HB 22-1370

  • Colorado House Bill
  • 2022 Regular Session
  • Introduced in House May 02, 2022
  • Passed House May 02, 2022
  • Passed Senate May 09, 2022
  • Signed by Governor May 18, 2022

Coverage Requirements For Health-care Products

Abstract

Beginning in 2023, the bill requires each health insurance carrier (carrier) that offers an individual or small group health benefit plan in this state to offer at least 25% of its health benefit plans on the Colorado health benefit exchange (exchange) and at least 25% of its plans not on the exchange in each bronze, silver, gold, and platinum benefit level in each service area as copayment-only payment structures for all prescription drug cost tiers. Starting in 2024, a carrier or, if a carrier uses a pharmacy benefit manager (PBM) for claims processing services or other prescription drug or device services under a health benefit plan offered by the carrier, the PBM, or a representative of the carrier or the PBM, is prohibited from modifying or applying a modification to the current prescription drug formulary during the current plan year. The bill repeals and reenacts the current requirements for step therapy and requires a carrier to use clinical review criteria to establish the step-therapy protocol. For each health benefit plan issued or renewed on or after January 1, 2024, the bill requires each carrier or PBM to demonstrate to the division of insurance that: 100% of the estimated rebates received or to be received in connection with dispensing or administering prescription drugs included in the carrier's prescription drug formulary are used to reduce costs for the employer or individual purchasing the plan; For small group and large employer health benefit plans, all rebates are used to reduce employer and individual employee costs; and For individual health benefit plans, all rebates are used to reduce consumers' premiums and out-of-pocket costs for prescription drugs to the extent practicable. The bill requires the commissioner of insurance (commissioner) to promulgate rules to implement prescription drug pass-through requirements for carriers. Each carrier or PBM is required to report annually specified prescription drug rebate information to the commissioner. Beginning in 2023, the bill requires the department of health care policy and financing, in collaboration with the administrator of the all-payer claims database, to conduct an annual analysis of the prescription drug rebates received in the previous calendar year, by carrier and prescription drug tier, and make the analysis available to the public. (Note: This summary applies to this bill as introduced.)

Bill Sponsors (4)

Votes


Actions


May 18, 2022

Office of the Governor

Governor Signed

May 17, 2022

Office of the Governor

Sent to the Governor

Senate

Signed by the President of the Senate

House

Signed by the Speaker of the House

May 11, 2022

House

House Considered Senate Amendments - Result was to Concur - Repass

May 10, 2022

House

House Considered Senate Amendments - Result was to Laid Over Daily

May 09, 2022

Senate

Senate Third Reading Passed - No Amendments

May 06, 2022

Senate

Senate Second Reading Special Order - Passed with Amendments - Committee

Senate

Senate Committee on Appropriations Refer Amended to Senate Committee of the Whole

  • Committee-Passage
  • Referral-Committee
Senate Committee of the Whole Appropriations

Senate

Senate Committee on State, Veterans, & Military Affairs Refer Amended to Appropriations

  • Referral-Committee
Appropriations State, Veterans, & Military Affairs

May 05, 2022

Senate

Senate Committee on State, Veterans, & Military Affairs Witness Testimony and/or Committee Discussion Only

State, Veterans, & Military Affairs

May 02, 2022

Senate

Introduced In Senate - Assigned to State, Veterans, & Military Affairs

  • Introduction
State, Veterans, & Military Affairs

House

House Third Reading Passed - No Amendments

Apr 29, 2022

House

House Second Reading Special Order - Passed with Amendments - Committee, Floor

House

House Committee on Appropriations Refer Amended to House Committee of the Whole

  • Committee-Passage
  • Referral-Committee
House Committee of the Whole Appropriations

Apr 27, 2022

House

House Committee on Health & Insurance Refer Amended to Appropriations

  • Referral-Committee
Appropriations

Apr 13, 2022

House

Introduced In House - Assigned to Health & Insurance

  • Introduction
Health & Insurance

Bill Text

Bill Text Versions Format
Signed Act (05/18/2022) PDF
Final Act (05/17/2022) PDF
Rerevised (05/09/2022) PDF
Revised (05/06/2022) PDF
Reengrossed (05/02/2022) PDF
Engrossed (04/29/2022) PDF
Introduced (04/13/2022) PDF
PA3 (05/06/2022) PDF
PA4 (05/06/2022) PDF
PA1 (04/29/2022) PDF
PA2 (04/29/2022) PDF
Committee Amendment PDF

Related Documents

Document Format
Fiscal Note SA1 (04/28/2022) PDF
Fiscal Note SA2 (05/06/2022) PDF
Fiscal Note FN1 (04/19/2022) PDF
Fiscal Note FN2 (05/03/2022) PDF

Sources

Data on Open States is updated periodically throughout the day from the official website of the Colorado General Assembly.

If you notice any inconsistencies with these official sources, feel free to file an issue.