The Department of Health Care Policy & Financing l(HCPF) is hosting its annual virtual Stakeholder Webinar on August 12 from 9:00 am to 11:00am MT. Leaders will discuss emerging federal threats to Medicaid, state budget challenges, Medicaid cost trend drivers and HCPF's priorities for fiscal year 2025-2026.  

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

The Department of Health Care Policy and Financing (HCPF) is soliciting stakeholder input before August 30, regarding the draft Supervision Policy for Medicaid Billable Behavioral Health Services. Feedback can be provided either by attending a stakeholder meeting or providing written feedback using this Google Form.  

Also in Colorado, the Department of Regulatory Agencies (DORA) Board of Pharmacy is hosting a pharmacy stakeholder meeting on proposed rules on July 31 at 9:00 am MDT. Oral comments will be taken from webinar participants. Written comments need to be submitted as soon as possible so that they can be included in this stakeholder meeting.  

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

Gov. Jared Polis (D) signed SB25-289, a law creating a new Drug Donation Program to facilitate the safe donation and dispensing of unused medicine to Coloradans in need. The program expands upon the drug donation provisions and the corresponding rules and regulations for the Board of Pharmacy; it establishes parameters for participation and sets directives for donation recipients on the requirements for record retention in the program; outlines how to distribute donated medicine; and identifies what types of medicine can be distributed through the donation program.  

Also in Colorado, the Health Care Policy & Financing (HCPF) annual Pharmacy Stakeholder Webinar is on August 12 from 9:00 am-11:00 am MT. Discussion will focus on emerging federal threats to Medicaid, state budget challenges, Medicaid cost trend drivers and priorities for fiscal year 2025-2026. Participants are encouraged to register for the webinar in advance.  

Finally in Colorado, SB25-308 creates a cash fund for state dollars designated to 1115 waiver programs such as health related social needs and re-entry services for those leaving prison or jail after incarceration.  

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

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.

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.

Gov. Jared Polis (D) released his budget of $17.4 billion total funds, including $5.4 billion General Fund to cover 1.4 million Coloradans under Medicaid and Child Health Plan Plus (CHP+), which represents about 38% of the total state budget and about 31% of the state’s General Fund operating budget.

Also in Colorado, the Department of Regulatory Agencies (DORA) scheduled a stakeholder meeting on proposed new Rule 17.00.00, Appendix G – Medication-Assisted Treatment (MAT) Prescription Protocol. The purpose is to create a new MAT Prescribing Statewide Protocol that is required as part of the implementation of Colorado HB 24-1045.

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

State House Democrats elected their slate of leaders for the 2025 session, including re-electing House Speaker Julie McCluskie (D), who is entering her fourth and final term. The full House must ratify Rep. McCluskie’s nomination when it convenes on January 8, 2025.

Also in Colorado, Senate Republicans elected new leaders this week. State Sen. Paul Lundeen (R) remains as Minority Leader.

Finally in Colorado, Phase III of the Medicaid program Accountable Care Collaborative (ACC) is scheduled to begin July 1, 2025. The Department of Health Care Policy and Financing (HCPF) developed the program with stakeholder input to improve quality of care, close health disparities, improve care access, improve the member as well as provider experience and manage costs, which is critical to protecting member coverage, benefits and provider reimbursements, especially in tight state budget years.

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

The Department of Health Care Policy and Financing (HCPF) continues to promote value based payments for prescription drugs and other care to reward improved access to high-quality, equitable and affordable care. In 2022, 36% of Medicaid payments were value-based payments.

Also in Colorado, the fourth annual substance use disorder (SUD) virtual stakeholder forum will be held on October 16. HCPF will review the Annual Report for Demonstration Year 3 and update the community about the 1115 Waiver “Expanding the Substance Use Disorder Continuum of Care.” Participants need to register in advance.

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

A Pharmacy Workplace Conditions and Well-being Summit, jointly sponsored by the University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences and Regis University School of Pharmacy, will be held on September 30^th.

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