Patient Choice of Pharmacy Bill Introduced in the Colorado Legislature

House Bill 18-1097 (HB 1097), also referred to as the Patient Choice of Pharmacy, is a bipartisan sponsored bill that focuses primarily on patient choices when filling prescription medications and is aimed at protecting small, rural pharmacies that may be closer to patients.

HB 1097, in its current form, states that an insurance carrier or its pharmacy benefit management (PBM) firm that offers or issues prescription drug coverage may not:

• Limit or restrict a covered person’s ability to select a pharmacy or pharmacist of the covered person’s choice if certain terms are met (i.e. a pharmacy or pharmacist is licensed and the pharmacy or pharmacist has agreed to the terms of the contract with the carrier or PBM)
• Impose a copayment, fee, or other cost-sharing requirement for selecting a pharmacy of the covered person’s choosing;
• Impose other conditions on a covered person, pharmacist, or pharmacy that limit or restrict a covered person’s ability to use a pharmacy of the covered person’s choosing; or
• Deny a pharmacy or pharmacist the right to participate in any of its network contracts in this state or as a contracting provider in this state if the pharmacy or pharmacist has a valid license in Colorado and the pharmacist or pharmacy agrees to specified conditions.

Proponents of HB 1097 will argue that all patients should be allowed to choose and use their local pharmacies and not those mandated by their insurance carrier.

Opponents to the bill, such as the insurance carriers, have long argued that this practice controls costs and that the Colorado Legislature should not tell them, as private businesses, how to conduct their business.

HB 1097 was introduced last week and still needs to be schedule for a hearing in front of the House Health, Insurance and Environment Committee.

Baer Law will keep you updated on the status of HB 1097.