HB 19-1154 Summary

• Prohibits health insurers and pharmacy benefit managers from limiting a covered person's ability to select a licensed pharmacy or pharmacist if the pharmacy agrees to contract terms.

• Prohibits imposing higher copayments, fees, or cost-sharing requirements on covered persons for choosing a pharmacy unless the same requirements apply uniformly to all pharmacies statewide.

• Prohibits imposing other conditions that restrict a covered person's ability to use a pharmacy of their choosing.

• Prohibits denying a validly licensed pharmacy or pharmacist the right to participate in pharmacy network contracts if they agree to accept contract terms and comply with state and federal laws.

• Exempts inpatient/emergency care in licensed facilities, managed care plans with employed physicians, self-funded ERISA plans, and state/federal employee plans; effective for plans issued or renewed on or after January 1, 2021.