Colorado 2025 Regular Session

Colorado Senate Bill SB084 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	First Regular Session
2	2	Seventy-fifth General Assembly
3	3	STATE OF COLORADO
4	4	INTRODUCED
5	5
6	6
7	7	LLS NO. 25-0194.01 Anna Petrini x5497
8	8	SENATE BILL 25-084
9	9	Senate Committees House Committees
10	10	Health & Human Services
11	11	A BILL FOR AN ACT
12	12	C
13	13	ONCERNING THE ADEQUACY OF THE INFUSION PHARMACY NETWORK101
14	14	SUPPLYING PARENTERAL NUTRI TION TO MEDICAID MEMBERS .102
15	15	Bill Summary
16	16	(Note: This summary applies to this bill as introduced and does
17	17	not reflect any amendments that may be subsequently adopted. If this bill
18	18	passes third reading in the house of introduction, a bill summary that
19	19	applies to the reengrossed version of this bill will be available at
20	20	http://leg.colorado.gov
21	21	.)
22	22	Infusion pharmacies supply medicaid members with parenteral
23	23	nutrition, which provides patients with essential nutrients through an
24	24	intravenous infusion.
25	25	The bill requires the state department of health care policy and
26	26	financing (state department) to ensure policies and reimbursement levels
27	27	for infusion pharmacies for the preparation and dispensing of parenteral
28	28	SENATE SPONSORSHIP
29	29	Mullica and Simpson,
30	30	HOUSE SPONSORSHIP
31	31	Bradfield and Rydin,
32	32	Shading denotes HOUSE amendment. Double underlining denotes SENATE amendment.
33	33	Capital letters or bold & italic numbers indicate new material to be added to existing law.
34	34	Dashes through the words or numbers indicate deletions from existing law. nutrition are sufficient to encourage an adequate level of market
35	35	participation among infusion pharmacies.
36	36	The bill requires the state department to annually report on the
37	37	adequacy of the infusion pharmacy network that supplies parenteral
38	38	nutrition to medicaid members.
39	39	Be it enacted by the General Assembly of the State of Colorado:1
40	40	SECTION 1. Legislative declaration. (1) The general assembly2
41	41	finds and declares that:3
42	42	(a) Parenteral nutrition is a feeding method that bypasses the4
43	43	gastrointestinal tract and delivers nutrition directly into a patient's veins.5
44	44	Parenteral nutrition is the only way for some patients with significant6
45	45	feeding and digestion disabilities to survive. Children who need7
46	46	parenteral nutrition may need it their entire lives.8
47	47	(b) Because parenteral nutrition is highly regulated and specially9
48	48	formulated for each individual patient, it is expensive to produce and10
49	49	store, according to data from the American Society for Parenteral and11
50	50	Enteral Nutrition. Infusion pharmacies that make parenteral nutrition and12
51	51	other in-home infusion medications must dedicate time, training, and13
52	52	facilities to their formulation. Infusion pharmacies must produce14
53	53	parenteral nutrition daily, with frequent formulation changes, and must15
54	54	ensure that the parenteral nutrition meets all safety and quality16
55	55	regulations.17
56	56	(c) According to recent data from the American Society for18
57	57	Parenteral and Enteral Nutrition, because of recent financial pressures,19
58	58	many infusion pharmacies have stopped supplying parenteral nutrition20
59	59	across the nation, particularly for children. As a result, medical providers21
60	60	spend more time locating infusion pharmacies that will agree to serve the22
61	61	medical providers' patients, who risk losing access to medically necessary23
62	62	SB25-084-2- and life-saving parenteral nutrition treatment.1
63	63	(d) Federal law establishes early and periodic screening,2
64	64	diagnosis, and treatment requirements as the cornerstone medicaid health3
65	65	coverage for children. Pursuant to 42 U.S.C. sec. 1396 and sec. 1396d4
66	66	(r)(5), children enrolled in medicaid are eligible for early and periodic5
67	67	screening, diagnosis, and treatment benefits. As a result, the state must6
68	68	ensure that children enrolled in medicaid have timely access to medically7
69	69	necessary health care in the most appropriate setting.8
70	70	(e) It is not clear if the medicaid reimbursement methodologies9
71	71	that are currently in place in Colorado are sufficient to cover the extensive10
72	72	costs of producing parenteral nutrition and other specialty11
73	73	pharmaceuticals.12
74	74	(2) Therefore, the general assembly declares that it is necessary to13
75	75	ensure that Colorado medicaid members have access to an adequate14
76	76	network of infusion pharmacies supplying parenteral nutrition.15
77	77	SECTION 2. In Colorado Revised Statutes, add 25.5-5-519 as16
78	78	follows:17
79	79	25.5-5-519. Pharmacy reimbursement - parenteral nutrition18
80	80	- report - definitions. (1) A
81	81	S USED IN THIS SECTION, UNLESS THE19
82	82	CONTEXT OTHERWISE REQUIRES :20
83	83	(a) "I
84	84	NFUSION PHARMACY" MEANS A PHARMACY THAT PREPARES21
85	85	AND DISPENSES A SOLUTION THAT INCLUDES PARENTERAL NUTRITION FOR22
86	86	DIRECT ADMINISTRATION INTO A PATIENT'S BLOODSTREAM. THE SOLUTION23
87	87	MAY CONTAIN MEDICATIONS OR OTHER TREATMENTS AND MAY BE24
88	88	ADMINISTERED IN A PATIENT'S HOME OR IN A HEALTH-CARE FACILITY.25
89	89	(b) "P
90	90	ARENTERAL NUTRITION" MEANS A FORM OF NUTRITIONAL26
91	91	SUPPORT THAT PROVIDES A PATIENT WITH NEEDED NUTRIENTS , INCLUDING,27
92	92	SB25-084
93	93	-3- AT A MINIMUM, CARBOHYDRATES, AMINO ACIDS, AND LIPIDS, THROUGH AN1
94	94	INTRAVENOUS INFUSION.2
95	95	(2) T
96	96	HE STATE DEPARTMENT SHALL ENSURE POLICIES AND3
97	97	REIMBURSEMENT LEVELS FOR INFUSION PHARMACIES FOR THE4
98	98	PREPARATION AND DISPENSING OF PARENTERAL NUTRITION ARE5
99	99	SUFFICIENT TO ENCOURAGE AN ADEQUATE LEVEL OF MARKET6
100	100	PARTICIPATION AMONG INFUSION PHARMACIES . AN ADEQUATE LEVEL OF7
101	101	MARKET PARTICIPATION PROVIDES A MEMBER WHO NEEDS PARENTERAL8
102	102	NUTRITION A CHOICE BETWEEN AT LEAST TWO INFUSION PHARMACIES ,9
103	103	REGARDLESS OF THE MEMBER 'S AGE OR DURATION OF NEED.10
104	104	(3) N
105	105	OTWITHSTANDING SECTION 24-1-136 (11)(a)(I), ON OR11
106	106	BEFORE NOVEMBER 1, 2025, AND ON OR BEFORE EVERY NOVEMBER 112
107	107	THEREAFTER, THE STATE DEPARTMENT SHALL , WITHIN EXISTING13
108	108	APPROPRIATIONS, REPORT IN ITS PRESENTATION TO THE JOINT BUDGET14
109	109	COMMITTEE AND ITS "SMART ACT" HEARING HELD PURSUANT TO15
110	110	SECTION 2-7-203 ON:16
111	111	(a) T
112	112	HE TOTAL NUMBER AND GEOGRAPHIC DISTRIBUTION OF17
113	113	INFUSION PHARMACIES THROUGHOUT COLORADO THAT PROVIDE18
114	114	PARENTERAL NUTRITION TO MEMBERS ;19
115	115	(b) S
116	116	EPARATE DATA ON THE PARENTERAL NUTRITION NEEDS OF20
117	117	ADULT AND CHILD MEMBERS AND THE SUFFICIENCY OF THE INFUSION21
118	118	PHARMACY NETWORK TO SERVE EACH ; AND22
119	119	(c) A
120	120	NY REGULATORY OR REIMBURSEMENT CHANGES THE STATE23
121	121	DEPARTMENT HAS UNDERTAKEN TO ENCOURAGE AN ADEQUATE LEVEL OF24
122	122	MARKET PARTICIPATION AMONG INFUSION PHARMACIES TO MEET THE25
123	123	PARENTERAL NUTRITION NEEDS OF MEMBERS .26
124	124	SECTION 3. Act subject to petition - effective date. This act27
125	125	SB25-084
126	126	-4- takes effect at 12:01 a.m. on the day following the expiration of the1
127	127	ninety-day period after final adjournment of the general assembly; except2
128	128	that, if a referendum petition is filed pursuant to section 1 (3) of article V3
129	129	of the state constitution against this act or an item, section, or part of this4
130	130	act within such period, then the act, item, section, or part will not take5
131	131	effect unless approved by the people at the general election to be held in6
132	132	November 2026 and, in such case, will take effect on the date of the7
133	133	official declaration of the vote thereon by the governor.8
134	134	SB25-084
135	135	-5-