CO HB1227

Starting in 2024, pharmacy benefit managers (PBMs) must register with the Colorado Insurance Commissioner and comply with registration requirements established by rule.

The Commissioner may deny, suspend, or revoke PBM registrations for material misstatements, fraudulent conduct, illegal activities, or violations of insurance law, with judicial review available.

Registration and renewal fees collected from PBMs are deposited in the Division of Insurance Cash Fund to cover administrative and enforcement costs.

The Commissioner is granted explicit enforcement authority and power to impose penalties or remedies against PBMs that fail to comply with existing requirements regarding maximum allowable cost pricing, formulary changes, pharmacy audits, benefit disclosures, and real-time benefit information.

Appropriates $206,647 for fiscal year 2023-24 to the Division of Insurance, including $183,262 for 2.5 additional FTE positions and $23,385 for operating expenses, with the bill taking effect 90 days after legislative adjournment.