Colorado § 10-16-144 Health-care services provided by pharmacists

Colorado Statutes

§ 10-16-144 — Health-care services provided by pharmacists

Colorado·Title 10 Insurance·Art. Health-care Coverage

(1)Any health benefit plan, except supplemental policies covering a specified disease or other limited benefit, that provides hospital, surgical, or medical expense insurance may provide coverage for health-care services under a specific treatment protocol provided by a pharmacist if:

(a)The pharmacist meets the requirements in part 6 of article 280 of title 12;

(b)The health benefit plan provides coverage for the same service provided by a licensed physician or an advanced practice registered nurse;

(c)The pharmacist is included in the health benefit plan's network of participating providers; and

(d)A reimbursement rate has been successfully negotiated in good faith between the pharmacist and the health plan.

(2)(a) A health benefit plan described in subsection (1) of th

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(1) Any health
benefit plan, except supplemental policies covering a specified disease or other
limited benefit, that provides hospital, surgical, or medical expense insurance may
provide coverage for health-care services under a specific treatment protocol
provided by a pharmacist if:

(a) The pharmacist meets the requirements in part 6 of article 280 of title 12;

(b) The health benefit plan provides coverage for the same service provided
by a licensed physician or an advanced practice registered nurse;

(c) The pharmacist is included in the health benefit plan's network of
participating providers; and

(d) A reimbursement rate has been successfully negotiated in good faith
between the pharmacist and the health plan.

(2) (a) A health benefit plan described in subsection (1) of this section shall
provide coverage for health-care services provided by a pharmacist within a health
professional shortage area, as defined in 42 U.S.C. sec. 254e, if the conditions
specified in subsection (1) of this section are met.

(b) This subsection (2) does not require a carrier to contract with a pharmacy
or pharmacist willing to abide by the terms and conditions for participation
established by the health benefit plan or carrier.

(3) (a) Notwithstanding the provisions of subsection (1) of this section to the
contrary, a health benefit plan described in subsection (1) of this section that
provides treatment for substance use disorders shall reimburse a licensed
pharmacist acting within the licensed pharmacist's scope of practice, and in
accordance with the requirements in part 6 of article 280 of title 12, for the
provision of medication-assisted treatment services if the health benefit plan
provides coverage for the same services provided by a licensed physician or an
advanced practice registered nurse.

(b) A health benefit plan reimbursing a licensed pharmacist pursuant to
subsection (3)(a) of this section shall reimburse a licensed pharmacist at the same
rate that the health benefit plan reimburses a licensed physician or an advanced
practice registered nurse within the health benefit plan's network of participating
providers for the same services.

Colorado § 10-16-144 (Health-care services provided by pharmacists) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

Legislative History

Source: L. 2016: Entire section added, (SB 16-135), ch. 239, p. 981, � 1, effective August 10. L. 2018: (2) added, (HB 18-1112), ch. 112, p. 806, � 1, effective August 8. L. 2019: (1)(a) amended, (HB 19-1172), ch. 136, p. 1657, � 52, effective October 1. L. 2024: (3) added, (HB 24-1045), ch. 470, p. 3277, � 2, effective August 7.