| Summary |
Opioid and Other Substance Use Disorders Study Committee.
Section 1 prohibits a carrier that provides coverage under a health benefit
plan for a drug used to treat a substance use disorder from requiring prior
authorization for the drug based solely on the dosage amount.
Section 2 requires an insurance carrier and the medical assistance
program to reimburse a licensed pharmacist prescribing or administering
medication-assisted treatment (MAT) pursuant to a collaborative
pharmacy practice agreement (collaborative agreement) at a rate equal to
the reimbursement rate for other providers. Section 7 amends the practice
of pharmacy to include exercising prescriptive authority for any
FDA-approved product or medication for opioid use disorder in
accordance with federal law, if authorized through a collaborative
agreement. Section 8 requires the state board of pharmacy, the Colorado
medical board, and the state board of nursing to develop a protocol for
pharmacists to prescribe, dispense, and administer medication-assisted
treatment. Section 23 requires the medical assistance program to
reimburse a pharmacist prescribing or administering medications for
opioid use disorder pursuant to a collaborative agreement at a rate equal
to the reimbursement rate for other providers.
Section 3 requires the commissioner of insurance to:
•
Review the network adequacy rules promulgated by the
commissioner and the division of insurance to ensure that
the rules are sufficient to require each carrier to maintain an
adequate number of substance use disorder treatment
providers in underserved areas and to maintain an adequate
number of behavioral health-care providers in all
communities; and
•
Report the rule review findings to the opioid and other
substance use disorders study committee, including any
recommended rule changes.
Sections 4, 5, 6, and 25 authorize licensed clinical social workers
and licensed professional counselors (professionals) within their scope of
practice to provide clinical supervision to individuals seeking certification
as addiction technicians and addiction specialists, and direct the state
board of addiction counselors and the state board of human services, as
applicable, to adopt rules relating to clinical supervision by these
professionals.
Section 9 and 10 establish the behavioral health diversion pilot
program (pilot program) to award grants to at least 2, but not more than
5, district attorneys to divert from the criminal justice system persons who
have a behavioral health disorder, including a substance use disorder, that
requires early recovery services and treatment that is reasonably expected
to deter future criminal behavior.
Sections 11 through 16 expand the medication-assisted treatment
expansion pilot program to include grants to provide training and ongoing
support to pharmacies and pharmacists who are authorized to prescribe,
dispense, and administer MAT pursuant to a collaborative agreement and
protocol to assist individuals with a substance use disorder.
Section 17 requires the department of health care policy and
financing (HCPF) to seek federal authorization to provide screening for
physical and behavioral health needs, brief intervention, administration
of medication-assisted treatment, physical and psychiatric prescription
medications provided upon release from jail, case management, and care
coordination services through the medical assistance program to persons
up to 90 days prior to release from jail, a juvenile institutional facility, or
a department of corrections facility.
Section 18 adds substance use disorder treatment to the list of
health-care or mental health-care services that are required to be
reimbursed at the same rate for telemedicine as a comparable in-person
service.
Section 19 requires HCPF to seek federal authorization to provide
partial hospitalization for substance use disorder treatment with full
federal financial participation.
Section 20 requires each managed care entity (MCE) that provides
prescription drug benefits or methadone administration for the treatment
of substance use disorders to:
•
Set the reimbursement rate for take-home methadone
treatment and office-administered methadone treatment at
the same rate; and
•
Not impose any prior authorization requirements on any
prescription medication approved by the FDA for the
treatment of substance use disorders, regardless of the
dosage amount.
Section 21 requires the behavioral health administration to collect
data from each withdrawal management facility on the total number of
individuals who were denied admittance or treatment for withdrawal
management and the reason for the denial and review and approve any
admission criteria established by a withdrawal management facility.
Section 22 requires each MCE to disclose the aggregated average
and lowest rates of reimbursement for a set of behavioral health services
determined by HCPF.
For the 2024-25 state fiscal year and each state fiscal year
thereafter, section 24 appropriates $150,000 from the general fund to the
Colorado child abuse prevention trust fund (trust fund) for programs to
reduce the occurrence of prenatal substance exposure. For the 2024-25
and 2025-26 state fiscal years, section 24 also annually appropriates
$50,000 from the general fund to the trust fund to convene a stakeholder
group to identify strategies to increase access to child care for families
seeking substance use disorder treatment and recovery services.
Section 26 requires the behavioral health administration (BHA) to
contract with an independent third-party entity to provide services and
supports to behavioral health providers seeking to become a behavioral
health safety net provider with the goal of the provider becoming
self-sustaining.
Section 27 creates the contingency management grant program in
the BHA to provide grants to substance use disorder treatment programs
that implement a contingency management program for individuals with
a stimulant use disorder.
Section 28 requires a county jail seeking to provide services to
incarcerated medicaid members to apply for a correctional services
provider license from the BHA.
Section 29 requires the BHA, in collaboration with HCPF, to
convene a working group to study and identify barriers to opening and
operating an opioid treatment program, including satellite medication
units and mobile methadone clinics.
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