NOTE:  This bill has been prepared for the signature of the appropriate legislative
officers and the Governor.  To determine whether the Governor has signed the bill
or taken other action on it, please consult the legislative status sheet, the legislative
      history, or the Session Laws.
      
      
      HOUSE BILL 08-1032
      
      
      BY REPRESENTATIVE(S) Massey, Green, Riesberg, Labuda, Madden,
      McFadyen, Middleton, Stafford, Summers, Borodkin, and Peniston;
      also SENATOR(S) Morse, and Boyd.
      
      
      Concerning a change in payments to pharmacies for certain drugs
           under medicaid.
       
      
      Be it enacted by the General Assembly of the State of Colorado:
      
           SECTION 1.  Part 5 of article 5 of title 25.5, Colorado Revised
      Statutes, is amended BY THE ADDITION OF A NEW SECTION to read:
      
           25.5-5-501.5.  Generic and nonpatented drugs - legislative
      declaration - dispensing fee - state maximum allowable cost - repeal.
      (1) (a)  The general assembly finds and declares that access to
      pharmacy services by medicaid recipients should not be impeded
      and that it would benefit the state to review the current
      methodology to determine the reimbursement rate for generic
      and nonpatented prescribed medications to assure continued
      access to pharmaceutical services.
      
           (b)  It is the intent of the general assembly in enacting this
      section that the state department review the overall
      reimbursement rate paid to pharmacies for generic and
      nonpatented medications and assure an adequate pharmacy
      reimbursement.
      
           (2)  As used in this section, unless the context otherwise
      requires:
      
           (a)  "Local pharmacy" means a prescription drug outlet
      required to register pursuant to section 12-22-120, C.R.S.
      
           (b) (I)  "State maximum allowable cost" or "S-MAC" means
      the per unit amount the state department reimburses a local
      pharmacy for a prescription drug included in the state maximum
      allowable cost program.
      
           (II)  "State maximum allowable cost" or "S-MAC" does not
      include dispensing fees or copayments, coinsurance, or other
      cost-sharing charges.
      
           (c)  "State maximum allowable cost program" means a rate
      schedule for prescription drugs created by the state department
      or for the state department by a contractor.
      
           (3)  The state department may use the state maximum
      allowable cost program to adjust the amount paid to pharmacies
      for prescription drugs.
      
           (4)  If the state department implements a state maximum
      allowable cost program pursuant to subsection (3) of this section
      for prescription drugs that are subject to the federal upper
      payment limit as established pursuant to the federal "Deficit
      Reduction Act of 2005", Pub.L. 109-171, to the extent possible the
      state department shall establish S-MAC costs to maximize the
      federal financial participation money paid to local pharmacies for
      pharmacy services.  The reimbursement rates for drugs that are
      not subject to the federal upper payment limit as established
      pursuant to the "Deficit Reduction Act of 2005" may be established
      using a method established by the department.
      
           (5)  If the cost of a drug as determined through other
      methods adopted in rules promulgated by the state board is lower
      than the cost under the state maximum allowable cost program,
      the state department may use the lower cost to reimburse
      pharmacies.
      
           (6)  If the state department changes the method used to
      establish S-MAC prices, it shall notify the joint budget committee
      of the general assembly of any anticipated fiscal impacts of the
      change to the state and to local pharmacies.
      
           SECTION 2.  Safety clause.  The general assembly hereby finds,
      determines, and declares that this act is necessary for the immediate
      preservation of the public peace, health, and safety.
      
      
      
      
      ________________________________________________________
      Andrew Romanoff                        Peter C. Groff
      SPEAKER OF THE HOUSE                     PRESIDENT OF
      OF REPRESENTATIVES                         THE SENATE
      
      
      
      
      
      
      ____________________________  ____________________________
      Marilyn Eddins                          Karen Goldman
      CHIEF CLERK OF THE HOUSE                 SECRETARY OF
      OF REPRESENTATIVES                         THE SENATE
      
      
      
      
                  APPROVED________________________________________
      
      
      
      
      
                                    _________________________________________
                                    Bill Ritter, Jr.
                                    GOVERNOR OF THE STATE OF COLORADO