Prior to the General Assembly adjourning on May 7, lawmakers passed several bills of interest to pharmacies, including:   

  • HB25-1094, governing PBM practices – Allowing a PBM to earn income derived from a flat-dollar service fee assessment and prohibits a PBM from earning income based on the cost of a prescription drug; prohibiting a PBM from designing a formulary to favor a certain branded pharmaceutical or biologic; requiring a PBM to credit income from a source other than a flat-dollar service fee to a health insurance carrier or a self-funded health benefit plan beneficiary; setting the amount that a PBM shall reimburse an unaffiliated pharmacy or a PBM-affiliated retail, mail order or specialty pharmacy for a prescription drug; and requiring a PBM to make certain documents and data available to a carrier, a self-funded plan or the insurance commissioner upon request and authorizing the health benefit plan to execute an audit to validate compliance with the contract.
  • HB25-1222, the bill's rate floor and telepharmacy provisions only apply to independent pharmacies, passed out of both houses on May 1. For the purposes of this bill, "rural independent pharmacies" are defined as a drug outlet that is privately owned by at least one licensed pharmacist with no ownership interest by or affiliation with a chain pharmacy or a publicly traded prescription drug outlet. The bill will reimburse independents not less than NADAC, plus pay a dispensing fee. It also includes audit protection provisions, and it exempts independent pharmacies from the direct supervision rule if the initial interpretation and final evaluation of the prescription are done by a pharmacist in person or remotely. 

Finally in Colorado, SB25-045, legislation that requires school of public health to analyze model legislation for implementing a single-payer, nonprofit, publicly financed, and privately delivered universal health-care payment system for Colorado that directly compensates a provider. A report detailing its findings must be submitted to the General Assembly by December 31, 2026. The bill creates the Statewide Health Care Analysis Collaborative under the Department of Health Care Policy and Financing (HCPF) to assist the university in its report. 

For more information, contact NACDS’ Mary Staples at 817-442-1155.