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March 17, 2023

Bills to Save Patients Money on Health Care Pass Committee

DENVER, CO - The House Health and Insurance Committee today passed two bills that would save patients and business owners money on prescription drugs and increase transparency of health care services.

“For every $100 spent at a pharmacy, $82 is evenly split between manufacturer profits and middlemen like Pharmacy Benefit Managers,” said Rep. Lindsey Daugherty, D-Arvada. “Pharmacy benefit managers are charging employers one price for prescription drugs while reimbursing pharmacies much less and pocketing the difference. I’m proud to bring this bill to save business owners money on the prescription drug coverage they provide to their employees by prohibiting the pharmacy benefits industry from price gouging.”

HB23-1201, also sponsored by Representative Matt Soper, passed by a vote of 10-1. Currently PBMs can charge employers one price, but reimburse pharmacies less and keep the difference, a practice known as spread pricing. This bill makes it an unfair business practice for PBMs to charge employers more for a drug than what they pay pharmacies for the same drug and increase transparency for employers into PBM and carrier behavior that impacts their costs.

“Coloradans deserve for their health care providers to be transparent about the care they can offer them,” said Rep. Kyle Brown, D-Louisville. "A lot of planning goes into seeking health care. Many people have to take off work, budget for the co-pay, pay for child care, and find transportation to the health care facility. This bill protects everyday Coloradans by ensuring they know exactly what services a facility will provide.”

“Unfortunately, many Coloradans, especially those in the LGBTQ+ community, have gone to a provider looking to receive care only to be turned away,” said Rep. Brianna Titone, D-Arvada. "People in our state have reached out to providers expecting routine medical services only to find out that the provider won’t offer them. Our legislation makes it easier for patients to compare services across providers so they can access essential health care like contraceptive services, abortion, and gender-affirming care.”

HB23-1218 requires certain health care facilities to share details with the Colorado Department of Public Health and Environment (CDPHE) of the health care services they provide. The CDPHE will create forms to compile a list of services that a health care facility may deny for non-medical reasons, like abortion and gender-affirming care. The forms will be shared with the public biannually so they have a better understanding of facilities that meet their specific health care needs. Providers must also make their forms available to their patients to disclose the care they offer due to the informed consent process.

By February 1, 2024, the CDPHE must publish the forms on their website so consumers can easily compare services across health care facilities.

The bill passed by a vote of 8-2.

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