BY SENATORS Matsunaka, Hernandez, Johnson, and Thiebaut;
also REPRESENTATIVES Entz, Leyba, Musgrave, Reeser,
Smith, Snyder, Spradley, and Tate.
CONCERNING EXPEDITIOUS ACCESS TO MEDICAL TREATMENT
FOR PERSONS WHO ARE COVERED BY INSURANCE.
Be it enacted by the General Assembly of the State
of Colorado:
SECTION 1. Part
1 of article 16 of title 10, Colorado Revised Statutes, is amended
BY THE ADDITION OF A NEW SECTION to read:
1016122. Access to prescription
drugs. (1) EXCEPT AS PROVIDED
IN SECTION 264115 (2) (s), C.R.S., ANY PHARMACY BENEFIT
MANAGEMENT FIRM OR INTERMEDIARY WHOSE CONTRACT WITH A CARRIER,
AS DEFINED IN SECTION 1016102 (8), INCLUDES AN OPEN
NETWORK SHALL ALLOW PARTICIPATION BY EACH PHARMACY PROVIDER IN
THE CONTRACT SERVICE AREA. IF A PHARMACY BENEFIT MANAGEMENT FIRM
OR INTERMEDIARY OFFERS AN OPEN NETWORK, THE PHARMACY BENEFIT MANAGEMENT
FIRM OR INTERMEDIARY MAY OFFER SUCH NETWORK ON A REGIONAL OR LOCAL
BASIS.
(2) FOR PURPOSES OF THIS SECTION, "OPEN
NETWORK" MEANS ANY PHARMACY NETWORK CREATED BY A PHARMACY
BENEFIT MANAGEMENT FIRM OR INTERMEDIARY THROUGH A CONTRACTING
PROCESS WITH PHARMACY PROVIDERS THAT DOES NOT INCLUDE COMPETITIVE
BIDDING AND ALLOWS PARTICIPATION BY ANY PHARMACY PROVIDER THAT
AGREES TO THE TERMS AND CONDITIONS OF THE CONTRACT OFFERED BY
THE PHARMACY BENEFIT MANAGEMENT FIRM OR INTERMEDIARY.
(3) A PHARMACY BENEFIT MANAGEMENT FIRM
OR INTERMEDIARY SHALL NOT BE PROHIBITED FROM CONTRACTING WITH
EXCLUSIVE PHARMACY NETWORKS IF, SIXTY DAYS BEFORE THE TERMINATION
OR EFFECTIVE DATE OF AN EXCLUSIVE PHARMACY NETWORK CONTRACT BETWEEN
THE PHARMACY PROVIDERS AND THE PHARMACY BENEFIT MANAGEMENT FIRM
OR INTERMEDIARY, NOTICE OF SUCH TERMINATION OR OF THE EFFECTIVE
DATE OF AN EXCLUSIVE PHARMACY NETWORK CONTRACT IS PUBLISHED IN
ONE OR MORE NEWSPAPERS OF GENERAL CIRCULATION IN THE AFFECTED
CONTRACT SERVICE AREA. NOTICE SHALL INCLUDE INFORMATION ABOUT
WHERE IN COLORADO A COPY OF THE PHARMACY PROVIDER SELECTION CRITERIA
MAY BE OBTAINED.
SECTION 2. Effective
date applicability. (1) This act shall take
effect at 12:01 a.m. on the day following the expiration of the
ninetyday period after final adjournment of the general
assembly that is allowed for submitting a referendum petition
pursuant to article V, section 1 (3) of the state constitution;
except that, if a referendum petition is filed against this act
or an item, section, or part of this act within such period, then
the act, item, section, or part, if approved by the people, shall
take effect on the date of the official declaration of the vote
thereon by proclamation of the governor.
(2) The provisions of this act shall apply to all contracts for pricing and terms for the administration of a prescription drug benefit negotiated, renegotiated, or renewed by insurers subject to article 16 of title 10, Colorado Revised Statutes, on or after the effective date of this act.
____________________________ ____________________________
Tom Norton Charles E. Berry
PRESIDENT OF SPEAKER OF THE HOUSE
THE SENATE OF REPRESENTATIVES
____________________________ ____________________________
Patricia K. Dicks Judith M. Rodrigue
ASSISTANT SECRETARY OF CHIEF CLERK OF THE HOUSE
THE SENATE OF REPRESENTATIVES
APPROVED________________________________________
_________________________________________
Roy Romer
GOVERNOR OF THE STATE
OF COLORADO