Colorado 2022 Regular Session

Colorado House Bill HB1122 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
	1	+	Second Regular Session
	2	+	Seventy-third General Assembly
	3	+	STATE OF COLORADO
	4	+	REREVISED
	5	+	This Version Includes All Amendments
	6	+	Adopted in the Second House
	7	+	LLS NO. 22-0243.02 Christy Chase x2008
1	8		HOUSE BILL 22-1122
2		-	BY REPRESENTATIVE(S) Will and Lindsay, Lontine, Bernett, Esgar,
3		-	Jodeh, Kipp, Ricks, Weissman, Daugherty, Hooton;
4		-	also SENATOR(S) Jaquez Lewis, Moreno.
	9	+	House Committees Senate Committees
	10	+	Health & Insurance Health & Human Services
	11	+	Appropriations Appropriations
	12	+	A BILL FOR AN ACT
5	13		C
6		-	ONCERNING PROHIBITING CERTAIN PRACTICES BY ENTITIES OBLIGATED TO
7		-	PAY FOR PRESCRIPTION DRUG BENEFITS
8		-	, AND, IN CONNECTION
9		-	THEREWITH
10		-	, MAKING AN APPROPRIATION.
	14	+	ONCERNING PROHIBITING CERT AIN PRACTICES BY ENTITIES101
	15	+	OBLIGATED TO PAY FOR PRESCRIPTION DRUG
	16	+	BENEFITS, AND, IN102
	17	+	CONNECTION THEREWITH , MAKING AN APPROPRIATION .103
	18	+	Bill Summary
	19	+	(Note: This summary applies to this bill as introduced and does
	20	+	not reflect any amendments that may be subsequently adopted. If this bill
	21	+	passes third reading in the house of introduction, a bill summary that
	22	+	applies to the reengrossed version of this bill will be available at
	23	+	http://leg.colorado.gov
	24	+	.)
	25	+	For contracts between a pharmacy benefit manager (PBM) and a
	26	+	pharmacy entered into or renewed on or after January 1, 2023, section 1
	27	+	of the bill prohibits the PBM or its representative from reimbursing a
	28	+	pharmacy for a prescription drug in an amount less than the national
	29	+	average drug acquisition cost for the prescription drug.
	30	+	SENATE
	31	+	3rd Reading Unamended
	32	+	May 9, 2022
	33	+	SENATE
	34	+	Amended 2nd Reading
	35	+	May 6, 2022
	36	+	HOUSE
	37	+	3rd Reading Unamended
	38	+	April 22, 2022
	39	+	HOUSE
	40	+	Amended 2nd Reading
	41	+	April 19, 2022
	42	+	HOUSE SPONSORSHIP
	43	+	Will and Lindsay, Lontine, Bernett, Esgar, Jodeh, Kipp, Ricks, Weissman
	44	+	SENATE SPONSORSHIP
	45	+	Jaquez Lewis, Moreno
	46	+	Shading denotes HOUSE amendment. Double underlining denotes SENATE amendment.
	47	+	Capital letters or bold & italic numbers indicate new material to be added to existing statute.
	48	+	Dashes through the words indicate deletions from existing statute. Section 2 enacts the "Colorado 340B Prescription Drug Program
	49	+	Anti-discrimination Act" (act), which prohibits health insurers, PBMs,
	50	+	and other third-party payers (third-party payers) from discriminating
	51	+	against entities, including pharmacies, participating in the federal 340B
	52	+	drug pricing program (340B covered entity). Specifically, the bill
	53	+	prohibits a third-party payer from:
	54	+	! Refusing to reimburse a 340B covered entity for dispensing
	55	+	340B drugs, imposing additional requirements or
	56	+	restrictions on 340B covered entities, or reimbursing a
	57	+	340B covered entity for a 340B drug at a rate lower than
	58	+	the amount paid for the same drug to pharmacies that are
	59	+	not 340B covered entities;
	60	+	! Assessing a fee, charge back, or other adjustment against
	61	+	a 340B covered entity, or restricting a 340B covered
	62	+	entity's access to the third-party payer's pharmacy network,
	63	+	because the covered entity participates in the 340B drug
	64	+	pricing program;
	65	+	! Requiring a 340B covered entity to contract with a specific
	66	+	pharmacy or health coverage plan in order to access the
	67	+	third-party payer's pharmacy network;
	68	+	! Imposing a restriction or an additional charge on a patient
	69	+	who obtains a prescription drug from a 340B covered
	70	+	entity; or
	71	+	! Restricting the methods by which a 340B covered entity
	72	+	may dispense or deliver 340B drugs.
	73	+	Section 2 makes a violation of the act an unfair or deceptive act or
	74	+	practice in the business of insurance and authorizes the commissioner of
	75	+	insurance to adopt rules to implement the act.
	76	+	Be it enacted by the General Assembly of the State of Colorado:1
11	77
12		-	~~Be it enacted by the General Assembly of the State of Colorado:~~
13		-	SECTION 1. In Colorado Revised Statutes, add part 15 to ~~article~~
14		-	16 of title 10 as follows:
15		-	PART 15
16		-	340B PRESCRIPTION DRUG PROGRAM
17		-	ANTI-DISCRIMINATION ACT
	78	+	2
	79	+	SECTION 1. In Colorado Revised Statutes, add part 15 to article3
	80	+	16 of title 10 as follows:4
	81	+	PART 155
	82	+	340B PRESCRIPTION DRUG PROGRAM 6
	83	+	ANTI-DISCRIMINATION ACT 7
18	84		10-16-1501. Short title. T
19		-	HE SHORT TITLE OF THIS PART 15 IS THE
20		-	"COLORADO 340B PRESCRIPTION DRUG PROGRAM ANTI-DISCRIMINATION
21		-	ACT".
22		-	NOTE: This bill has been prepared for the signatures of the appropriate legislative
23		-	officers and the Governor. To determine whether the Governor has signed the bill
24		-	or taken other action on it, please consult the legislative status sheet, the legislative
25		-	history, or the Session Laws.
26		-	________
27		-	Capital letters or bold & italic numbers indicate new material added to existing law; dashes
28		-	through words or numbers indicate deletions from existing law and such material is not part of
29		-	the act. 10-16-1502. Legislative declaration. (1) T HE GENERAL ASSEMBLY
30		-	DECLARES THAT THE PURPOSE OF THIS PART
31		-	15 IS TO:
	85	+	HE SHORT TITLE OF THIS PART 15 IS THE8
	86	+	"C
	87	+	OLORADO 340B PRESCRIPTION DRUG PROGRAM ANTI-DISCRIMINATION9
	88	+	1122-2- ACT".1
	89	+	10-16-1502. Legislative declaration. (1) T
	90	+	HE GENERAL2
	91	+	ASSEMBLY DECLARES THAT THE PURPOSE OF THIS PART 15 IS TO:3
32	92		(a) P
33		-	ROHIBIT A PHARMACY BENEFIT MANAGER OR CARRIER FROM
34		-	IMPOSING FEES
35		-	, CHARGE BACKS, OR OTHER ADJUSTMENTS ON COVERED
36		-	ENTITIES OR CONTRACT PHARMACIES BASED ON THEIR PARTICIPATION IN THE
37		-	340B DRUG PRICING PROGRAM;
	93	+	ROHIBIT A PHARMACY BENEFIT MANAGER OR CARRIER FROM4
	94	+	IMPOSING FEES, CHARGE BACKS, OR OTHER ADJUSTMENTS ON COVERED5
	95	+	ENTITIES OR CONTRACT PHARMACIES BASED ON THEIR PARTICIPATION IN6
	96	+	THE 340B DRUG PRICING PROGRAM;7
38	97		(b) P
39		-	ROHIBIT A PHARMACY BENEFIT MANAGER OR CARRIER FROM
40		-	REQUIRING A CLAIM FOR A DRUG TO INCLUDE A MODIFIER TO INDICATE THAT
41		-	THE DRUG IS A
42		-	340B DRUG UNLESS THE CLAIM IS FOR PAYMENT , DIRECTLY
43		-	OR INDIRECTLY
44		-	, BY THE MEDICAID PROGRAM; AND
45		-	(c) PROVIDE FOR POWERS AND DUTIES OF THE COMMISSIONER AND
46		-	THE DIVISION
47		-	.
	98	+	ROHIBIT A PHARMACY BENEFIT MANAGER OR CARRIER FROM8
	99	+	REQUIRING A CLAIM FOR A DRUG TO INCLUDE A MODIFIER TO INDICATE9
	100	+	THAT THE DRUG IS A 340B DRUG UNLESS THE CLAIM IS FOR PAYMENT ,10
	101	+	DIRECTLY OR INDIRECTLY, BY THE MEDICAID PROGRAM; AND11
	102	+	(c) P
	103	+	ROVIDE FOR POWERS AND DUTIES OF THE COMMISSIONER AND12
	104	+	THE DIVISION.13
48	105		10-16-1503. Definitions. A
49		-	S USED IN THIS PART 15, UNLESS THE
50		-	CONTEXT OTHERWISE REQUIRES
51		-	:
	106	+	S USED IN THIS PART 15, UNLESS THE14
	107	+	CONTEXT OTHERWISE REQUIRES :15
52	108		(1) "340B
53		-	COVERED ENTITY" MEANS A COVERED ENTITY, ~~AS DEFINED~~
54		-	IN SECTION
55		-	~~340B (a)(4) OF THE FEDERAL "PUBLIC HEALTH SERVICE ACT",~~
56		-	42
57		-	~~U.S.C. SEC.~~ ~~256b (a)(4), AS AMENDED.~~
	109	+	COVERED ENTITY" MEANS A COVERED ENTITY , AS16
	110	+	DEFINED IN SECTION 340B (a)(4) OF THE FEDERAL "PUBLIC HEALTH17
	111	+	S
	112	+	ERVICE ACT", 42 U.S.C. SEC. 256b (a)(4), AS AMENDED.
	113	+	18
58	114		(2) "340B
59		-	DRUG" MEANS A DRUG PURCHASED THROUGH THE ~~340B~~
60		-	DRUG PRICING PROGRAM BY A 340B COVERED ENTITY.
	115	+	DRUG" MEANS A DRUG PURCHASED THROUGH THE 340B19
	116	+	DRUG PRICING PROGRAM BY A 340B COVERED ENTITY.20
61	117		(3) "340B
62		-	DRUG PRICING PROGRAM" OR "340B PROGRAM" MEANS
63		-	THE PROGRAM DESCRIBED IN
64		-	42 U.S.C. SEC. 256b.
	118	+	DRUG PRICING PROGRAM" OR "340B PROGRAM" MEANS21
	119	+	THE PROGRAM DESCRIBED IN 42 U.S.C. SEC. 256b.22
65	120		(4) "C
66		-	ONTRACT PHARMACY" MEANS A PHARMACY OPERATING UNDER
67		-	CONTRACT WITH A
68		-	340B COVERED ENTITY TO PROVIDE DISPENSING SERVICES
69		-	TO THE
70		-	340B COVERED ENTITY AS DESCRIBED IN 75 FED. REG. 10272 (2010)
71		-	OR ANY SUPERSEDING GUIDANCE .
	121	+	ONTRACT PHARMACY " MEANS A PHARMACY OPERATING23
	122	+	UNDER CONTRACT WITH A 340B COVERED ENTITY TO PROVIDE DISPENSING24
	123	+	SERVICES TO THE 340B COVERED ENTITY AS DESCRIBED IN 75 FED. REG.25
	124	+	10272
	125	+	(2010) OR ANY SUPERSEDING GUIDANCE .26
72	126		(5) (a) "D
73		-	RUG COVERAGE" MEANS COVERAGE OR PAYMENT FOR A
74		-	~~PRESCRIPTION DRUG DISPENSED BY A PHARMACY TO A PATIENT PURSUANT~~
75		-	TO
76		-	:
	127	+	RUG COVERAGE" MEANS COVERAGE OR PAYMENT FOR A27
	128	+	1122
	129	+	-3- PRESCRIPTION DRUG DISPENSED BY A PHARMACY TO A PATIENT PURSUANT1
	130	+	TO:2
77	131		(I) A
78		-	HEALTH COVERAGE PLAN;
79		-	PAGE 2-HOUSE BILL 22-1122 (II) A MANAGED CARE ORGANIZATION , AS DEFINED IN SECTION
80		-	25.5-5-403 (5); OR
81		-	(III) ANY OTHER CONTRACTUAL OR OTHER LEGAL OBLIGATION TO
82		-	PROVIDE COVERAGE OR PAYMENT FO R A PRESCRIPTION DRUG DISPENSED BY
83		-	A PHARMACY TO A PATIENT
84		-	.
	132	+	HEALTH COVERAGE PLAN; 3
	133	+	(II) A
	134	+	MANAGED CARE ORGANIZATION , AS DEFINED IN SECTION4
	135	+	25.5-5-403
	136	+	(5); OR5
	137	+	(III) A
	138	+	NY OTHER CONTRACTUAL OR OTHER LEGAL OBLIGATION TO6
	139	+	PROVIDE COVERAGE OR PAYMENT FOR A PRESCRIPTION DRUG DISPENSED7
	140	+	BY A PHARMACY TO A PATIENT.8
85	141		(b) "D
86		-	RUG COVERAGE" DOES NOT INCLUDE:
	142	+	RUG COVERAGE" DOES NOT INCLUDE:9
87	143		(I) R
88		-	EIMBURSEMENT FOR COVERED OUTPATIENT DRUGS , AS THAT
89		-	TERM IS DEFINED IN SECTION
90		-	42 U.S.C. SEC. 1396r-8 (k)(2), ON A
91		-	FEE
92		-	-FOR-SERVICE BASIS UNDER THE MEDICAID PROGRAM ; OR
93		-	(II) ANY AMOUNTS PAID BY AN INDIVIDUAL ON THE INDIVIDUAL 'S
94		-	OWN BEHALF OR ON BEHALF OF ANOTHER INDIVIDUAL WITHOUT A
95		-	CONTRACTUAL OR LEGAL OBLIGATION TO DO SO
96		-	.
97		-	(6) "M
98		-	EDICAID PROGRAM" MEANS THE MEDICAL ASSISTANCE
99		-	PROGRAM ESTABLISHED PURSUANT TO ARTICLES
100		-	4 TO 6 OF TITLE 25.5.
	144	+	EIMBURSEMENT FOR COVERED OUTPATIENT DRUGS , AS THAT10
	145	+	TERM IS DEFINED IN SECTION 42 U.S.C. SEC. 1396r-8 (k)(2), ON A11
	146	+	FEE-FOR-SERVICE BASIS UNDER THE MEDICAID PROGRAM ; OR12
	147	+	(II) A
	148	+	NY AMOUNTS PAID BY AN INDIVIDUAL ON THE INDIVIDUAL 'S13
	149	+	OWN BEHALF OR ON BEHALF OF ANOTHER INDIVIDUAL WITHOUT A14
	150	+	CONTRACTUAL OR LEGAL OBLIGATION TO DO SO .15
	151	+	(6)
	152	+	"MEDICAID PROGRAM" MEANS THE MEDICAL ASSISTANCE16
	153	+	PROGRAM ESTABLISHED PURSUANT TO ARTICLES 4 TO 6 OF TITLE 25.5.17
101	154		(7) (a) "T
102		-	HIRD PARTY" MEANS:
	155	+	HIRD PARTY" MEANS:18
103	156		(I) A
104		-	CARRIER OR PHARMACY BENEFIT MANAGER THAT ~~PROVIDES OR~~
105		-	MANAGES DRUG COVERAGE ~~UNDER~~ A HEALTH COVERAGE PLAN
106		-	~~; OR~~
107		-	(II) A ~~SYSTEM OF HEALTH INSURANCE FOR STATE OR LOCAL~~
108		-	~~GOVERNMENT EMPLOYEES~~
109		-	, THEIR DEPENDENTS, AND RETIREES, ~~INCLUDING~~
110		-	A GROUP BENEFIT PLAN
111		-	~~, AS DEFINED IN~~ SECTION ~~24-50-603 (9), AND A GROUP~~
112		-	~~HEALTH CARE PROGRAM DESIGNED PURSUANT TO SECTION~~
113		-	24-51-1202.
	157	+	CARRIER OR PHARMACY BENEFIT MANAGER THAT PROVIDES19
	158	+	OR MANAGES DRUG COVERAGE UNDE R A HEALTH COVERAGE PLAN ;
	159	+	OR20
	160	+	(II) A
	161	+	SYSTEM OF HEALTH INSURANCE FOR STATE OR LOCAL21
	162	+	GOVERNMENT EMPLOYEES , THEIR DEPENDENTS, AND RETIREES, INCLUDING22
	163	+	A GROUP BENEFIT PLAN, AS DEFINED IN SECTION 24-50-603 (9), AND A23
	164	+	GROUP HEALTH CARE PROGRAM DESIGNED PURSUANT TO SECTION
	165	+	24
	166	+	24-51-1202.25
114	167		(b) "T
115		-	HIRD PARTY" DOES NOT INCLUDE:
116		-	(I) A
117		-	N INSURER THAT PROVIDES COVERAGE UNDER A POLICY OF
118		-	PROPERTY AND CASUALTY INSURANCE
119		-	; OR
120		-	(II) AN INSURER OR ENTITY THAT PROVIDES HEALTH COVERAGE ,
121		-	BENEFITS, OR COVERAGE OF PRESCRIPTION DRUGS AS PART OF COVERAGE
122		-	REQUIRED UNDER THE
123		-	"WORKERS' COMPENSATION ACT OF COLORADO",
124		-	ARTICLES 40 TO 47 OF TITLE 8, OR WORKERS' COMPENSATION COVERAGE
125		-	REQUIRED UNDER FEDERAL LAW
126		-	.
127		-	PAGE 3-HOUSE BILL 22-1122 10-16-1504. Applicability - exclusions. (1) T HIS PART 15 APPLIES
128		-	TO ANY THIRD PARTY THAT REIMBURSES
129		-	340B COVERED ENTITIES OR
130		-	CONTRACT PHARMACIES IN THIS STATE
131		-	.
132		-	(2) N
133		-	OTHING IN THIS PART 15:
134		-	(a) P
135		-	ROHIBITS A THIRD PARTY FROM MAINTAINING DIFFERENTIAL
136		-	REIMBURSEMENT RATES FOR PARTICIPATING AND NONPARTICIPATING
137		-	PROVIDERS
138		-	, SO LONG AS THE RATES ARE NOT DETERMINED ON THE BASIS OF
139		-	A PROVIDER
140		-	'S STATUS AS A 340B COVERED ENTITY OR CONTRACT
141		-	PHARMACY
142		-	;
	168	+	HIRD PARTY" DOES NOT
	169	+	INCLUDE:26
	170	+	(I) AN INSURER THAT PROVIDES COVERAGE UNDER A POLICY OF27
	171	+	1122
	172	+	-4- PROPERTY AND CASUALTY INSURANCE; OR1
	173	+	(II) AN INSURER OR ENTITY THAT PROVIDES HEALTH COVERAGE ,2
	174	+	BENEFITS, OR COVERAGE OF PRESCRIPTION DRUGS AS PART OF COVERAGE3
	175	+	REQUIRED UNDER THE "WORKERS' COMPENSATION ACT OF COLORADO",4
	176	+	ARTICLES 40 TO 47 OF TITLE 8, OR WORKERS' COMPENSATION COVERAGE5
	177	+	REQUIRED UNDER FEDERAL LAW .6
	178	+	10-16-1504. Applicability - exclusions. (1) THIS PART 157
	179	+	APPLIES TO ANY THIRD PARTY THAT REIMBURSES 340B COVERED ENTITIES8
	180	+	OR CONTRACT PHARMACIES IN THIS STATE .9
	181	+	(2) NOTHING IN THIS PART 15:10
	182	+	(a) PROHIBITS A THIRD PARTY FROM MAINTAINING DIFFERENTIAL11
	183	+	REIMBURSEMENT RATES FOR PARTICIPATING AND NONPARTICIPATING12
	184	+	PROVIDERS, SO LONG AS THE RATES ARE NOT DETERMINED ON THE BASIS13
	185	+	OF A PROVIDER'S STATUS AS A 340B COVERED ENTITY OR CONTRACT14
	186	+	PHARMACY;15
	187	+	(b) AFFECTS A THIRD PARTY'S ABILITY TO ESTABLISH COVERAGE16
	188	+	GUIDELINES AND EXCLUDE SPECIFIC DRUGS FROM ITS PRESCRIPTION DRUG17
	189	+	FORMULARIES, SO LONG AS THE GUIDELINES AND EXCLUSIONS ARE NOT18
	190	+	DETERMINED ON THE BASIS OF A PROVIDER'S STATUS AS A 340B COVERED19
	191	+	ENTITY OR CONTRACT PHARMACY OR OF A DRUG'S STATUS AS A 340B20
	192	+	DRUG; OR21
	193	+	(c) REQUIRES A THIRD PARTY TO CONTRACT WITH A 340B22
	194	+	COVERED ENTITY OR CONTRACT PHARMACY FOR PURPOSES OF23
	195	+	PARTICIPATING IN THE THIRD PARTY'S NETWORK, SO LONG AS THE THIRD24
	196	+	PARTY'S CONTRACTING DECISIONS ARE NOT DETERMINED ON THE BASIS OF25
	197	+	A PROVIDER'S STATUS AS A 340B COVERED ENTITY OR CONTRACT26
	198	+	PHARMACY.27
	199	+	1122
	200	+	-5- 10-16-1505. Prohibition on 340B discrimination. (1) A THIRD1
	201	+	PARTY THAT REIMBURSES A 340B COVERED ENTITY OR CONTRACT2
	202	+	PHARMACY FOR 340B DRUGS SHALL NOT:3
	203	+	(a) R
	204	+	EIMBURSE THE 340B COVERED ENTITY
	205	+	OR CONTRACT4
	206	+	PHARMACY FOR A PHARMACY -DISPENSED DRUG AT A RATE LOWER THAN5
	207	+	THE AMOUNT PAID FOR THE SAME DRUG TO PHARMACIES SIMILAR IN6
	208	+	PRESCRIPTION VOLUME THAT ARE NOT 340B COVERED ENTITIES OR7
	209	+	CONTRACT PHARMACIES ;8
143	210		(b) A
144		-	FFECTS A THIRD PARTY'S ABILITY TO ESTABLISH COVERAGE
145		-	GUIDELINES AND EXCLUDE SPECIFIC DRUGS FROM ITS PRESCRIPTION DRUG
146		-	FORMULARIES
147		-	, SO LONG AS THE GUIDELINES AND EXCLUSIONS ARE NOT
148		-	DETERMINED ON THE BASIS OF A PROVIDER
149		-	'S STATUS AS A 340B COVERED
150		-	ENTITY OR CONTRACT PHARMACY OR OF A DRUG
151		-	'S STATUS AS A 340B DRUG;
152		-	OR
153		-	(c) REQUIRES A THIRD PARTY TO CONTRACT WITH A 340B COVERED
154		-	ENTITY OR CONTRACT PHARMACY FOR PURPOSES OF PARTICIPATING IN THE
155		-	THIRD PARTY
156		-	'S NETWORK, SO LONG AS THE THIRD PARTY'S CONTRACTING
157		-	DECISIONS ARE NOT DETERMINED ON THE BASIS OF A PROVIDER
158		-	'S STATUS AS
159		-	A
160		-	340B COVERED ENTITY OR CONTRACT PHARMACY .
161		-	10-16-1505. Prohibition on 340B discrimination. (1) A
162		-	THIRD
163		-	PARTY THAT REIMBURSES A
164		-	340B COVERED ENTITY OR CONTRACT
165		-	PHARMACY FOR
166		-	340B DRUGS SHALL NOT:
167		-	(a) R
168		-	EIMBURSE THE 340B COVERED ENTITY OR CONTRACT
169		-	PHARMACY FOR A PHARMACY
170		-	-DISPENSED DRUG AT A RATE LOWER THAN THE
171		-	AMOUNT PAID FOR THE SAME DRUG TO PHARMACIES SIMILAR IN
172		-	PRESCRIPTION VOLUME THAT ARE NOT
173		-	340B COVERED ENTITIES OR
174		-	CONTRACT PHARMACIES
175		-	;
	211	+	SSESS ANY FEE, CHARGE BACK, OR OTHER ADJUSTMENT9
	212	+	AGAINST THE 340B COVERED ENTITY
	213	+	OR CONTRACT PHARMACY ON THE10
	214	+	BASIS THAT THE 340B COVERED ENTITY OR CONTRACT PHARMACY11
	215	+	PARTICIPATES IN THE 340B PROGRAM;12
	216	+	(c) R
	217	+	ESTRICT ACCESS TO THE THIRD PARTY'S PHARMACY NETWORK13
	218	+	FOR ANY 340B COVERED ENTITY
	219	+	OR CONTRACT PHARMACY ON THE BASIS14
	220	+	THAT THE 340B COVERED ENTITY OR CONTRACT PHARMACY PARTICIPATES15
	221	+	IN THE 340B PROGRAM;16
	222	+	(d) R
	223	+	EQUIRE THE 340B COVERED ENTITY
	224	+	OR CONTRACT17
	225	+	PHARMACY TO ENTER INTO A CONTRACT WITH A SPECIFIC PHARMACY OR18
	226	+	HEALTH COVERAGE PLAN TO PARTICIPATE IN THE THIRD PARTY 'S19
	227	+	PHARMACY NETWORK ;20
	228	+	(e) C
	229	+	REATE A RESTRICTION OR AN ADDITIONAL CHARGE ON A21
	230	+	PATIENT WHO CHOOSES TO RECEIVE DRUGS FROM A 340B COVERED ENTITY22 OR CONTRACT PHARMACY ; 23
	231	+	(f) R
	232	+	ESTRICT THE METHODS BY WHICH A 340B COVERED ENTITY24OR CONTRACT PHARMACY MAY DISPENSE OR DELIVER 340B DRUGS;25
	233	+	(g) R
	234	+	EFUSE TO PROVIDE REIMBURSEMENT OR COVERAGE FOR 340B26
	235	+	DRUGS; OR27
	236	+	1122
	237	+	-6- (h) CREATE ANY ADDITIONAL REQUIREMENTS OR RESTRICTIONS ON1
	238	+	A 340B COVERED ENTITY OR CONTRACT PHARMACY .2
	239	+	(2) U
	240	+	NLESS A CLAIM IS FOR PAYMENT, DIRECTLY OR INDIRECTLY,3
	241	+	BY THE MEDICAID PROGRAM , A PHARMACY BENEFIT MANAGER OR ANY4
	242	+	OTHER THIRD PARTY THAT REIMBURSES A 340B COVERED ENTITY
	243	+	OR5
	244	+	CONTRACT PHARMACY FOR 340B DRUGS SHALL NOT REQUIRE A CLAIM FOR6
	245	+	A 340B DRUG TO INCLUDE:7
	246	+	(a) A
	247	+	MODIFIER TO INDICATE THAT THE DRUG IS A 340B DRUG; OR8
176	248		(b) A
177		-	SSESS ANY FEE, CHARGE BACK, OR OTHER ADJUSTMENT
178		-	AGAINST THE
179		-	340B COVERED ENTITY OR CONTRACT PHARMACY ON THE
180		-	BASIS THAT THE
181		-	340B COVERED ENTITY OR CONTRACT PHARMACY
182		-	PARTICIPATES IN THE
183		-	340B PROGRAM;
184		-	PAGE 4-HOUSE BILL 22-1122 (c) RESTRICT ACCESS TO THE THIRD PARTY'S PHARMACY NETWORK
185		-	FOR ANY
186		-	340B COVERED ENTITY OR CONTRACT PHARMACY ON THE BASIS
187		-	THAT THE
188		-	340B COVERED ENTITY OR CONTRACT PHARMACY PARTICIPATES
189		-	IN THE
190		-	340B PROGRAM;
191		-	(d) R
192		-	EQUIRE THE 340B COVERED ENTITY OR CONTRACT PHARMACY
193		-	TO ENTER INTO A CONTRACT WITH A SPECIFIC PHARMACY OR HEALTH
194		-	COVERAGE PLAN TO PARTICIPATE IN THE THIRD PARTY
195		-	'S PHARMACY
196		-	NETWORK
197		-	;
198		-	(e) C
199		-	REATE A RESTRICTION OR AN ADDITIONAL CHARGE ON A
200		-	PATIENT WHO CHOOSES TO RECEIVE DRUGS FROM A
201		-	340B COVERED ENTITY
202		-	OR CONTRACT PHARMACY
203		-	;
204		-	(f) R
205		-	ESTRICT THE METHODS BY WHICH A 340B COVERED ENTITY OR
206		-	CONTRACT PHARMACY MAY DISPENSE OR DELIVER
207		-	340B DRUGS;
208		-	(g) R
209		-	EFUSE TO PROVIDE REIMBURSEMENT OR COVERAGE FOR 340B
210		-	DRUGS; OR
211		-	(h) CREATE ANY ADDITIONAL REQUIREMENTS OR RESTRICTIONS ON
212		-	A
213		-	340B COVERED ENTITY OR CONTRACT PHARMACY .
214		-	(2) U
215		-	NLESS A CLAIM IS FOR PAYMENT, DIRECTLY OR INDIRECTLY, BY
216		-	THE MEDICAID PROGRAM
217		-	, A PHARMACY BENEFIT MANAGER OR ANY OTHER
218		-	THIRD PARTY THAT REIMBURSES A
219		-	340B COVERED ENTITY OR CONTRACT
220		-	PHARMACY FOR
221		-	340B DRUGS SHALL NOT REQUIRE A CLAIM FOR A 340B
222		-	DRUG TO INCLUDE:
223		-	(a) A
224		-	MODIFIER TO INDICATE THAT THE DRUG IS A 340B DRUG; OR
225		-	(b) ANY OTHER METHOD OF IDENTIFYING THE CLAIM FOR A 340B
226		-	DRUG.
	249	+	NY OTHER METHOD OF IDENTIFYING THE CLAIM FOR A 340B9
	250	+	DRUG.10
227	251		(3) W
228		-	ITH RESPECT TO A PATIENT ELIGIBLE TO RECEIVE 340B DRUGS,
229		-	A PHARMACY BENEFIT MANAGER OR ANY OTHER THIRD PARTY THAT MAKES
230		-	PAYMENT FOR THE DRUGS SHALL NOT DISCRIMINATE AGAINST A
231		-	340B
232		-	COVERED ENTITY OR CONTRACT PHARMACY IN A MANNER THAT PREVENTS
233		-	OR INTERFERES WITH THE PATIENT
234		-	'S CHOICE TO RECEIVE THE DRUGS FROM
235		-	THE
236		-	340B COVERED ENTITY OR CONTRACT PHARMACY .
237		-	PAGE 5-HOUSE BILL 22-1122 10-16-1506. Enforcement - rules. (1) A THIRD PARTY THAT
238		-	VIOLATES THIS PART
239		-	15 ENGAGES IN AN UNFAIR OR DECEPTIVE ACT OR
240		-	PRACTICE IN THE BUSINESS OF INSURANCE UNDER SECTION
241		-	10-3-1104 (1)(tt),
242		-	AND THE ACT OF THE THIRD PARTY THAT VIOLATES THIS PART 15 IS VOID AND
243		-	UNENFORCEABLE
244		-	.
	252	+	ITH RESPECT TO A PATIENT ELIGIBLE TO RECEIVE 340B11
	253	+	DRUGS, A PHARMACY BENEFIT MANAGER OR ANY OTHER THIRD PARTY12
	254	+	THAT MAKES PAYMENT FOR THE DRUGS SHALL NOT DISCRIMINATE13
	255	+	AGAINST A 340B COVERED ENTITY
	256	+	OR CONTRACT PHARMACY IN A MANNER14
	257	+	THAT PREVENTS OR INTERFERES WITH THE PATIENT 'S CHOICE TO RECEIVE15
	258	+	THE DRUGS FROM THE 340B COVERED ENTITY OR CONTRACT PHARMACY. 16
	259	+	10-16-1506. Enforcement - rules. (1) A
	260	+	THIRD PARTY THAT17
	261	+	VIOLATES THIS PART 15 ENGAGES IN AN UNFAIR OR DECEPTIVE ACT OR18
	262	+	PRACTICE IN THE BUSINESS OF INSURANCE UNDER SECTION 10-3-110419
	263	+	(1)(tt),
	264	+	AND THE ACT OF THE THIRD PARTY THAT VIOLATES THIS PART 15 IS20
	265	+	VOID AND UNENFORCEABLE .21
245	266		(2) T
246		-	HE COMMISSIONER MAY ADOPT RULES AS NECESSARY TO
247		-	IMPLEMENT THIS PART
248		-	15.
249		-	SECTION 2. In Colorado Revised Statutes, 10-3-1104, add (1)(tt)
250		-	as follows:
251		-	10-3-1104. Unfair methods of competition - unfair or deceptive
252		-	practices. (1) The following are defined as unfair methods of competition
253		-	and unfair or deceptive acts or practices in the business of insurance:
	267	+	HE COMMISSIONER MAY ADOPT RULES AS NECESSARY TO22
	268	+	IMPLEMENT THIS PART 15. 23
	269	+	SECTION 2.
	270	+	In Colorado Revised Statutes, 10-3-1104, add24
	271	+	(1)(tt) as follows:25
	272	+	10-3-1104. Unfair methods of competition - unfair or deceptive26
	273	+	practices. (1) The following are defined as unfair methods of27
	274	+	1122
	275	+	-7- competition and unfair or deceptive acts or practices in the business of1
	276	+	insurance:2
254	277		(tt) A
255		-	VIOLATION OF PART 15 OF ARTICLE 16 OF THIS TITLE 10.
256		-	SECTION 3. Appropriation. For the 2022-23 state fiscal year,
257		-	$17,109 is appropriated to the department of regulatory agencies for use by
258		-	the division of insurance. This appropriation is from the division of
259		-	insurance cash fund created in section 10-1-103 (3), C.R.S., and is based on
260		-	an assumption that the division will require an additional 0.3 FTE. To
261		-	implement this act, the division may use this appropriation for personal
262		-	services.
263		-	SECTION 4. Act subject to petition - effective date. This act
264		-	takes effect at 12:01 a.m. on the day following the expiration of the
265		-	ninety-day period after final adjournment of the general assembly; except
266		-	that, if a referendum petition is filed pursuant to section 1 (3) of article V
267		-	of the state constitution against this act or an item, section, or part of this act
268		-	within such period, then the act, item, section, or part will not take effect
269		-	unless approved by the people at the general election to be held in
270		-	PAGE 6-HOUSE BILL 22-1122 November 2022 and, in such case, will take effect on the date of the official
271		-	declaration of the vote thereon by the governor.
272		-	____________________________ ____________________________
273		-	Alec Garnett Steve Fenberg
274		-	SPEAKER OF THE HOUSE PRESIDENT OF
275		-	OF REPRESENTATIVES THE SENATE
276		-	____________________________ ____________________________
277		-	Robin Jones Cindi L. Markwell
278		-	CHIEF CLERK OF THE HOUSE SECRETARY OF
279		-	OF REPRESENTATIVES THE SENATE
280		-	APPROVED________________________________________
281		-	(Date and Time)
282		-	_________________________________________
283		-	Jared S. Polis
284		-	GOVERNOR OF THE STATE OF COLORADO
285		-	PAGE 7-HOUSE BILL 22-1122
	278	+	VIOLATION OF PART 15 OF ARTICLE 16 OF THIS TITLE 10.3
	279	+	SECTION 3. Appropriation. For the 2022-23 state fiscal year,4
	280	+	$17,109 is appropriated to the department of regulatory agencies for use5
	281	+	by the division of insurance. This appropriation is from the division of6
	282	+	insurance cash fund created in section 10-1-103 (3), C.R.S., and is based7
	283	+	on an assumption that the division will require an additional 0.3 FTE. To8
	284	+	implement this act, the division may use this appropriation for personal9
	285	+	services.10
	286	+	SECTION 4. Act subject to petition - effective date. This act11
	287	+	takes effect at 12:01 a.m. on the day following the expiration of the12
	288	+	ninety-day period after final adjournment of the general assembly; except13
	289	+	that, if a referendum petition is filed pursuant to section 1 (3) of article V14
	290	+	of the state constitution against this act or an item, section, or part of this15
	291	+	act within such period, then the act, item, section, or part will not take16
	292	+	effect unless approved by the people at the general election to be held in17
	293	+	November 2022 and, in such case, will take effect on the date of the18
	294	+	official declaration of the vote thereon by the governor.19
	295	+	1122
	296	+	-8-