarker testing is denied.

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

The bill:

• Requires a contract between a health insurance carrier (carrier) and a licensed health-care provider (provider) for the provision of health-care services to covered persons under a health coverage plan issued by the carrier (contract) to offer at least one method of payment to the provider for which there is not an associated fee; and
• Prohibits the contract from restricting the form or method of payment the carrier uses to make payments to the provider so that the only acceptable payment method is a credit card payment.

If a carrier initiates a payment to a provider using, or changes the payment method to, electronic funds transfer payments, including virtual credit card payments, the bill requires the carrier to:

• Notify the provider of any fees associated with the particular payment method;
• Advise the provider of the available payment methods and include instructions on how to select an alternative available method; and
• With each payment, remit an explanation of benefits.

The bill prohibits a carrier from charging a fee for a change in the payment method to a specified electronic transaction and allows a provider's billing service to charge a fee under certain circumstances.

The bill makes it an unfair method of competition and unfair or deceptive act or practice in the business of insurance if a carrier violates or fails to comply with the requirements of the contract limitations and requirements.

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

Under current law, a mental health professional must be licensed by the department of education (department) in order to work in a school. The bill authorizes a school district, the state charter school institute, and a board of cooperative services that operates a school to employ certain mental health professionals who are not licensed by the department but hold a Colorado license for their profession. Before being employed, the mental health professional must satisfy other requirements for nonlicensed school employees, including a fingerprint-based criminal background check. Any mental health professional employed may be supervised by a mentor special services provider in the field in which the person is employed or a licensed administrator.
(Note: This summary applies to this bill as introduced.)

The bill prohibits a prescriber from issuing to a patient a prescription for an opioid that will be dispensed or administered outside of a health-care facility or the prescriber's practice location if the amount of the opioid exceeds 90 morphine milligram equivalents per day, unless the patient suffers from intractable pain.
(Note: This summary applies to this bill as introduced.)

Colorado Youth Advisory Council Committee. The bill establishes the office of disordered eating prevention (office) in the department of public health and environment (department).

The office and the department are required to:

• Create and maintain a resource bank for research, intervention methods, treatment resources, information on crisis services, awareness programs, and educational resources regarding disordered eating prevention and care in Colorado;
• Collaborate with the office of suicide prevention, the behavioral health administration, and organizations within the health-care industry to close gaps in care and provide support to individuals with disordered eating who transition out of inpatient care, facilitate public outreach, and increase awareness regarding disordered eating prevention and care with a focus on impacted communities, such as youth, people of color, and lesbian, gay, bisexual, and transgender individuals;
• Create outreach resources directing youth on how to seek care for disordered eating and how to report concerns for other youth, with a focus on impacted communities, such as lesbian, gay, bisexual, and transgender youth and youth of color;
• Partner with the department of education to inform teachers, administrators, school staff, students, and parents on disordered eating preventions and treatment for youth;
• Collaborate with advocacy groups, including faith-based organizations, to support a shift in public perception regarding health-care systems and disordered eating treatment and prevention;
• Coordinate the disordered eating prevention research grant program; and
• Prepare written information for primary care offices and providers throughout the state. The information must be culturally specific concerning how to recognize and respond to a patient with disordered eating and include separate written information for providers and information that may be shared with an adult patient or a youth patient and the caregivers of the youth patient.

The bill creates the disordered eating prevention commission (commission) in the department. The commission will have 17 members with professional or personal connections to disordered eating prevention. The purpose of the commission is to:

• Provide public and private leadership on disordered eating prevention in Colorado;
• Set statewide, data-driven, evidence-based, and clinically informed priorities for disordered eating prevention in Colorado;
• Serve as the advisor to the office of disordered eating prevention;
• Establish and lead subgroups to set strategy and implementation plans for the office;
• Provide a forum for government agencies, community members, and lawmakers to examine the current status of disordered eating prevention policies;
• Provide a voice for youth and focus on youth issues;
• Provide a forum for diverse perspectives to support and inform diverse communities; and
• Provide a forum for perspectives from rural communities to support and inform rural communities.

The bill creates the disordered eating prevention research grant program (grant program) in the department. The purpose of the grant program is to provide financial assistance to eligible applicants to conduct research on risk factors for disordered eating, the impact disordered eating has on Colorado, or public health interventions that examine and address the root causes of disordered eating.

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

The bill creates the Colorado multidisciplinary health-care provider access training program (program) to improve the health care of medically complex, costly, compromised, and vulnerable older Coloradans. The university of Colorado Anschutz medical campus shall develop, implement, and administer the program. The program may be offered to Colorado institutions of higher education with clinical health professions graduate degree programs. The program coordinates and expands geriatric training opportunities for clinical health professions graduate students (students) enrolled in participating Colorado institutions of higher education (participating institutions) across Colorado studying to become advanced practice providers; dentists; nurses; occupational therapists; pharmacists; physicians, including medical doctors and doctors of osteopathy; physical therapists; psychologists; social workers; and speech-language therapists. Students who successfully complete the program are awarded certificates and issued letters authorizing those students to become trainers for the program in clinics across the state.

The bill creates the Colorado multidisciplinary health-care provider access training program advisory committee (committee) to ensure that the training for the program is consistent and collaborative across the fields of study. The committee is required to:

• Appoint a program chair;
• Set the program's standards for training and delivery of multidisciplinary medical care to medically complex, costly, compromised, and vulnerable older Coloradans;
• Establish requirements for the program;
• Identify and invite institutions of higher education that offer appropriate clinical health professions graduate degree programs to become participating institutions;
• Collaborate with participating institutions of higher education across Colorado to enhance recruitment of students to enter a field specific to geriatrics and select students with an interest in geriatric care to participate in the program;
• Assist with updating the program's curricula;
• Analyze data collected by the program;
• Build a multidisciplinary network of trained geriatric clinicians to collaborate and provide opportunities for clinicians to work together to better understand the roles of each health-care discipline in urban, rural, and underserved communities when caring for older Coloradans;
• Improve placement of students in experiential clinical training opportunities, prioritizing rural and underserved communities;
• Coordinate with graduates of the program to become geriatric trainers for future students; and
• Increase the number of clinical training sites across Colorado, specifically in rural and underserved communities.
  (Note: This summary applies to this bill as introduced.)