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DENVER, CO - The House Health & Insurance Committee today passed legislation to improve oversight of Pharmacy Benefit Managers to reduce the cost of prescription drugs. It passed by a vote of 9-1.
“Pharmacy Benefit Managers act as the middleman between health insurers, employers and patients, giving them a lot of power in determining the cost of prescription drugs,” said Rep. Iman Jodeh, D-Aurora. “Strengthening the Division of Insurance’s ability to enforce the cost-saving legislation we’ve passed in recent years will hold Pharmacy Benefit Managers accountable for not following the rules. Colorado Democrats are committed to finding solutions that drive down costs so all Coloradans can afford their essential medication.”
“Colorado Democrats have made significant strides in making quality health care more affordable, but these cost-saving measures are not as effective when Pharmacy Benefit Managers don’t act in accordance with the law,” said Rep. David Ortiz, D-Littleton. “This legislation will require Pharmacy Benefit Managers to register with the state and create new tools to ensure that they follow the cost-saving measures and consumer protections we’ve created to save Coloradans money. Affordable access to prescription drugs and health care is essential in creating an equitable health care system.”
HB23-1227 will ensure that Pharmacy Benefit Managers (PBM) follow through on critical cost savings reforms that the legislature has passed in recent years to save consumers money. This bill will provide the Division of Insurance (DOI) with more direct oversight over PBMs by requiring them to register and specifying that the DOI has the ability to enforce those reforms.
This bill would grant the commissioner the power to investigate and impose penalties on PBMs for failing to comply with consumer protections such as charging pharmacies fees to adjudicate claims, clawing back money from pharmacies inappropriately, and discriminating against independent pharmacies versus PBM affiliated pharmacies.