CO HB1222

Defines "rural independent pharmacy" as a prescription drug outlet privately owned by at least one licensed pharmacist with no chain pharmacy or publicly traded company affiliation

Prohibits pharmacy benefit managers (PBMs) from blocking rural independent pharmacies from using private couriers or delivery services to deliver prescriptions to patients

Requires PBMs to reimburse rural independent pharmacies at no less than the national average drug acquisition cost plus a dispensing fee, effective January 1, 2026, with 1% annual inflation adjustments starting January 1, 2027

Mandates PBMs provide multiple electronic notifications and formal service of process to rural independent pharmacies before any recoupment or penalty exceeding $1,000, with 30-day response windows at each stage

Allows rural independent pharmacies to operate without a pharmacist physically present if prescription interpretation and evaluation is performed by a state-licensed pharmacist in person or remotely