SB 24-110
signedMedicaid Prior Authorization Prohibition
Plain-English Summary
AI-generatedSenate Bill 24-110, which has been approved and is now effective, stops Medicaid from requiring adults to switch to a different antipsychotic medication if they have already tried another preferred drug without success or are currently stable on a non-preferred drug. This bill affects Medicaid recipients who need antipsychotic medications for mental health conditions. The bill also allocates funds to help cover the costs of these medical services, ensuring that patients can continue their current treatment plans without unnecessary changes.
Official Summary
The act prohibits the department of health care policy and financing (department) from requiring an adult to be prescribed an antipsychotic prescription drug that is included on the preferred drug list and used to treat a mental health disorder or mental health condition if:
During the preceding year, the adult was prescribed and unsuccessfully treated with an antipsychotic prescription drug that is included on the preferred drug list and used to treat a mental health disorder or mental health condition and for which a single claim is paid; or
The adult is stable on an antipsychotic drug used to treat a mental health disorder or mental health condition that is not included on the preferred drug list.
The act appropriates $1,092,134 to the department. This appropriation consists of $888,555 from the general fund and $203,579 from the healthcare affordability and sustainability fee cash fund. The department may use this appropriation for medical and long-term care services for medicaid-eligible individuals. It is anticipated that the department will receive an additional $2,295,189 in federal funds for the implementation of this act.
APPROVED by Governor June 3, 2024
EFFECTIVE June 3, 2024(Note: This summary applies to this bill as enacted.)
Details
- Chamber
- Senate
- First action
- 2024-06-03
- Latest action
- 2024-02-05
- Last action desc.
- Introduced In Senate - Assigned to Health & Human Services
- OpenStates
- View source ↗
Related Legislation
This bill affects (39)
relatesSB 22-173(2022A)· signedTelepharmacy Criteria Remove Location Restriction
relatesHB 22-1370(2022A)· signedCoverage Requirements For Health-care Products
relatesHB 18-1161(2018A)· signedSupplemental Appropriation - Dept Of Health Care Policy & Financing
relatesHB 18-1207(2018A)· signedHospital Financial Transparency Measures
relatesSB 22-091(2022A)· signedNonsubstantive Changes To Rule Review Statutes
relatesSB 23-222(2023A)· signedMedicaid Pharmacy And Outpatient Services Copayment
relatesHB 23-1243(2023A)· signedHospital Community Benefit
relatesSB 24-116(2024A)· signedDiscounted Care for Indigent Patients
relatesSB 22-235(2022A)· signedCounty Administration Of Public Assistance Programs
relatesHB 22-1114(2022A)· signedTransportation Services For Medicaid Waiver Recipients
relatesHB 24-1399(2024A)· signedDiscounted Care for Indigent Patients
relatesSB 24-176(2024A)· signedUpdate Medicaid Member Terminology
relatesSB 23-033(2023A)· signedMedicaid Preauthorization Exemption
relatesHB 18-1358(2018A)· signedHealth Care Charges Billing Required Disclosures
relatesSB 23-162(2023A)· signedIncrease Access To Pharmacy Services
relatesSB 23-167(2023A)· signedBoard Of Nursing Regulate Certified Midwives
relatesSB 17-267(2017A)· signedSustainability Of Rural Colorado
relatesHB 22-1173(2022A)· signedDepartment of Health Care Policy & Financing Supplemental
relatesHB 22-1188(2022A)· signedARPA American Rescue Plan Act Money For Home- And Community-based Services
relatesHB 22-1133(2022A)· signedFamily And Medical Leave Insurance Fund
relatesHB 22-1095(2022A)· signedPhysician Assistant Collaboration Requirements
relatesSB 23-083(2023A)· signedPhysician Assistant Collaboration Requirements
relatesHB 22-1235(2022A)· signedSunset Continue Regulation Of Veterinary Practice
relatesSB 18-266(2018A)· signedControlling Medicaid Costs
relatesHB 18-1321(2018A)· signedEfficient Administration Medicaid Transportation
relatesSB 22-052(2022A)· signedMedical Assistance Income Eligibility Requirements
relatesSB 23-117(2023A)· signedDepartment of Health Care Policy & Financing Supplemental
relatesSB 23-298(2023A)· signedAllow Public Hospital Collaboration Agreements
relatesSB 17-057(2017A)· failedColorado Healthcare Affordability & Sustainability Enterprise
relatesHB 18-1136(2018A)· signedSubstance Use Disorder Treatment
relatesHB 22-1289(2022A)· signedHealth Benefits For Colorado Children And Pregnant Persons
relatesSB 22-162(2022A)· signedAdministration Organization Act Modernization
relatesHB 23-1226(2023A)· signedHospital Transparency And Reporting Requirements
relatesHB 24-1185(2024A)· signedDepartment of Health Care Policy & Financing Supplemental
relatesSB 18-195(2018A)· signedHealthcare Affordability & Sustainability Fee Cash Fund Appropriations
relatesSB 22-038(2022A)· signedHealthcare Affordability And Sustainability Fee
relatesHB 23-1215(2023A)· signedLimits On Hospital Facility Fees
Affected by (30)
amendsSB 24-121(2024A)· signedLicensure of Critical Access Hospitals
amendsHB 24-1037(2024A)· signedSubstance Use Disorders Harm Reduction
relatesSB 25-071(2025A)· signedProhibit Restrictions on 340B Drugs
relatesHB 25-1222(2025A)· signedPreserving Access to Rural Independent Pharmacies
relatesSB 25-301(2025A)· signedRemove Authorization Requirement Adjust Chronic Prescription
relatesSB 26-130(2026A)· failedMedical Spas Deceptive Trade Practices
relatesHB 26-1198(2026A)· signedAccess to Veterinary Care
relatesHB 26-1366(2026A)· signedDenver Health Federal Funds for Physician Services
relatesHB 26-1375(2026A)· signedRepeal County Administration Funding Model
relatesHB 26-1069(2026A)· signedAvailability of Emergency Medical Services
relatesHB 26-1411(2026A)· signedChanges to Cover All Coloradans Program
relatesHB 26-1327(2026A)· failedLarge Employer Worker Health-Care Support
relatesHB 26-1328(2026A)· signedMedicaid Nonemergency Medical Transportation
relatesHB 26-1155(2026A)· signedDepartment of Health Care Policy & Financing Supplemental
relatesSB 24-175(2024A)· signedImproving Perinatal Health Outcomes
relatesHB 26-1335(2026A)· signedAbortion Medication Access on College Campuses
relatesSB 24-209(2024A)· signedPharmacy Practice Act
relatesSB 25-066(2025A)· signedState Contracts with Opioid Antagonist Businesses
relatesHB 24-1045(2024A)· signedTreatment for Substance Use Disorders
relatesSB 25-093(2025A)· signedDepartment of Health Care Policy & Financing Supplemental
relatesSB 25-270(2025A)· signedEnterprise Nursing Facility Provider Fees
relatesSB 25-166(2025A)· signedHealth-Care Workplace Violence Incentive Payments
relatesSB 25-229(2025A)· signedReimbursement for Community Health Workers
relatesSB 25-228(2025A)· signedEnterprise Disability Buy-in Premiums
relatesHB 26-1177(2026A)· signedEnd Nursing Provider Wage Enhancement Payments
relatesHB 26-1429(2026A)· signedCounty Administration Public Assistance Programs
relatesHB 24-1149(2024A)· signedPrior Authorization Requirements Alternatives
relatesHB 26-1336(2026A)· signedIncrease Access to Pharmacy Services
repealsHB 26-1432(2026A)· signedHealth-Care Payment Programs
Votes
REPASS
2024-05-06 · Senate · pass — Yes: 32 · No: 2 · Other: —
CONCUR
2024-05-06 · Senate · pass — Yes: 34 · No: 0 · Other: —
BILL
2024-05-05 · House · pass — Yes: 57 · No: 5 · Other: —
BILL
2024-04-24 · Senate · pass — Yes: 31 · No: 2 · Other: —