Colo. Rev. Stat. § 25.5-5-422

Current through 11/5/2024 election
Section 25.5-5-422 - Medication-assisted treatment - limitations on MCEs - definition
(1) As used in this section, "FDA" means the food and drug administration in the United States department of health and human services.
(2) Notwithstanding any provision of law to the contrary, each MCE that provides prescription drug benefits or methadone administration for the treatment of substance use disorders shall:
(a) 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;
(b) Not impose any step therapy requirements as a prerequisite to authorizing coverage for a prescription medication approved by the FDA for the treatment of substance use disorders;
(c) Not exclude coverage for any prescription medication approved by the FDA for the treatment of substance use disorders and any associated counseling or wraparound services solely on the grounds that the medications and services were court ordered; and
(d) Set the reimbursement rate for take-home methadone treatment and office-administered methadone treatment at the same rate.

C.R.S. § 25.5-5-422

Amended by 2024 Ch. 470,§ 21, eff. 8/7/2024.
Added by 2019 Ch. 195, § 15, eff. 5/16/2019.
L. 2019: Entire section added, (HB 19-1269), ch. 2136, p. 2136, § 15, effective May 16.

Section 17(1) of chapter 195 (HB 19-1269), Session Laws of Colorado 2019, provides that the act adding this section applies to conduct occurring on or after May 16, 2019.

2024 Ch. 470, was passed without a safety clause. See Colo. Const. art. V, § 1(3).

For the short title ("Behavioral Health Care Coverage Modernization Act") in HB 19-1269, see section 1 of chapter 195, Session Laws of Colorado 2019.