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