(1) Notwithstanding any provision of law to the contrary, beginning January 1, 2020, a carrier that provides prescription drug benefits for the treatment of substance use disorders shall, for prescription medications that are on the carrier's formulary:
Not impose prior authorization requirements on any prescription medication approved by the FDA for the treatment of substance use disorders;
Not impose any step therapy requirements as a prerequisite for coverage for a prescription medication approved by the FDA for the treatment of substance use disorders;
Place at least one covered prescription medication approved by the FDA for the treatment of substance use disorders on the lowest tier of the drug formulary developed and maintained by the carrier; and
Not exclude coverage for any prescription medication approved by the FDA for thetreatment of substance use disorders and any associated counseling or wraparound services solely on the grounds that the medications and services were court ordered.
(1.5) The commissioner, in consultation with the department of public health and environment, may promulgate rules or seek a revision to the prescription drug benefits required under the essential health benefits package concerning prescription medications that must be included on a carrier's formulary for medication-assisted treatment of substance use disorders.
(2) As used in this section, "FDA" means the food and drug administration in the United States department of health and human services.
Source: L. 2019: Entire section added, (HB 19-1269), ch. 195, p. 2131, § 10, effective May 16. L. 2020: (1.5) added, (SB 20-007), ch. 286, p. 1391, § 8, effective July 13.
Cross references: 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.