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.

Gov. Jared Polis (D) announced his new chief of staff, David Oppenheim, replacing Alec Garnett, who has been in that role since January 1, 2023. Garnett has accepted the position of vice president for government and regulatory affairs for the University of Colorado Health.

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

NACDS is continuing to work with a coalition urging Gov. Jared Polis (D) to expedite implementation of SB24-168, a new law that expands diabetes care access for Medicaid enrollees.

Also in Colorado, Gov. Jarod Polis (D) convened a special session on August 26 to address property tax reform.

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

On August 19, the Board of Pharmacy is holding a Stakeholder Meeting to receive feedback on proposed changes to the following draft rules:

1. Rule 14.00.00 – OTHER OUTLETS – The purpose of the proposed amendments to

Board Rule 14 is to allow off-site dispensing by hospital staff.

2. Rule 15.00.00 – WHOLESALERS – The purpose of the proposed amendments to

Board Rule 15 is to update recordkeeping requirements of wholesalers

specifically related to animal drugs.

3. Rule 17.00.00 – COLLABORATIVE PHARMACY PRACTICE – The purpose of the

proposed amendments to Board Rule 17 is to update Collaborative Pharmacy

Practice Rules as they relate physician assistants to align them with

superseding regulatory changes around physician assistants.

4. Rule 21-00-00 – COMPOUNDING – The purpose of the proposed amendments to

Board Rule 21 is to update controlled substance distribution laws to better

clarify the law and align with federal requirements.

5. Rule 17, Appendix A – The purpose of the proposed amendments to Board Rule

17, Appendix A is to update clinical standards and to fix minor clerical errors.

6. Rule 3.00.00 – DISPENSING – The purpose of the proposed amendments to Board

Rule 3 is to add a short rule clarifying and referring to the new legislative

requirement of prescription label accessibility from HB24-1115.

7. Rule 23.00.00 – ELECTRONIC PRESCRIPTION MONITORING PROGRAM – The

purpose of this Rule Revision is to change the requirement to report pharmacy

data submission delinquency to the Board and give flexibility may changing

“will” to “may” which statute allows.

8. Rule 11.00.00 – RECORDS – The purpose of this Rule revision is to update

outdated terminology that no longer exists related to board approval of

electronic record storage.

9. Rules 2.00.00 – ORDERS, 3.00.00 -DISPENSING, and 31.00.00 – TELEPHARMACY –

The purpose of the proposed amendments to Board Rule 2, 3, and 31 is to

implement SB24-209 Changes to the Pharmacy Practice Act Regarding

Dispensing of Prescription Drugs, including repeal of Area of Need from

Telepharmacies, updated labeling requirements, and updated functional ability

for technicians.

Also on the Stakeholder Meeting agenda are two new proposed rules:

1. Rule 17.00.00, Appendix F – MAT Prescription Protocol – The purpose of the

proposed Rule 17, Appendix F is to create a new MAT Prescribing Statewide

Protocol required as part of implementation of HB24-1045.

2. Rule 17.00.00, Appendix E – The purpose of the proposed amendments to Board

Rule 17, Appendix E, is to create a new state-wide protocol of clinical

standards for statin therapy.

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