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June 30, 2023 SB 23-144
Legislative Council Staff
Nonpartisan Services for Colorado’s Legislature
Final Fiscal Note
Drafting Number:
Prime Sponsors:
LLS 23-0797
Sen. Ginal
Rep. Mabrey
Date:
Bill Status:
Fiscal Analyst:
June 30, 2023
Signed into Law
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 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 enacted 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 in accordance with legitimate medical purpose in the usual course of professional practice.
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 for pharmacists, health
insurance carriers, and pharmacy benefit managers to refuse to fill a patient’s required dosage. Page 2
June 30, 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
This bill was signed into law by the Governor and took effect on May 4, 2023.
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.