Gov. Jared Polis (D) signed into law HB25-1222, a rate floor and telepharmacy bill that applies to independent pharmacies only, 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 law will reimburse independents no less than NADAC, plus 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.
Also in Colorado, the Governor also signed HB25-1094 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.
Also in Colorado, the Governor signed SB25-301, law that streamlines prior authorization approvals for pharmacists.
Finally in Colorado, the Governor signed SB25-071, the 340B bill.
For more information, contact NACDS’ Mary Staples at 817-442-1155.