Substance Use Disorder Payment And Coverage | Mental Health Colorado Action Dashboard

HB 18-1007 - House Bill

Substance Use Disorder Payment And Coverage

Introduced
Jan 10, 2018
Passed House
Passed Senate
Signed Into Law

The bill requires all individual and group health benefit plans to provide coverage without prior authorization for a five-day supply of buprenorphine for a first request within a 12-month period.

Additionally, all individual and group health benefit plans that cover physical therapy, acupuncture, or chiropractic services shall not subject those services to dollar limits, deductibles, copayments, or coinsurance provisions that are less favorable than those applicable to primary care services under the plan if the covered person has a diagnosis of chronic pain and has or has had a substance use disorder diagnosis.

The bill prohibits carriers from taking adverse action against a provider or from providing financial incentives or disincentives to a provider based solely on a patient satisfaction survey relating to the patient's satisfaction with pain treatment. The bill clarifies that an 'urgent prior authorization request' to a carrier includes a request for authorization of medication-assisted treatment for substance use disorders. The bill permits a pharmacist who has entered into a collaborative pharmacy practice agreement with one or more physicians to administer injectable medication-assisted treatment for substance use disorders and receive an enhanced dispensing fee for the administration. The bill prohibits carriers from requiring a covered person to undergo step therapy using a prescription drug or drugs that include an opioid before covering a non-opioid prescription drug recommended by the covered person's provider. The bill requires the Colorado medical assistance program to authorize reimbursement for a ready-to-use version of intranasal naloxone hydrochloride without prior authorization.

The bill prohibits the requirement that a recipient of medical assistance undergo a step-therapy protocol using a prescription drug containing an opioid prior to authorizing reimbursement for a non-opioid prescription drug recommended by the person's health care provider. The bill permits a pharmacist who has entered into a collaborative pharmacy practice agreement with one or more physicians to administer injectable medication-assisted treatment for substance use disorders and receive an enhanced dispensing fee under the Colorado medical assistance program for the administration. The bill requires the department of health care policy and financing and the office of behavioral health in the department of human services to establish rules that standardize utilization management authority timelines for the non-pharmaceutical components of medication-assisted treatment for substance use disorders.

(Note: This summary applies to this bill as introduced.)

Opioid and Other Substance Use Disorders Interim Study Committee.

Votes

Yes No Other
BILL 28 5 0
BILL 42 19 0

Actions

Date Chamber Action
May 21, 2018 executive Governor Signed
May 14, 2018 upper Signed by the President of the Senate
May 14, 2018 executive Sent to the Governor
May 11, 2018 lower Signed by the Speaker of the House
May 03, 2018 upper Senate Third Reading Passed - No Amendments
May 02, 2018 upper Senate Second Reading Special Order - Passed - No Amendments
May 01, 2018 upper Senate Committee on State, Veterans, & Military Affairs Refer Unamended - Consent Calendar to Senate Committee of the Whole
Apr 23, 2018 upper Introduced In Senate - Assigned to State, Veterans, & Military Affairs
Apr 20, 2018 lower House Third Reading Passed - No Amendments
Apr 19, 2018 lower House Second Reading Special Order - Passed with Amendments - Committee, Floor
Apr 17, 2018 lower House Second Reading Laid Over to 04/19/2018 - No Amendments
Apr 16, 2018 lower House Second Reading Laid Over to 04/17/2018 - No Amendments
Apr 13, 2018 lower House Second Reading Special Order - Laid Over Daily - No Amendments
Apr 10, 2018 lower House Second Reading Laid Over to 04/13/2018 - No Amendments
Apr 09, 2018 lower House Second Reading Laid Over to 04/10/2018 - No Amendments
Apr 02, 2018 lower House Second Reading Laid Over to 04/09/2018 - No Amendments
Mar 29, 2018 lower House Second Reading Laid Over to 04/02/2018 - No Amendments
Mar 28, 2018 lower House Second Reading Laid Over to 03/29/2018 - No Amendments
Mar 27, 2018 lower House Second Reading Laid Over to 03/28/2018 - No Amendments
Mar 26, 2018 lower House Second Reading Laid Over to 03/27/2018 - No Amendments
Mar 19, 2018 lower House Second Reading Laid Over to 03/26/2018 - No Amendments
Mar 16, 2018 lower House Second Reading Special Order - Laid Over to 03/19/2018 - No Amendments
Mar 13, 2018 lower House Committee on Public Health Care & Human Services Refer Amended to House Committee of the Whole
Jan 10, 2018 lower Introduced In House - Assigned to Public Health Care & Human Services