Colorado § 10-16-148 Medication-assisted treatment - limitations on carriers - rules

Colorado Statutes

§ 10-16-148 — Medication-assisted treatment - limitations on carriers - rules

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

(1)Notwithstanding any provision of law to the contrary, beginning January 1, 2020, a carrier that provides prescription drug benefits for the treatment of substance use disorders shall, for prescription medications that are on the carrier's formulary:

(a)Not impose prior authorization requirements on any prescription medication approved by the FDA for the treatment of substance use disorders;

(b)Not impose any step therapy requirements as a prerequisite for coverage for a prescription medication approved by the FDA for the treatment of substance use disorders;

(c)Place at least one covered prescription medication approved by the FDA for the treatment of substance use disorders on the lowest tier of the drug formulary developed and maintained by the carrier; and

(d)Not excl

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(1) Notwithstanding any provision of law to the contrary, beginning January 1, 2020,
a carrier that provides prescription drug benefits for the treatment of substance
use disorders shall, for prescription medications that are on the carrier's formulary:

(a) Not impose prior authorization requirements on any prescription
medication approved by the FDA for the treatment of substance use disorders;

(b) Not impose any step therapy requirements as a prerequisite for coverage
for a prescription medication approved by the FDA for the treatment of substance
use disorders;

(c) Place at least one covered prescription medication approved by the FDA
for the treatment of substance use disorders on the lowest tier of the drug
formulary developed and maintained by the carrier; and

(d) Not exclude coverage for any prescription medication approved by the
FDA for the treatment of substance use disorders and any associated counseling or
wraparound services solely on the grounds that the medications and services were
court ordered.

(1.5) The commissioner, in consultation with the department of public health
and environment, may promulgate rules or seek a revision to the prescription drug
benefits required under the essential health benefits package concerning
prescription medications that must be included on a carrier's formulary for
medication-assisted treatment of substance use disorders.

(2) Repealed.

Colorado § 10-16-148 (Medication-assisted treatment - limitations on carriers - rules) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

Legislative History

Source: L. 2019: Entire section added, (HB 19-1269), ch. 195, p. 2131, � 10, effective May 16. L. 2020: (1.5) added, (SB 20-007), ch. 286, p. 1391, � 8, effective July 13. L. 2022: (2) repealed, (HB 22-1264), ch. 126, p. 888, � 5, effective August 10.