SB 6

NOTE: This bill has been prepared for the signatures of the appropriate legislative
officers and the Governor. To determine whether the Governor has signed the bill
or taken other action on it, please consult the legislative status sheet, the legislative
history, or the Session Laws.
     SENATE BILL 26-006
     BY SENATOR(S) Amabile and Kirkmeyer, Bright, Catlin, Cutter, Frizell,
     Pelton B., Wallace, Coleman;
     also REPRESENTATIVE(S) Brown and Taggart, Bacon, Boesenecker,
     Duran, McCormick, Sirota, Smith.
     CONCERNING PARITY FOR THE USE OF NON-OPIOID PAIN MANAGEMENT
          DRUGS , AND , IN CONNECTION THEREWITH , MAKING AN
          APPROPRIATION.
     Be it enacted by the General Assembly of the State of Colorado:
             SECTION 1. In Colorado Revised Statutes, 10-16-145.5, add (2.5)
     as follows:
            10-16-145.5. Step therapy - prior authorization - prohibited -
     stage four advanced metastatic cancer - non-opioid pain management
     drug - definitions.
           (2.5) (a) NOTWITHSTANDING SECTION 10-16-145, A CARRIER THAT
     PROVIDES PRESCRIPTION DRUG BENEFITS SHALL REQUIRE THAT:
             (I) THE UTILIZATION REVIEW REQUIREMENTS, INCLUDING PRIOR
     ________
     Capital letters or bold & italic numbers indicate new material added to existing law; dashes
     through words or numbers indicate deletions from existing law and such material is not part of
     the act.
AUTHORIZATION AND STEP THERAPY, FOR A NON-OPIOID DRUG PRESCRIBED
AND APPROVED BY THE FDA FOR THE TREATMENT OR MANAGEMENT OF
CHRONIC OR ACUTE PAIN ARE NO MORE RESTRICTIVE THAN THE LEAST
RESTRICTIVE UTILIZATION REVIEW REQUIREMENTS FOR OPIOID DRUGS
PRESCRIBED FOR THE TREATMENT OR MANAGEMENT OF CHRONIC OR ACUTE
PAIN; AND
      (II)   THE COST-SHARING, COPAYMENT, OR DEDUCTIBLE FOR A
NON-OPIOID DRUG PRESCRIBED FOR THE TREATMENT OR MANAGEMENT OF
CHRONIC OR ACUTE PAIN IS NO GREATER THAN THE COST-SHARING,
COPAYMENT, OR DEDUCTIBLE FOR AN OPIOID DRUG PRESCRIBED FOR THE
TREATMENT OR MANAGEMENT OF CHRONIC OR ACUTE PAIN.
      (b) (I) EXCEPT AS PROVIDED IN SUBSECTION (2.5)(b)(II) OF THIS
SECTION, ALL INDIVIDUAL AND SMALL GROUP HEALTH BENEFIT PLANS ISSUED
OR RENEWED IN THIS STATE ON OR AFTER JANUARY 1, 2027, SHALL ENSURE
THERE IS AT LEAST ONE NON-OPIOID PRESCRIPTION DRUG AVAILABLE AS A
CLINICALLY APPROPRIATE ALTERNATIVE FOR AN OPIOID PRESCRIPTION DRUG.
       (II) SUBSECTION (2.5)(b)(I) OF THIS SECTION IS INOPERATIVE AND
THE STATE SHALL NOT ASSUME AN OBLIGATION FOR THE COVERAGE
REQUIRED PURSUANT TO SUBSECTION (2.5)(b)(I) OF THIS SECTION IF THE
DIVISION DETERMINES THAT THE BENEFIT SPECIFIED IN SUBSECTION
(2.5)(b)(I) OF THIS SECTION REQUIRES STATE DEFRAYAL OF THE COST OF
COVERAGE PURSUANT TO A PROVISION OF THE FEDERAL ACT, INCLUDING 42
U.S.C. SEC. 18031 (d)(3)(B) OR A SUCCESSOR PROVISION, AND THE
IMPLEMENTING REGULATIONS OR THE STATE IS OTHERWISE REQUIRED TO
DEFRAY THE COST OF COVERAGE REQUIRED PURSUANT TO SUBSECTION
(2.5)(b)(I) OF THIS SECTION.
      (III) ALL LARGE EMPLOYER HEALTH BENEFIT PLANS ISSUED OR
RENEWED IN THIS STATE ON AND AFTER JANUARY 1, 2028, SHALL ENSURE
THERE IS AT LEAST ONE NON-OPIOID PRESCRIPTION DRUG AVAILABLE AS A
CLINICALLY APPROPRIATE ALTERNATIVE FOR AN OPIOID PRESCRIPTION DRUG.
      (IV) THE COVERAGE REQUIRED BY THIS SUBSECTION (2.5) MAY BE
OFFERED THROUGH A HIGH DEDUCTIBLE PLAN THAT WOULD QUALIFY FOR A
HEALTH SAVINGS ACCOUNT PURSUANT TO 26 U.S.C. SEC. 223; EXCEPT THAT
A CARRIER MAY APPLY DEDUCTIBLE AMOUNTS FOR THE REQUIRED COVERAGE
IF IT IS NOT CONSIDERED BY THE UNITED STATES DEPARTMENT OF THE
PAGE 2-SENATE BILL 26-006
TREASURY TO BE PREVENTIVE OR TO HAVE AN ACCEPTABLE DEDUCTIBLE.
       (c) THIS SUBSECTION (2.5) DOES NOT APPLY TO A GROUP BENEFIT
PLAN ISSUED PURSUANT TO THE "STATE EMPLOYEE GROUP BENEFITS ACT",
PART 6 OF ARTICLE 50 OF TITLE 24.
       SECTION 2. Appropriation. For the 2026-27 state fiscal year,
$15,415 is appropriated to the department of regulatory agencies for use by
the division of insurance. This appropriation is from the division of
insurance cash fund created in section 10-1-103 (3)(a)(I), C.R.S., and is
based on an assumption that the division will require an additional 0.2 FTE.
To implement this act, the division may use this appropriation for personal
services.
       SECTION 3. Act subject to petition - effective date. This act
takes effect at 12:01 a.m. on the day following the expiration of the
ninety-day period after final adjournment of the general assembly (August
12, 2026, if adjournment sine die is on May 13, 2026); except that, if a
referendum petition is filed pursuant to section 1 (3) of article V of the state
constitution against this act or an item, section, or part of this act within
such period, then the act, item, section, or part will not take effect unless
approved by the people at the general election to be held in November 2026
PAGE 3-SENATE BILL 26-006
and, in such case, will take effect on the date of the official declaration of
the vote thereon by the governor.
____________________________  ____________________________
James Rashad Coleman, Sr.  Julie McCluskie
PRESIDENT OF  SPEAKER OF THE HOUSE
THE SENATE  OF REPRESENTATIVES
____________________________  ____________________________
Esther van Mourik  Vanessa Reilly
SECRETARY OF  CHIEF CLERK OF THE HOUSE
THE SENATE  OF REPRESENTATIVES
       APPROVED________________________________________
                          (Date and Time)
                    _________________________________________
                   Jared S. Polis
                   GOVERNOR OF THE STATE OF COLORADO
PAGE 4-SENATE BILL 26-006