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March 22, 2023 SB 23-144
Legislative Council Staff
Nonpartisan Services for Colorado’s Legislature
Revised Fiscal Note
(replaces fiscal note dated February 21, 2023)
Drafting Number:
Prime Sponsors:
LLS 23-0797
Sen. Ginal
Rep. Mabrey
Date:
Bill Status:
Fiscal Analyst:
March 22, 2023
House Health & Insurance
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:
This revised fiscal note reflects the reengrossed 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. If a provider decides
to taper or maintain a medication, they must provide an assessment of the patient’s condition and
treatment plan, and discuss the decision with the patient.
The bill also prohibits policies at health facilities and pharmacies that allow providers to reject patients
based on their required dosage of drug for chronic pain treatment, and pharmacists, health insurance
carriers, and pharmacy benefit managers to refuse to fill a patient’s required dosage. Page 2
March 22, 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.