Senators Kirkmeyer and Roberts presented House Bill 24-1149, which establishes prior authorization requirements for certain health care services and prescription drug benefits covered under a health benefit plan. Specifically, carriers, private utilization review organizations, and pharmacy benefit managers must:
·        develop and adopt a program that eliminates or substantially modifies the prior authorization administrative process for qualified health care providers who meet certain criteria;
·        establish a binding arbitration process for a carrier’s failure to include a provider in the program;
·        publicly disclose information on prior authorization requirements and restrictions including a list of drugs that require prior authorization, clinical criteria for reauthorization, standard forms, data on prior authorization request determinations, exemptions, and prescription drug formularies;
·        annually review and eliminate prior authorization requirements for services and drugs that do not promote health care quality or equity, nor reduce health care spending;
·        upon denial of a prior authorization, provide relevant alternative services or treatments that may be covered;
·        use an application programming interface that automates the prior authorization process for providers to access certain information; and
·        accept and respond to prior authorization requests through the secure electronic transmission system through which the request was submitted.

Ms. Saskia Young, representing Colorado Association of Health Plans, testified in opposition to the bill.

Karlee Tebbutt, representing America's Health Insurance Plans (AHIP), testified in opposition to the bill.

Mr. Jonathan Buxton, representing PCMA, testified in opposition to the bill.

Hope Stonner, representing Colorado Consumer Health Initiative, testified in support of the bill.

Kelly Erb, representing Colorado Rural Health Center, testified in support of the bill.

Dr. Rhonda Parker, representing Colorado Medical Society, testified in support of the bill.

Dr. Nolan Wessell, representing University of Colorado School of Medicine Department of Orthopedic Surgery, testified in support of the bill.