HB 1336

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.
     HOUSE BILL 26-1336
     BY REPRESENTATIVE(S) Lindsay and Winter T., Boesenecker, Brown,
     Clifford, Duran, Goldstein, Gonzalez R., Johnson, Marshall, McCormick,
     Nguyen, Rydin, Smith, Stewart K., McCluskie, Bacon, Barron, Caldwell,
     Mauro, Paschal, Rutinel, Soper;
     also SENATOR(S) Pelton R. and Cutter, Ball, Bright, Carson, Catlin,
     Exum, Gonzales J., Jodeh, Kipp, Kolker, Marchman, Roberts, Snyder,
     Wallace, Weissman, Coleman.
     CONCERNING MEASURES TO INCREASE ACCESS TO PHARMACY SERVICES.
     Be it enacted by the General Assembly of the State of Colorado:
            SECTION 1. In Colorado Revised Statutes, 10-16-144, amend (1)
     introductory portion, (1)(a), and (2) as follows:
             10-16-144. Health-care services provided by pharmacists.
            (1) Any A health benefit plan, except supplemental policies
     covering a specified disease or other limited benefit, that provides hospital,
     surgical, or medical expense insurance may MUST provide coverage for
     health-care services under a specific treatment protocol provided by a
     pharmacist if:
     ________
     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.
        (a) The pharmacist meets the requirements in part 6 of article 280
of title 12 IS PROVIDING SERVICES THAT ARE WITHIN THE PHARMACIST'S
SCOPE OF PRACTICE UNDER ARTICLE 280 OF TITLE 12;
       (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) (a) This subsection (2) does not require a carrier to contract with
IF a pharmacy or pharmacist IS willing to abide by the terms and conditions
for participation established by the health benefit plan or carrier, A HEALTH
BENEFIT PLAN OR CARRIER SHALL NOT DISCRIMINATE, WITH RESPECT TO
PARTICIPATION, REFERRAL, OR REIMBURSEMENT OF COVERED SERVICES OR
INDEMNIFICATION AS TO PHARMACISTS WHO ARE ACTING WITHIN THE SCOPE
OF THEIR LICENSE UNDER STATE LAW, SOLELY ON THE BASIS OF THE TYPE OF
LICENSURE. IN SELECTING PROVIDERS OF HEALTH-CARE SERVICES FOR
MEMBERSHIP IN A PROVIDER NETWORK, A HEALTH BENEFIT PLAN OR CARRIER
SHALL NOT DISCRIMINATE AGAINST PHARMACISTS WHO PROVIDE SERVICES
THAT ARE COVERED BY THE PLAN BY PROHIBITING PHARMACISTS FROM
MEMBERSHIP IN A PROVIDER NETWORK.
       (b) SUBSECTION (2)(a) OF THIS SECTION SHALL NOT BE CONSTRUED
AS:
       (I)     PROHIBITING A HEALTH BENEFIT PLAN OR CARRIER FROM
INCLUDING PROVIDERS IN A PROVIDER NETWORK ONLY TO THE EXTENT
NECESSARY TO MEET THE NEEDS OF THE HEALTH BENEFIT PLAN AND ITS
ENROLLEES OR FROM LIMITING REFERRALS OR ESTABLISHING ANY OTHER
MEASURE DESIGNED TO MAINTAIN QUALITY AND CONTROL COSTS
CONSISTENT WITH THE PROVISIONS OF THE HEALTH BENEFIT PLAN;
       (II) REQUIRING A HEALTH BENEFIT PLAN OR CARRIER TO CONTRACT
WITH ANY PROVIDER WILLING TO ABIDE BY THE TERMS AND CONDITIONS FOR
PARTICIPATION ESTABLISHED BY THE HEALTH BENEFIT PLAN OR CARRIER; OR
       (III)REQUIRING COVERAGE FOR ANY SERVICE THAT IS NOT
OTHERWISE COVERED UNDER THE TERMS OF A HEALTH BENEFIT PLAN.
PAGE 2-HOUSE BILL 26-1336
       SECTION 2. In Colorado Revised Statutes, 12-280-103, amend
(38.5)(a)(X), (38.5)(a)(XI), (39)(g)(IV) introductory portion,
(39)(g)(IV)(C), and (39)(g)(V); and add (17.5), (38.5)(a)(XII), and
(39)(g)(VII) as follows:
       12-280-103. Definitions - rules.
       As used in this article 280, unless the context otherwise requires or
the term is otherwise defined in another part of this article 280:
      (17.5) "FINAL PRODUCT VERIFICATION" MEANS, AFTER PRESCRIPTION
OR ORDER INFORMATION IS ENTERED INTO A PHARMACY'S ELECTRONIC
SYSTEM AND REVIEWED BY A PHARMACIST FOR ACCURACY, THERAPEUTIC
APPROPRIATENESS, AND OTHER ASPECTS OF DRUG REGIMEN REVIEW, A
PHYSICAL VERIFICATION THAT THE DRUG, DEVICE, OR PRODUCT SELECTED
FROM THE PHARMACY'S INVENTORY IS THE CORRECT DRUG, DRUG STRENGTH,
DRUG FORMULATION, DEVICE, OR PRODUCT FOR THE PRESCRIPTION OR
ORDER.
       (38.5) (a) "Practice as a pharmacy technician" means engaging in
any of the following activities involved in the practice of pharmacy, under
the supervision and delegation of a supervising pharmacist:
       (X) Redispensing a prescription drug pursuant to section 12-280-141
(9)(b) and (9)(c); and
       (XI) Requesting refill authorization from the prescriber or
prescriber's agent and receiving clarifying prescription information from the
prescriber or prescriber's agent; AND
     (XII) FINAL PRODUCT VERIFICATION FOR A DRUG, DEVICE, OR
PRODUCT THAT IS NOT A CONTROLLED SUBSTANCE.
       (39) "Practice of pharmacy" means:
       (g) Exercising independent prescriptive authority:
      (IV) For drugs that are not controlled substances, drug categories,
or devices that are prescribed in accordance with the product's
FDA-approved labeling and to patients who are at least twelve years of age
PAGE 3-HOUSE BILL 26-1336
OLD and that are limited to conditions that:
       (C) Have a test that is used to guide diagnosis or clinical
decision-making and is waived under the federal "Clinical Laboratory
Improvement Amendments of 1988", Pub.L. 100-578, as amended, or AND,
IF TESTING OR TREATMENT OCCURS, FOR A PATIENT TWELVE YEARS OLD OR
OLDER BUT UNDER EIGHTEEN YEARS OLD, THE PATIENT'S PRIMARY CARE
PROVIDER IS NOTIFIED AS SOON AS PRACTICABLE CONSISTENT WITH THE
FEDERAL "HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT OF
1996", PUB.L. 104-191, OR, IF THE PATIENT DOES NOT HAVE OR DISCLOSE A
PRIMARY CARE PROVIDER, THE PATIENT'S PHARMACIST REFERS THE PATIENT
TO A PRIMARY CARE PROVIDER FOR FURTHER CARE;
       (V) For any FDA-approved product indicated for opioid use disorder
in accordance with federal law and regulations, including medications for
opioid use disorder, if authorized pursuant to part 6 of this article 280; OR
     (VII) FOR DRUGS THAT ARE NOT CONTROLLED SUBSTANCES, DRUG
CATEGORIES, OR DEVICES THAT ARE PRESCRIBED IN ACCORDANCE WITH THE
PRODUCT'S FDA-APPROVED LABELING AND TO PATIENTS WHO ARE FIVE
YEARS OLD OR OLDER BUT UNDER TWELVE YEARS OLD AND THAT ARE
LIMITED TO CONDITIONS THAT:
       (A) DO NOT REQUIRE A NEW DIAGNOSIS;
       (B) ARE MINOR AND GENERALLY SELF-LIMITING; OR
      (C) HAVE A TEST THAT IS USED TO GUIDE DIAGNOSIS OR CLINICAL
DECISION - MAKING FOR INFLUENZA , SARS-C O V-2, GROUP A
STREPTOCOCCUS, OR RESPIRATORY SYNCYTIAL VIRUS THAT IS WAIVED
UNDER THE FEDERAL "CLINICAL LABORATORY IMPROVEMENT AMENDMENTS
OF 1988", PUB.L. 100-578, AS AMENDED; DO NOT REQUIRE MEDICATIONS
THAT ARE ONLY PRESCRIBED PURSUANT TO A CERTIFIED EDUCATION
PROGRAM AND A LIMITED DISTRIBUTION NETWORK; AND, IF TESTING OR
TREATMENT OCCURS, THE PATIENT'S PRIMARY CARE PROVIDER IS NOTIFIED
AS SOON AS PRACTICABLE CONSISTENT WITH THE FEDERAL "HEALTH
INSURANCE PORTABILITY AND ACCOUNTABILITY ACT OF 1996", PUB.L.
104-191, OR, IF THE PATIENT DOES NOT HAVE OR DISCLOSE A PRIMARY CARE
PROVIDER, THE PATIENT'S PHARMACIST REFERS THE PATIENT TO A PRIMARY
CARE PROVIDER FOR FURTHER CARE;
PAGE 4-HOUSE BILL 26-1336
      SECTION 3. In Colorado Revised Statutes, 12-280-122, add (5) as
follows:
       12-280-122. Limited authority to delegate activities constituting
practice of pharmacy to pharmacy interns or pharmacy technicians -
supervision ratio - final product verification - rules - definition.
      (5) (a)   A SUPERVISING PHARMACIST MAY DELEGATE, AND A
PHARMACY TECHNICIAN OR AN INTERN MAY PERFORM UNDER THE
SUPERVISION OF THE SUPERVISING PHARMACIST, TASKS ASSOCIATED WITH
THE PHYSICAL PREPARATION AND PROCESSING OF DRUG, DEVICE, OR
PRODUCT ORDERS THAT ARE NOT FOR CONTROLLED SUBSTANCES.
      (b) FINAL PRODUCT VERIFICATION TASKS THAT MAY BE DELEGATED
BY THE SUPERVISING PHARMACIST INCLUDE:
      (I) VERIFICATION OF THE PRESCRIPTION OR DRUG, DEVICE, OR
PRODUCT BY A SECOND PHARMACY TECHNICIAN OR INTERN CONCERNING THE
WORK OF THE FIRST PHARMACY TECHNICIAN OR INTERN;
      (II) USE OF BARCODE OR OTHER TECHNOLOGY TO VERIFY EACH
DRUG, DEVICE, OR PRODUCT PRIOR TO ADMINISTRATION TO AN INDIVIDUAL
BY A HEALTH-CARE PROVIDER;
      (III) VERIFICATION BY A SECOND PHARMACY TECHNICIAN OR INTERN
CONCERNING THE WORK OF THE FIRST PHARMACY TECHNICIAN OR INTERN IN
THE REPACKAGING OF DRUGS FROM BULK TO UNIT DOSE; OR
      (IV) OTHER ACTIVITIES AS AUTHORIZED BY THE BOARD BY RULE.
      (c)  IN DELEGATING FINAL PRODUCT VERIFICATION TASKS, A
SUPERVISING PHARMACIST SHALL USE THE PHARMACIST'S REASONABLE
PROFESSIONAL JUDGMENT AND SHALL ENSURE THAT AUTHORIZED TASKS DO
NOT REQUIRE THE EXERCISE OF DISCRETION OR CLINICAL JUDGMENT BY A
PHARMACY TECHNICIAN.
      (d) A PHARMACY OR OTHER OUTLET SHALL HAVE A CONTINUOUS
QUALITY ASSESSMENT SYSTEM IN PLACE TO PERIODICALLY VERIFY THE
ACCURACY OF A FINAL DRUG, DEVICE, OR PRODUCT, WHICH INCLUDES A
PROCESS FOR THE RECORDING AND EVALUATION OF ERRORS THAT OCCUR
PAGE 5-HOUSE BILL 26-1336
AND POTENTIAL ERRORS, EVEN IF THE ERRORS DO NOT REACH THE PATIENT.
      (e) A PHARMACY INTENDING TO IMPLEMENT A FINAL PRODUCT
VERIFICATION PROGRAM SHALL CREATE AND MAINTAIN A PROGRAM PLAN,
INCLUDING HOW PHARMACISTS' HOURS WILL BE MAINTAINED AND
REDIRECTED FOR PROVIDING DIRECT PATIENT CARE ACTIVITIES.
       (f) NO LATER THAN DECEMBER 31, 2026, THE BOARD SHALL ADOPT
RULES CONCERNING FINAL PRODUCT VERIFICATION BY A PHARMACY
TECHNICIAN OR INTERN PURSUANT TO THIS SUBSECTION (5). THE BOARD'S
RULES MUST INCLUDE:
       (I) TRAINING REQUIREMENTS;
       (II) EXCLUDED MEDICATIONS;
       (III) LIABILITY ISSUES; AND
       (IV) ANY OTHER RULES THE BOARD DEEMS APPROPRIATE.
        SECTION 4. In Colorado Revised Statutes, 25.5-5-511, amend
(2)(a) as follows:
       25.5-5-511.    Reimbursement for pharmacists' services -
legislative declaration.
      (2) (a) A pharmacist is eligible to receive reimbursement under the
medical assistance program for medically necessary services authorized in
part 6 of THAT ARE WITHIN THE PHARMACIST'S SCOPE OF PRACTICE
PURSUANT TO article 280 of title 12 AND that are not duplicative of other
pharmacist services or programs reimbursed under the medical assistance
program.
       SECTION 5. 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
PAGE 6-HOUSE BILL 26-1336
approved by the people at the general election to be held in November 2026
and, in such case, will take effect on the date of the official declaration of
the vote thereon by the governor.
____________________________  ____________________________
Julie McCluskie  James Rashad Coleman, Sr.
SPEAKER OF THE HOUSE  PRESIDENT OF
OF REPRESENTATIVES  THE SENATE
____________________________  ____________________________
Vanessa Reilly  Esther van Mourik
CHIEF CLERK OF THE HOUSE  SECRETARY OF
OF REPRESENTATIVES  THE SENATE
       APPROVED________________________________________
                          (Date and Time)
                    _________________________________________
                   Jared S. Polis
                   GOVERNOR OF THE STATE OF COLORADO
PAGE 7-HOUSE BILL 26-1336