HB 25-1222
Fiscal Note
Legislative Council Staff
Nonpartisan Services for Colorado’s Legislature
HB 25-1222: PRESERVING ACCESS TO RURAL INDEPENDENT PHARMACIE S
Prime Sponsors:
Rep. Winter T.; Lukens
Sen. Roberts; Simpson
Published for: Senate Health & Human Services
Drafting number: LLS 25-0494
Fiscal Analyst:
Brendan Fung, 303-866-4781
brendan.fung@coleg.gov
Version: First Revised Note
Date: March 28, 2025
Fiscal note status: This revised fiscal note reflects the reengrossed bill.
Summary Information
Overview. The bill places requirements on pharmacy benefit managers engaging with rural independent
pharmacies and modifies requirements for certain prescription drug outlets.
Types of impacts. The bill is projected to affect the following areas on an ongoing basis:
Minimal State Workload
Appropriations. No appropriation is required.
Table 1
State Fiscal Impacts
Type of Impact
Budget Year
FY 2025-26
Out Year
FY 2026-27
State Revenue $0 $0
State Expenditures $0 $0
Transferred Funds $0 $0
Change in TABOR Refunds $0 $0
Change in State FTE 0.0 FTE 0.0 FTE
Page 2
March 28, 2025 HB 25-1222
Summary of Legislation
The bill establishes requirements for pharmacy benefit managers (PBM) who engage with rural
independent pharmacies and modifies rules pertaining to certain prescription drug outlets.
Pharmacy Benefit Managers
Beginning on January 1, 2026, the bill requires PBMs to reimburse rural independent pharmacies
for prescription drugs at a rate that is equal to or greater than the national average drug
acquisition cost plus a dispensing fee. On January 1, 2027, and every other year thereafter, a
PBM must increase the amount of the dispensing fee by one percent to account for inflation.
Additionally, when recouping more than $1,000 as a result of an audit conducted on a rural
independent pharmacy, PBMs must notify the pharmacy of the recoupment and right to appeal.
Lastly, PBMs may not prohibit a rural independent pharmacy from using a private courier to
deliver a prescription drug to a patient or require a rural independent pharmacy to obtain
consent from the PBM to use a private courier.
Rural Independent Pharmacies
The bill also permits a prescription drug outlet that is acting as a rural independent pharmacy to
operate without the direct charge of a pharmacist if the initial interpretation and final evaluation
of the prescription is done by a pharmacist, in person or remotely.
State Expenditures
Starting in FY 2025-26, the bill may minimally increase workload in the Department of
Regulatory Agencies and the Department of Health Care Policy and Financing, as described
below.
Department of Regulatory Agencies
Workload in DORA will minimally increase to promulgate rules for rural independent
pharmacies, handle additional PBM complaints, and conduct outreach and education. The
department may require legal services, provided by the Department of Law, related to
rulemaking, implementation, and ongoing administration of the program, as well as a rise in
complaints. It is assumed this work can be accomplished within existing appropriations.
Department of Health Care Policy and Financing
Workload in the Department of Health Care Policy and Financing will minimally increase to
create a rural pharmacy provider type in the Medicaid enrollment system. No change in
appropriations is required. Page 3
March 28, 2025 HB 25-1222
Effective Date
The bill takes effect 90 days following adjournment of the General Assembly sine die, assuming
no referendum petition is filed, except that Section 4 related to reimbursement amounts takes
effect on January 1, 2026. The bill applies to conduct occurring on or after the applicable
effective date.
State and Local Government Contacts
Counties
Health Care Policy and Financing
Law
Municipalities
Personnel
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 the General Assembly website.