Page 1 February 21, 2023 SB 23-144 Legislative Council Staff Nonpartisan Services for Colorado’s Legislature Fiscal Note Drafting Number: Prime Sponsors: LLS 23-0797 Sen. Ginal Date: Bill Status: Fiscal Analyst: February 21, 2023 Senate Health & Human Services Shukria Maktabi | 303-866-4720 shukria.maktabi@coleg.gov Bill Topic: PRESCRIPTION DRUGS FOR CHRONIC PAIN Summary of Fiscal Impact: ☐ State Revenue ☒ State Expenditure ☐ State Transfer ☐ TABOR Refund ☐ Local Government ☐ Statutory Public Entity The bill allows health care providers to prescribe certain controlled substances to patients for the treatment of chronic pain. The bill minimally increases state workload beginning in FY 2023-24. Appropriation Summary: No appropriation is required. Fiscal Note Status: The fiscal note reflects the introduced bill. Summary of Legislation The bill allows a health care provider to prescribe, dispense, or administer certain controlled substances to patients with chronic pain caused by a diagnosed condition, with a few exceptions. A prescribing provider is not subject to disciplinary action by their regulator for prescribing medication, including in doses that exceed the recommended morphine milligram equivalent dosage or state or federal opioid prescribing guidelines. The provider must keep records of the controlled substance, write accurate prescriptions, and prescribe according to the current standard of care. Before prescribing, providers must discuss the risks of using a controlled substance with the patient or their guardian. Providers also cannot taper a dosage to meet a predetermined dosage recommendation if the patient is stable, compliant with the treatment plan, and not experiencing harm from the current prescribed dosage. The bill also prohibits providers from rejecting patients based on their required dosage of drug for chronic pain treatment, and pharmacists, health insurance carriers, and pharmacy benefit managers from refusing to fill a patient’s required dosage. Page 2 February 21, 2023 SB 23-144 State Expenditures Beginning in FY 2023-24, workload for the Division of Professions and Occupations in the Department of Regulatory Agencies will increase to update policies, conduct rulemaking, and address complaints. Workload for state pharmacies and health care facilities may also increase to perform outreach and train staff on policy changes and additional record keeping responsibilities. These workload impacts are expected to be minimal and can be accomplished within existing appropriations. Effective Date The bill takes effect upon signature of the Governor, or upon becoming law without his signature. State and Local Government Contacts Corrections Health Care Policy and Financing Higher Education Human Services Information Technology Public Health and Environment Regulatory Agencies The revenue and expenditure impacts in this fiscal note represent changes from current law under the bill for each fiscal year. For additional information about fiscal notes, please visit: leg.colorado.gov/fiscalnotes.