CO SB203

Prohibits health insurance carriers from requiring covered persons to undergo step therapy, which is a protocol requiring use of alternative prescription drugs before covering a physician-recommended drug.

Requires carriers to cover a prescribed medication that is on their formulary when a patient has previously tried the step-therapy-required drugs under current or previous insurance and the drugs were discontinued due to lack of efficacy, diminished effect, or adverse events.

Pharmacy drug samples do not count as trial and failure of a preferred prescription drug for purposes of overriding step therapy requirements.

Allows carriers, health benefit plans, and utilization review organizations to request relevant documentation from patients or providers to support override requests.

Takes effect September 1, 2017, subject to approval by voters in November 2018 if a referendum petition is filed within 90 days after the legislative session ends.