Colorado 2023 Regular Session

Colorado Senate Bill SB144 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
	1	+	First Regular Session
	2	+	Seventy-fourth General Assembly
	3	+	STATE OF COLORADO
	4	+	REREVISED
	5	+	This Version Includes All Amendments
	6	+	Adopted in the Second House
	7	+	LLS NO. 23-0797.01 Kristen Forrestal x4217
1	8		SENATE BILL 23-144
2		-	BY SENATOR(S) Ginal, Marchman, Buckner, Fields, Gardner, Kirkmeyer,
3		-	Liston, Lundeen, Pelton R., Rich, Smallwood, Will, Zenzinger;
4		-	also REPRESENTATIVE(S) Mabrey and Young, Bacon, Bird,
5		-	Boesenecker, Duran, Epps, Froelich, Garcia, Gonzales-Gutierrez, Hamrick,
6		-	Herod, Jodeh, Joseph, Kipp, Lieder, Lindsay, Ortiz, Parenti, Snyder, Story,
7		-	Titone, Velasco, Willford.
	9	+	Senate Committees House Committees
	10	+	Health & Human Services Health & Insurance
	11	+	A BILL FOR AN ACT
8	12		C
9		-	ONCERNING PRESCRIPTION DRUGS FOR THE TREATMENT OF CHRONIC PAIN .
10		-	Be it enacted by the General Assembly of the State of Colorado:
11		-	SECTION 1. In Colorado Revised Statutes, add 12-30-109.5 as
12		-	follows:
13		-	12-30-109.5. Prescription drugs for treatment of chronic pain -
14		-	patients - prescribers - definitions. (1) A
15		-	S USED IN THIS SECTION, UNLESS
16		-	THE CONTEXT OTHERWISE REQUIRES
17		-	:
	13	+	ONCERNING PRESCRIPTION DRUGS FOR THE TREATMENT OF CHRONIC101
	14	+	PAIN.102
	15	+	Bill Summary
	16	+	(Note: This summary applies to this bill as introduced and does
	17	+	not reflect any amendments that may be subsequently adopted. If this bill
	18	+	passes third reading in the house of introduction, a bill summary that
	19	+	applies to the reengrossed version of this bill will be available at
	20	+	http://leg.colorado.gov
	21	+	.)
	22	+	The bill allows a health-care provider to prescribe, dispense, or
	23	+	administer a schedule II, III, IV, or V controlled substance (drug) to a
	24	+	patient in the course of treatment for a diagnosed condition that causes
	25	+	chronic pain. The bill also clarifies that the prescribing health-care
	26	+	provider is not subject to disciplinary action by the appropriate regulator
	27	+	for prescribing a dosage of a drug that is equal to or more than a
	28	+	HOUSE
	29	+	3rd Reading Unamended
	30	+	April 13, 2023
	31	+	HOUSE
	32	+	Amended 2nd Reading
	33	+	April 12, 2023
	34	+	SENATE
	35	+	3rd Reading Unamended
	36	+	March 9, 2023
	37	+	SENATE
	38	+	Amended 2nd Reading
	39	+	March 7, 2023
	40	+	SENATE SPONSORSHIP
	41	+	Ginal, Marchman, Buckner, Fields, Gardner, Kirkmeyer, Liston, Lundeen, Pelton R., Rich,
	42	+	Smallwood, Van Winkle, Will, Zenzinger
	43	+	HOUSE SPONSORSHIP
	44	+	Mabrey and Young, Bacon, Bird, Boesenecker, Duran, Epps, Froelich, Garcia, Gonzales-
	45	+	Gutierrez, Hamrick, Herod, Jodeh, Joseph, Kipp, Lieder, Lindsay, Ortiz, Parenti, Snyder,
	46	+	Story, Titone, Velasco, Willford
	47	+	Shading denotes HOUSE amendment. Double underlining denotes SENATE amendment.
	48	+	Capital letters or bold & italic numbers indicate new material to be added to existing law.
	49	+	Dashes through the words or numbers indicate deletions from existing law. morphine milligram equivalent dosage recommendation or threshold
	50	+	specified in state or federal opioid prescribing guidelines or policies.
	51	+	The bill prohibits a health-care provider from refusing to accept or
	52	+	continue to treat a patient solely on the basis of the dosage of a drug the
	53	+	patient requires for the treatment of chronic pain. A health-care provider
	54	+	is also prohibited from tapering a needed dosage solely to meet a
	55	+	predetermined dosage recommendation.
	56	+	The bill also prohibits a pharmacist, health insurance carrier, or
	57	+	pharmacy benefit manager from refusing to fill or approve the coverage
	58	+	for a drug solely on the basis of the dosage requirement of a patient.
	59	+	Be it enacted by the General Assembly of the State of Colorado:1
	60	+	SECTION 1. In Colorado Revised Statutes, add 12-30-109.5 as2
	61	+	follows:3
	62	+	12-30-109.5. Prescription drugs for treatment of chronic pain4
	63	+	- patients - prescribers - definitions. (1) A
	64	+	S USED IN THIS SECTION,5
	65	+	UNLESS THE CONTEXT OTHERWISE REQUIRES :6
18	66		(a) "C
19		-	ARRIER" HAS THE SAME MEANING AS SET FORTH IN 10-16-102
20		-	(8).
	67	+	ARRIER" HAS THE SAME MEANING AS SET FORTH IN7
	68	+	10-16-102
	69	+	(8).8
21	70		(b) (I) "C
22		-	HRONIC PAIN" MEANS A PAIN THAT TYPICALLY LASTS THREE
23		-	NOTE: This bill has been prepared for the signatures of the appropriate legislative
24		-	officers and the Governor. To determine whether the Governor has signed the bill
25		-	or taken other action on it, please consult the legislative status sheet, the legislative
26		-	history, or the Session Laws.
27		-	________
28		-	Capital letters or bold & italic numbers indicate new material added to existing law; dashes
29		-	through words or numbers indicate deletions from existing law and such material is not part of
30		-	the act. MONTHS OR LONGER AND MAY BE THE RESULT OF AN UNDERLYING MEDICAL
31		-	DISEASE OR CONDITION
32		-	, INJURY, MEDICAL TREATMENT, INFLAMMATION, OR
33		-	UNKNOWN CAUSE
34		-	. "CHRONIC PAIN" IS A PAIN STATE IN WHICH THE CAUSE OF
35		-	THE PAIN OFTEN CANNOT BE REMOVED WITH REAS ONABLE MEDICAL EFFORTS
36		-	AT THE CONSENT OF THE PATIENT
37		-	, OR PAIN FOR WHICH NO CURE CAN BE
38		-	FOUND AFTER REASONABLE MEDICAL EFFORTS
39		-	. CHRONIC PAIN MAY RESTRICT
40		-	THE ABILITY OF INDIVIDUALS TO WORK
41		-	, CARE FOR THEMSELVES , AND
42		-	ENGAGE IN BASIC LIFE
43		-	, SOCIAL, AND PHYSICAL ACTIVITIES.
	71	+	HRONIC PAIN" MEANS A PAIN THAT TYPICALLY LASTS
	72	+	9
	73	+	THREE MONTHS OR LONGER AND MAY BE THE RESULT OF AN UNDERLYING10
	74	+	MEDICAL DISEASE OR CONDITION , INJURY, MEDICAL TREATMENT ,11
	75	+	INFLAMMATION, OR UNKNOWN CAUSE. "CHRONIC PAIN" IS A PAIN STATE12
	76	+	IN WHICH THE CAUSE OF THE PAIN OFTEN CANNOT BE REMOVED WITH13
	77	+	REASONABLE MEDICAL EFFORTS AT THE CONSENT OF THE PATIENT , OR PAIN14
	78	+	FOR WHICH NO CURE CAN BE FOUND AFTER REASONABLE MEDICAL15
	79	+	EFFORTS. CHRONIC PAIN MAY RESTRICT THE ABILITY OF INDIVIDUALS TO16
	80	+	WORK, CARE FOR THEMSELVES, AND ENGAGE IN BASIC LIFE, SOCIAL, AND17
	81	+	PHYSICAL ACTIVITIES.18
44	82		(II) C
45		-	ONDITIONS ASSOCIATED WITH CHRONIC PAIN MAY INCLUDE ,
46		-	BUT ARE NOT LIMITED TO, CANCER AND THE RECOVERY PERIOD, SICKLE CELL
47		-	DISEASE
48		-	, NONCANCER PAIN, RARE DISEASES, SEVERE INJURIES, AND HEALTH
49		-	CONDITIONS REQUIRING THE PROVISION OF PALLIATIVE CARE OR HOSPICE
50		-	CARE
51		-	.
	83	+	ONDITIONS ASSOCIATED WITH CHRONIC PAIN MAY INCLUDE ,19
	84	+	BUT ARE NOT LIMITED TO, CANCER AND THE RECOVERY PERIOD , SICKLE20
	85	+	144-2- CELL DISEASE, NONCANCER PAIN, RARE DISEASES, SEVERE INJURIES, AND1
	86	+	HEALTH CONDITIONS REQUIRING THE PROVISION OF PALLIATIVE CARE OR2
	87	+	HOSPICE CARE.3
52	88		(III) R
53		-	EASONABLE EFFORTS FOR RELIEVING OR CURING THE CAUSE OF
54		-	THE CHRONIC PAIN MAY BE DETERMINED ON THE BASIS OF
55		-	, BUT ARE NOT
56		-	LIMITED TO
57		-	, THE FOLLOWING:
	89	+	EASONABLE EFFORTS FOR RELIEVING OR CURING THE CAUSE4
	90	+	OF THE CHRONIC PAIN MAY BE DETERMINED ON THE BASIS OF , BUT ARE NOT5
	91	+	LIMITED TO, THE FOLLOWING:6
58	92		(A) W
59		-	HEN TREATING A NONTERMINALLY ILL PATIENT FOR CHRONIC
60		-	PAIN
61		-	, AN EVALUATION CONDUCTED BY THE TREATING HEALTH -CARE
62		-	PROVIDER OR A HEALTH
63		-	-CARE PROVIDER SPECIALIZING IN PAIN MEDICINE OR
64		-	TREATMENT OF THE AREA
65		-	, SYSTEM, OR ORGAN OF THE BODY CONFIRMED OR
66		-	PERCEIVED AS THE SOURCE OF THE CHRONIC PAIN
67		-	; OR
68		-	(B) WHEN TREATING A TERMINALLY ILL PATIENT , AN EVALUATION
69		-	CONDUCTED BY THE TREATING HEALTH
70		-	-CARE PROVIDER WHO CONDUCTS THE
71		-	EVALUATION IN ACCORDANCE WITH THE STANDARD OF CARE AND THE LEVEL
72		-	OF CARE
73		-	, SKILL, AND TREATMENT THAT WOULD BE RECOGNIZED BY A
74		-	HEALTH
75		-	-CARE PROVIDER UNDER SIMILAR CONDITIONS AND CIRCUMSTANCES .
	93	+	HEN TREATING A NONTERMINALLY ILL PATIENT FOR CHRONIC7
	94	+	PAIN, AN EVALUATION CONDUCTED BY THE TREATING HEALTH -CARE8
	95	+	PROVIDER OR A HEALTH-CARE PROVIDER SPECIALIZING IN PAIN MEDICINE9
	96	+	OR TREATMENT OF THE AREA , SYSTEM, OR ORGAN OF THE BODY10
	97	+	CONFIRMED OR PERCEIVED AS THE SOURCE OF THE CHRONIC PAIN ; OR11
	98	+	(B) W
	99	+	HEN TREATING A TERMINALLY ILL PATIENT, AN EVALUATION12
	100	+	CONDUCTED BY THE TREATING HEALTH -CARE PROVIDER WHO CONDUCTS13
	101	+	THE EVALUATION IN ACCORDANCE WITH THE STANDARD OF CARE AND THE14
	102	+	LEVEL OF CARE, SKILL, AND TREATMENT THAT WOULD BE RECOGNIZED BY15
	103	+	A HEALTH-CARE PROVIDER UNDER SIMILAR CONDITIONS AND16
	104	+	CIRCUMSTANCES.17
76	105		(c) "D
77		-	RUG DIVERSION" MEANS THE UNLAWFUL TRANSFER OF
78		-	PRESCRIPTION DRUGS FROM A LICIT MEDICAL PURPOSE TO THE ILLICIT
79		-	MARKETPLACE
80		-	.
	106	+	RUG DIVERSION" MEANS THE UNLAWFUL TRANSFER OF18
	107	+	PRESCRIPTION DRUGS FROM A LICIT MEDICAL PURPOSE TO THE ILLICIT19
	108	+	MARKETPLACE.20
81	109		(d) "H
82		-	EALTH-CARE PROVIDER" MEANS A PHYSICIAN, A PHYSICIAN
83		-	ASSISTANT
84		-	, OR AN ADVANCED PRACTICE REGISTERED NURSE LICENSED
85		-	PURSUANT TO THIS TITLE
86		-	12.
87		-	(e) "R
88		-	ARE DISEASE" MEANS A DISEASE, DISORDER, OR CONDITION
89		-	PAGE 2-SENATE BILL 23-144 THAT AFFECTS FEWER THAN TWO HUNDRED THOUSAND INDIVIDUALS IN THE
90		-	UNITED STATES AND IS CHRONIC , SERIOUS, LIFE-ALTERING, OR
91		-	LIFE
92		-	-THREATENING.
93		-	(f) "S
94		-	CHEDULE II, III, IV, OR V CONTROLLED SUBSTANCE" MEANS A
95		-	CONTROLLED SUBSTANCE AS DESCRIBED IN SECTION
96		-	18-18-204, 18-18-205,
97		-	18-18-206,
98		-	OR 18-18-207, RESPECTIVELY.
99		-	(2) Criteria for the evaluation and treatment of chronic pain.
	110	+	EALTH-CARE PROVIDER" MEANS A PHYSICIAN, A PHYSICIAN21
	111	+	ASSISTANT, OR AN ADVANCED PRACTICE REGISTERED NURSE LICENSED22
	112	+	PURSUANT TO THIS TITLE 12.23
	113	+
	114	+	24
	115	+	(e) "RARE DISEASE" MEANS A DISEASE, DISORDER, OR CONDITION25
	116	+	THAT AFFECTS FEWER THAN TWO HUNDRED THOUSAND INDIVIDUALS IN26
	117	+	THE UNITED STATES AND IS CHRONIC, SERIOUS, LIFE-ALTERING, OR27
	118	+	144
	119	+	-3- LIFE-THREATENING.1
	120	+	(f) "SCHEDULE II, III, IV, OR V CONTROLLED SUBSTANCE" MEANS2
	121	+	A CONTROLLED SUBSTANCE AS DESCRIBED IN SECTION 18-18-204,3
	122	+	18-18-205,
	123	+	18-18-206, OR 18-18-207, RESPECTIVELY.4
	124	+	(2) Criteria for the evaluation and treatment of chronic pain.5
100	125		W
101		-	HEN TREATING A NONTERMINALLY ILL PATIENT , THE EVALUATION OF THE
102		-	PATIENT AND THE TREATMENT OF THE PATIENT
103		-	'S CHRONIC PAIN IS GOVERNED
104		-	BY THE FOLLOWING CRITERIA
105		-	:
	126	+	HEN TREATING A NONTERMINALLY ILL PATIENT , THE EVALUATION OF6
	127	+	THE PATIENT AND THE TREATMENT OF THE PATIENT 'S CHRONIC PAIN IS7
	128	+	GOVERNED BY THE FOLLOWING CRITERIA :8
106	129		(a) A
107		-	DIAGNOSIS OF A CONDITION CAUSING CHRONIC PAIN BY THE
108		-	TREATING HEALTH
109		-	-CARE PROVIDER OR A HEALTH -CARE PROVIDER
110		-	SPECIALIZING IN PAIN MEDICINE OR TREATMENT OF THE AREA
111		-	, SYSTEM, OR
112		-	ORGAN OF THE BODY CONFIRMED OR PERCEIVED AS THE SOURCE OF THE PAIN
113		-	THAT IS SUFFICIENT TO MEET THE DEFINITION OF CHRONIC PAIN
114		-	; AND
115		-	(b) THE CAUSE OF THE DIAGNOSIS OF CHRONIC PAIN MUST NOT
116		-	INTERFERE WITH MEDICALLY NECESSARY TREATMENT
117		-	, INCLUDING BUT NOT
118		-	LIMITED TO PRESCRIBING OR ADMINISTERING A SCHEDULE
119		-	II, III, IV, OR V
120		-	CONTROLLED SUBSTANCE .
121		-	(3) Prescription and administration of controlled substances for
122		-	chronic pain. (a) N
123		-	OTWITHSTANDING ANY OTHER PROVISION OF LAW , A
124		-	HEALTH
125		-	-CARE PROVIDER MAY PRESCRIBE , DISPENSE, OR ADMINISTER A
126		-	SCHEDULE
127		-	II, III, IV, OR V CONTROLLED SUBSTANCE TO A PATIENT IN THE
128		-	COURSE OF THE HEALTH
129		-	-CARE PROVIDER'S TREATMENT OF THE PATIENT FOR
130		-	A DIAGNOSED CONDITION CAUSING CHRONIC PAIN
131		-	. A HEALTH-CARE
132		-	PROVIDER IS NOT SUBJECT TO DISCIPLINARY ACTION BY THE REGULATOR FOR
133		-	APPROPRIATELY PRESCRIBING
134		-	, DISPENSING, OR ADMINISTERING A SCHEDULE
135		-	II, III, IV, OR V CONTROLLED SUBSTANCE IN THE COURSE OF TREATMENT OF
136		-	A PATIENT FOR CHRONIC PAIN IF THE HEALTH
137		-	-CARE PROVIDER KEEPS
138		-	ACCURATE RECORDS OF THE PURPOSE
139		-	, USE, PRESCRIPTION, AND DISPOSAL OF
140		-	THE CONTROLLED SUBSTANCE
141		-	, WRITES ACCURATE PRESCRIPTIONS , AND
142		-	PRESCRIBES MEDICATIONS IN ACCORDANCE WITH LEGITIMATE MEDICAL
143		-	PURPOSE IN THE USUAL COURSE OF PROFESSIONAL PRACTICE
144		-	.
	130	+	DIAGNOSIS OF A CONDITION CAUSING CHRONIC PAIN BY THE9
	131	+	TREATING HEALTH-CARE PROVIDER OR A HEALTH -CARE PROVIDER10
	132	+	SPECIALIZING IN PAIN MEDICINE OR TREATMENT OF THE AREA , SYSTEM, OR11
	133	+	ORGAN OF THE BODY CONFIRMED OR PERCEIVED AS THE SOURCE OF THE12
	134	+	PAIN THAT IS SUFFICIENT TO MEET THE DEFINITION OF CHRONIC PAIN; AND13
	135	+	(b) T
	136	+	HE CAUSE OF THE DIAGNOSIS OF CHRONIC PAIN MUST NOT14
	137	+	INTERFERE WITH MEDICALLY NECESSARY TREATMENT , INCLUDING BUT15
	138	+	NOT LIMITED TO PRESCRIBING OR ADMINISTERING A SCHEDULE II, III, IV,16
	139	+	OR V CONTROLLED SUBSTANCE.17
	140	+	(3) Prescription and administration of controlled substances18
	141	+	for chronic pain. (a) N
	142	+	OTWITHSTANDING ANY OTHER PROVISION OF LAW ,19
	143	+	A HEALTH-CARE PROVIDER MAY PRESCRIBE , DISPENSE, OR ADMINISTER A20
	144	+	SCHEDULE II, III, IV, OR V CONTROLLED SUBSTANCE TO A PATIENT IN THE21
	145	+	COURSE OF THE HEALTH-CARE PROVIDER'S TREATMENT OF THE PATIENT22
	146	+	FOR A DIAGNOSED CONDITION CAUSING CHRONIC PAIN . A HEALTH-CARE23
	147	+	PROVIDER IS NOT SUBJECT TO DISCIPLINARY ACTION BY THE REGULATOR24
	148	+	FOR APPROPRIATELY PRESCRIBING , DISPENSING, OR ADMINISTERING A25
	149	+	SCHEDULE II, III, IV, OR V CONTROLLED SUBSTANCE IN THE COURSE OF26
	150	+	TREATMENT OF A PATIENT FOR CHRONIC PAIN IF THE HEALTH -CARE27
	151	+	144
	152	+	-4- PROVIDER KEEPS ACCURATE RECORDS OF THE PURPOSE , USE,1
	153	+	PRESCRIPTION, AND DISPOSAL OF THE CONTROLLED SUBSTANCE , WRITES2
	154	+	ACCURATE PRESCRIPTIONS , AND PRESCRIBES MEDICATIONS IN3
	155	+	ACCORDANCE WITH LEGITIMATE MEDICAL PURPOSE IN THE USUAL COURSE 4
	156	+	OF PROFESSIONAL PRACTICE.5
145	157		(b) A
146		-	HEALTH-CARE PROVIDER ACTING IN GOOD FAITH AND BASED ON
147		-	PAGE 3-SENATE BILL 23-144 THE NEEDS OF THE PATIENT WITH A DIAGNOSED CONDITION CAUSING
148		-	CHRONIC PAIN IS NOT SUBJECT TO DISCIPLINE FROM THE REGULATOR SOLELY
149		-	FOR PRESCRIBING A DOSAGE THAT EQUATES TO AN UPWARD DEVIATION FROM
150		-	MORPHINE MILLIGRAM EQUIVALENT DOSAGE RECOMMENDATIONS OR FROM
151		-	THRESHOLDS SPECIFIED IN STATE OR FEDERAL OPIOID PRESCRIBING
152		-	GUIDELINES OR POLICIES
153		-	.
	158	+	HEALTH-CARE PROVIDER ACTING IN GOOD FAITH AND BASED6
	159	+	ON THE NEEDS OF THE PATIENT WITH A DIAGNOSED CONDITION CAUSING7
	160	+	CHRONIC PAIN IS NOT SUBJECT TO DISCIPLINE FROM THE REGULATOR8
	161	+	SOLELY FOR PRESCRIBING A DOSAGE THAT EQUATES TO AN UPWARD9
	162	+	DEVIATION FROM MORPHINE MILLIGRAM EQUIVALENT DOSAGE10
	163	+	RECOMMENDATIONS OR FROM THRESHOLDS SPECIFIED IN STATE OR11
	164	+	FEDERAL OPIOID PRESCRIBING GUIDELINES OR POLICIES .12
	165	+
	166	+	13
154	167		(c) A
155	168		HEALTH-CARE PROVIDER TREATING A PATIENT WITH CHRONIC
156		-	PAIN BY PRESCRIBING
157		-	, DISPENSING, OR ADMINISTERING ONE OR MORE
158		-	SCHEDULE
159		-	II, III, IV, OR V CONTROLLED SUBSTANCES THAT INCLUDE , BUT
160		-	ARE NOT LIMITED TO
161		-	, OPIOID ANALGESICS SHALL NOT BE REQUIRED TO TAPER
162		-	A PATIENT
163		-	'S MEDICATION DOSAGE SOLELY TO MEET A PREDETERMINED
164		-	MORPHINE MILLIGRAM EQUIVALENT DOSAGE RECOMMENDATION OR
165		-	THRESHOLD IF THE PATIENT IS STABLE AND COMPLIANT WITH THE
166		-	TREATMENT PLAN AND IS NOT EXPERIENCING SERIOUS HARM FROM THE
167		-	LEVEL OF MEDICATION CURRENTLY BEING PRESCRIBED OR PREVIOUSLY
168		-	PRESCRIBED
169		-	. A DECISION TO TAPER OR MAINTAIN MEDICATION MUST
170		-	INCLUDE AN INDIVIDUALIZED ASSESSMENT OF THE PATIENT
171		-	'S CURRENT
172		-	MEDICAL CONDITION AND TREATMENT PLAN
173		-	, THE RISKS AND BENEFITS OF
174		-	MAINTAINING OR TAPERING THE PATIENT
175		-	'S MEDICATION, AND A DISCUSSION
176		-	WITH THE PATIENT
177		-	.
178		-	(d) (I) A
179		-	PHARMACY, CARRIER, OR PHARMACY BENEFIT MANAGER
180		-	SHALL NOT HAVE A POLICY IN PLACE THAT REQUIRES THE PHARMACIST TO
181		-	REFUSE TO FILL A PRESCRIPTION FOR AN OPIATE ISSUED BY A HEALTH
182		-	-CARE
183		-	PROVIDER WITH THE AUTHORITY TO PRESCRIBE OPIATES SOLELY BECAUSE
184		-	THE PRESCRIPTION IS FOR AN OPIATE OR BECAUSE THE PRESCRIPTION ORDER
185		-	EXCEEDS A PREDETERMINED MORPHINE MILLIGRAM EQUIVALENT DOSAGE
186		-	RECOMMENDATION OR THRESHOLD
187		-	.
	169	+	14
	170	+	PAIN BY PRESCRIBING, DISPENSING, OR ADMINISTERING ONE OR MORE15
	171	+	SCHEDULE II, III, IV, OR V CONTROLLED SUBSTANCES THAT INCLUDE , BUT16
	172	+	ARE NOT LIMITED TO, OPIOID ANALGESICS SHALL NOT BE REQUIRED TO17
	173	+	TAPER A PATIENT 'S MEDICATION DOSAGE SOLELY TO MEET A18
	174	+	PREDETERMINED MORPHINE MILLIGRAM EQUIVALENT DOSAGE19
	175	+	RECOMMENDATION OR THRESHOLD IF THE PATIENT IS STABLE AND20
	176	+	COMPLIANT WITH THE TREATMENT PLAN AND IS NOT EXPERIENCING21
	177	+	SERIOUS HARM FROM THE LEVEL OF MEDICATION CURRENTLY BEING22
	178	+	PRESCRIBED OR PREVIOUSLY PRESCRIBED . A DECISION TO TAPER OR23
	179	+	MAINTAIN MEDICATION MUST INCLUDE AN INDIVIDUALIZED ASSESSMENT24
	180	+	OF THE PATIENT'S CURRENT MEDICAL CONDITION AND TREATMENT PLAN ,25
	181	+	THE RISKS AND BENEFITS OF MAINTAINING OR TAPERING THE PATIENT 'S26
	182	+	MEDICATION, AND A DISCUSSION WITH THE PATIENT.27
	183	+	144
	184	+	-5- (d) (I) A PHARMACY, CARRIER, OR PHARMACY BENEFIT MANAGER1
	185	+	SHALL NOT HAVE A POLICY IN PLACE THAT REQUIRES THE PHARMACIST TO2
	186	+	REFUSE TO FILL A PRESCRIPTION FOR AN OPIATE ISSUED BY A HEALTH-CARE3
	187	+	PROVIDER WITH THE AUTHORITY TO PRESCRIBE OPIATES SOLELY BECAUSE4
	188	+	THE PRESCRIPTION IS FOR AN OPIATE OR BECAUSE THE PRESCRIPTION5
	189	+	ORDER EXCEEDS A PREDETERMINED MORPHINE MILLIGRAM EQUIVALENT6
	190	+	DOSAGE RECOMMENDATION OR THRESHOLD .7
188	191		(II) A
189		-	HEALTH-CARE PRACTICE OR CLINIC IN WHICH A HEALTH-CARE
190		-	PROVIDER IS AUTHORIZED TO PRESCRIBE SCHEDULE
191		-	II, III, IV, OR V
192		-	CONTROLLED SUBSTANCES SHALL NOT HAVE A POLICY IN PLACE THAT
193		-	REQUIRES THE HEALTH
194		-	-CARE PROVIDER TO REFUSE TO PRESCRIBE ,
195		-	ADMINISTER, OR DISPENSE A PRESCRIPTION FOR AN OPIATE SOLELY BECAUSE
196		-	THE PRESCRIPTION EXCEEDS A PREDETERMINED MORPHINE MILLIGRAM
197		-	EQUIVALENT DOSAGE RECOMMENDATION OR THRESHOLD
198		-	.
199		-	(e) B
200		-	EFORE TREATING A PATIENT FOR CHRONIC PAIN IN ACCORDANCE
201		-	WITH THIS SUBSECTION
202		-	(3), A HEALTH-CARE PROVIDER SHALL DISCUSS WITH
203		-	PAGE 4-SENATE BILL 23-144 THE PATIENT OR THE PATIENT'S LEGAL GUARDIAN, IF APPLICABLE, THE RISKS
204		-	ASSOCIATED WITH THE SCHEDULE
205		-	II, III, IV, OR V CONTROLLED SUBSTANCE
206		-	TO BE PRESCRIBED OR ADMINISTERED IN THE COURSE OF THE HEALTH
207		-	-CARE
208		-	PROVIDER
209		-	'S TREATMENT OF THE PATIENT AND DOCUMENT THE DISCUSSION
210		-	IN THE PATIENT
211		-	'S RECORD.
212		-	(4) Limits on applicability. (a) T
213		-	HIS SECTION DOES NOT APPLY TO:
214		-	(I) A
215		-	HEALTH-CARE PROVIDER'S TREATMENT OF A PATIENT FOR A
216		-	SUBSTANCE USE DISORDER RESULTING FROM THE USE OF A SCHEDULE
217		-	II, III,
	192	+	HEALTH-CARE PRACTICE OR CLINIC IN WHICH A
	193	+	8
	194	+	HEALTH-CARE PROVIDER IS AUTHORIZED TO PRESCRIBE SCHEDULE II, III,9
218	195		IV,
219		-	OR V CONTROLLED SUBSTANCE;
220		-	(II) T
221		-	HE PRESCRIPTION OR ADMINISTRATION OF A SCHEDULE II, III,
222		-	IV,
223		-	OR V CONTROLLED SUBSTANCE TO A PATIENT WHOM THE HEALTH -CARE
224		-	PROVIDER KNOWS TO BE USING THE CONTROLLED SUBSTANCE FOR
225		-	NONTHERAPEUTIC OR DRUG DIVERSION PURPOSES
226		-	;
227		-	(III) T
228		-	HE PRESCRIPTION, DISPENSING, OR ADMINISTRATION OF A
229		-	SCHEDULE
230		-	II, III, IV, OR V CONTROLLED SUBSTANCE FOR THE PURPOSE OF
231		-	TERMINATING THE LIFE OF A PATIENT WITH CHRONIC PAIN
232		-	; OR
233		-	(IV) THE PRESCRIPTION, DISPENSING, OR ADMINISTRATION OF A
234		-	SCHEDULE
235		-	II, III, IV, OR V CONTROLLED SUBSTANCE THAT IS NOT A
236		-	CONTROLLED SUBSTANCE APPROVED BY THE FEDERAL FOOD AND DRUG
237		-	ADMINISTRATION FOR PAIN RELIEF
238		-	.
239		-	(b) T
240		-	HIS SECTION DOES NOT LIMIT THE POWERS AND DUTIES OF THE
241		-	COLORADO MEDICAL BOARD PURSUANT TO SECTION 12-240-106 OR THE
242		-	STATE BOARD OF NURSING PURSUANT TO SECTION
243		-	12-255-107.
244		-	SECTION 2. Safety clause. The general assembly hereby finds,
245		-	PAGE 5-SENATE BILL 23-144 determines, and declares that this act is necessary for the immediate
246		-	preservation of the public peace, health, or safety.
247		-	____________________________ ____________________________
248		-	Steve Fenberg
249		-	Julie McCluskie
250		-	PRESIDENT OF SPEAKER OF THE HOUSE
251		-	THE SENATE OF REPRESENTATIVES
252		-	____________________________ ____________________________
253		-	Cindi L. Markwell Robin Jones
254		-	SECRETARY OF CHIEF CLERK OF THE HOUSE
255		-	THE SENATE OF REPRESENTATIVES
256		-	APPROVED________________________________________
257		-	(Date and Time)
258		-	_________________________________________
259		-	Jared S. Polis
260		-	GOVERNOR OF THE STATE OF COLORADO
261		-	PAGE 6-SENATE BILL 23-144
	196	+	OR V CONTROLLED SUBSTANCES SHALL NOT HAVE A POLICY IN PLACE
	197	+	10
	198	+	THAT REQUIRES THE HEALTH-CARE PROVIDER TO REFUSE TO PRESCRIBE ,11
	199	+	ADMINISTER, OR DISPENSE A PRESCRIPTION FOR AN OPIATE SOLELY12
	200	+	BECAUSE THE PRESCRIPTION EXCEEDS A PREDETERMINED MORPHINE13
	201	+	MILLIGRAM EQUIVALENT DOSAGE RECOMMENDATION OR THRESHOLD .14
	202	+	(e) BEFORE TREATING A PATIENT FOR CHRONIC PAIN IN15
	203	+	ACCORDANCE WITH THIS SUBSECTION (3), A HEALTH-CARE PROVIDER16
	204	+	SHALL DISCUSS WITH THE PATIENT OR THE PATIENT'S LEGAL GUARDIAN, IF17
	205	+	APPLICABLE, THE RISKS ASSOCIATED WITH THE SCHEDULE II, III, IV, OR V18
	206	+	CONTROLLED SUBSTANCE TO BE PRESCRIBED OR ADMINISTERED IN THE19
	207	+	COURSE OF THE HEALTH-CARE PROVIDER'S TREATMENT OF THE PATIENT20
	208	+	AND DOCUMENT THE DISCUSSION IN THE PATIENT 'S RECORD.21
	209	+	(4) Limits on applicability. (a) THIS SECTION DOES NOT APPLY22
	210	+	TO:23
	211	+	(I) A HEALTH-CARE PROVIDER'S TREATMENT OF A PATIENT FOR A24
	212	+	SUBSTANCE USE DISORDER RESULTING FROM THE USE OF A SCHEDULE II,25
	213	+	III,
	214	+	IV, OR V CONTROLLED SUBSTANCE;26 (II) THE PRESCRIPTION OR ADMINISTRATION OF A SCHEDULE II, III,27
	215	+	144
	216	+	-6- IV, OR V CONTROLLED SUBSTANCE TO A PATIENT WHOM THE1
	217	+	HEALTH-CARE PROVIDER KNOWS TO BE USING THE CONTROLLED2
	218	+	SUBSTANCE FOR NONTHERAPEUTIC OR DRUG DIVERSION PURPOSES ;3
	219	+	(III) THE PRESCRIPTION, DISPENSING, OR ADMINISTRATION OF A4
	220	+	SCHEDULE II, III, IV, OR V CONTROLLED SUBSTANCE FOR THE PURPOSE OF5
	221	+	TERMINATING THE LIFE OF A PATIENT WITH CHRONIC PAIN ; OR6
	222	+	(IV) THE PRESCRIPTION, DISPENSING, OR ADMINISTRATION OF A7
	223	+	SCHEDULE II, III, IV, OR V CONTROLLED SUBSTANCE THAT IS NOT A8
	224	+	CONTROLLED SUBSTANCE APPROVED BY THE FEDERAL FOOD AND DRUG9
	225	+	ADMINISTRATION FOR PAIN RELIEF.10
	226	+	(b) THIS SECTION DOES NOT LIMIT THE POWERS AND DUTIES OF THE11
	227	+	COLORADO MEDICAL BOARD PURSUANT TO SECTION 12-240-106 OR THE12
	228	+	STATE BOARD OF NURSING PURSUANT TO SECTION 12-255-107.13
	229	+	SECTION 2. Safety clause. The general assembly hereby finds,14
	230	+	determines, and declares that this act is necessary for the immediate15
	231	+	preservation of the public peace, health, or safety.16
	232	+	144
	233	+	-7-