(1) As used in this
section:
(a) Independent pharmacy means a prescription drug outlet privately
owned by at least one licensed pharmacist with no ownership interest by or
affiliation with a chain or publicly owned pharmacy.
(b) Practitioner means a physician or a physician assistant licensed
pursuant to article 240 of title 12, an advanced practice registered nurse licensed
pursuant to article 255 of title 12, or any other person who, within the person's
scope of practice, is authorized by law to administer a vaccine to an individual.
(c) Publicly funded vaccine means a vaccine that is paid for and distributed
by the federal, the state, or a local government at no cost to the practitioner
administering the vaccine.
(2) (a) A practitioner may ask an individual who seeks to receive a publicly
funded vaccine to present proof of health insurance or a government-issued
identification card, social security card, or social security number but shall not
condition an individual's receipt of a publicly funded vaccine on the presentation of
the requested documentation.
(b) (I) A practitioner who administers a publicly funded vaccine shall post and
keep posted a notice provided by the department of public health and environment,
in multiple languages if requested, that confirms that the publicly funded vaccine
will be provided regardless of the individual's provision of the requested
documentation.
(II) A practitioner, except for an independent pharmacy, as defined in
subsection (1)(a) of this section, who administers a publicly funded vaccine shall
post and keep posted a notice provided by the department of public health and
environment, in multiple languages if requested, that confirms that the publicly
funded vaccine will be provided regardless of the individual's ability to pay a
vaccine administration fee.
(III) A notice required by this subsection (2) must be posted by the
practitioner in a location conspicuous to the individual, or a parent or legal guardian
consenting to the vaccination of an individual who is under eighteen years of age, at
the location of the individual's appointment. Each practitioner shall take steps to
ensure that the notice is not altered, defaced, or covered by other material.
(c) A practitioner, except for an independent pharmacy as defined in
subsection (1)(a) of this section, shall provide the individual, or a parent or legal
guardian consenting to the vaccination of the individual who is under eighteen
years of age, with a disclosure statement in the language understood by the
individual receiving the vaccine, or the parent or legal guardian consenting to the
vaccination of an individual under eighteen years of age, that confirms that the
publicly funded vaccine will be provided regardless of the individual's provision of
the requested documentation or of payment of a vaccine administration fee.
(d) The department of public health and environment shall create the
disclosure statement required by this subsection (2) and shall make it available
electronically to practitioners. A practitioner may request that the department
provide the practitioner with the disclosure statement in a language other than
English to meet the needs of an individual.
(3) (a) A practitioner shall not charge an individual or bill an individual's
insurance provider or plan for the product cost of a publicly funded vaccine.
(b) A practitioner shall not condition an individual's receipt of a publicly
funded vaccine on the individual's ability to pay a vaccine administration fee, but
the practitioner may charge a vaccine administration fee to the individual's
insurance provider or plan or attempt to collect an out-of-pocket payment for the
administration of the publicly funded vaccine from an uninsured individual at the
time that the publicly funded vaccine is administered.
(c) A practitioner who chooses to bill an individual or otherwise pursue the
payment for a vaccine administration fee from an individual to whom a publicly
funded vaccine is administered after the vaccine has been administered may issue
only a single bill to the individual within ninety days after the vaccine is
administered. The practitioner shall not send an unpaid vaccine administration bill
to a collection agency.
(d) A practitioner may charge a vaccine administration fee that is equal to or
less than the practitioner's vaccine administration costs or the vaccine
administration reimbursement rate set pursuant to the Colorado Medical
Assistance Act, articles 4, 5, and 6 of title 25.5, whichever is less.
(e) Notwithstanding subsection (3)(b) of this section, an independent
pharmacy may condition receipt of a publicly funded vaccine on the individual's
ability to pay. The vaccine administration fee charged by the independent pharmacy
must be equal to or less than the practitioner's vaccine administration costs or the
vaccine administration reimbursement rate set pursuant to the Colorado Medical
Assistance Act, articles 4, 5, and 6 of title 25.5, whichever is less. If an
independent pharmacy denies an individual a publicly funded vaccine due to an
inability to pay the vaccine administration fee, the independent pharmacy must
provide the individual with a list of practitioners provided by the department who
will not condition an individual's receipt of a publicly funded vaccine on the
individual's ability to pay a vaccine administration fee. Nothing in this section
exempts independent pharmacies from meeting all of the requirements of federal
vaccine programs, should independent pharmacies choose to enroll and be
approved for such programs.
(f) If federal or state money is made available to pay for the administration
costs of a publicly funded vaccine, a practitioner who administers the vaccine may
request payment from the federal or state source.
(4) This section does not authorize a practitioner to charge a vaccine
administration fee to an individual who receives services through the Colorado
Medical Assistance Act, articles 4, 5, and 6 of title 25.5.
(5) A practitioner shall provide a publicly funded vaccine to any age-appropriate individual who registers for an appointment with the practitioner to
receive the publicly funded vaccine within the practitioner's scope of practice.
(6) Each practitioner is encouraged to establish an electronic link and a
telephone number for individuals to use to schedule an appointment for a publicly
funded vaccine. To be accessible, the link should be separate from any regular
patient portal with restricted access and the scheduling services should be
accessible to individuals with disabilities.
(7) This section does not modify the requirements for practitioners, including
independent pharmacies, serving clients pursuant to the Colorado Medical
Assistance Act, articles 4, 5, and 6 of title 25.5, or federally qualified health
centers to meet the federal requirements for these programs for the administration
of publicly funded vaccines.