Colorado 2020 Regular Session Status: Enacted Bipartisan · 1 D · 1 R cosponsors

HB 20-1078 — Pharmacy Benefit Management Firm Claims Payments

Last action — Governor Signed

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  1. ✓
    Introduced
  2. ✓
    In Committee
  3. ✓
    Passed House
  4. ✓
    Passed Senate
  5. ✓
    To Executive
  6. 6
    Enacted

This bill has been enacted into law. Introduced January 08, 2020. Enacted.

Prognosis

Likely to advance 92% · high confidence

Where this bill stands today.

Odds of enactment

High

How often bills like it became law.

  • Enacted

    Current position in the legislative process.

  • 3 sponsors

    3 primary, 0 co-sponsors signed on.

  • Bipartisan support

    Sponsored across 2 parties (1 D · 1 R) — cross-party backing.

  • Cleared a recorded vote

    Passed 5 recorded votes so far.

Prognosis reads this bill's own signals — stage, sponsorship breadth, committee status, recorded votes and cross-state momentum. Odds come from a model trained on which bills have become law.

Summary

Beginning January 1, 2021, the act: Prohibits a pharmacy benefit management firm (PBM) from reimbursing a pharmacy in an amount less than the amount that the PBM reimburses any affiliate for the same pharmacy services; Prohibits PBMs from retroactively reducing payment on a clean claim submitted by a pharmacy unless as the result of an audit conducted in accordance with state law; and Requires health insurers that contract with PBMs to ensure that the PBMs are complying with this prohibition. The division of insurance is authorized to promulgate rules to establish the manner in which carriers and pharmacy benefit management firms are required to show compliance with the act. (Note: This summary applies to this bill as enacted.)

Bill Text

What changed in the latest version

24 added · 17 removed

Plain-language change summary

The bill has been amended to clarify that pharmacy benefit managers (PBMs) cannot retroactively reduce payments for prescription drug claims submitted by pharmacies. This change ensures that once a claim is approved, the pharmacy will receive fair compensation without the risk of unexpected fees. This matters because it creates more financial stability for pharmacies, helping them manage their operations and potentially pass on savings to patients.

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Latest
Second Regular Session Seventy-second General Assembly STATE OF COLORADO ENGROSSED This Version Includes All Amendments Adopted on Second Reading in the House of Introduction LLS NO.
Second Regular Session Seventy-second General Assembly STATE OF COLORADO REENGROSSED This Version Includes All Amendments Adopted in the House of Introduction LLS NO.
20-0021.01 Yelana Love x2295 HOUSE BILL 20-1078 HOUSE SPONSORSHIP Jaquez Lewis and Mullica, SENATE SPONSORSHIP Winter, House Committees Senate Committees Health & Insurance A BILL FOR AN ACT C ONCERNING PRESCRIPTION DRUG CLAIMS SUBMITTED BY A PHARMACY ,AND ,IN CONNECTION THEREWITH ,PROHIBITING RETROACTIVE FEES .
20-0021.01 Yelana Love x2295 HOUSE BILL 20-1078 HOUSE SPONSORSHIP Jaquez Lewis and Mullica, Bird, Buckner, Duran, Esgar, Froelich, Herod, Hooton, Kennedy, Lontine, Melton, Michaelson Jenet, Roberts, Tipper, Titone, Valdez A.
Bill Summary (Note:
SENATE SPONSORSHIP Winter, House Committees Senate Committees Health & Insurance A BILL FOR AN ACT C ONCERNING PRESCRIPTION DRUG CLAIMS SUBMITTED BY A PHARMACY ,AND , IN CONNECTION THEREWITH , PROHIBITING RETROACTIVE FEES .
This summary applies to this bill as introduced and does notreflectanyamendmentsthatmaybesubsequentlyadopted.Ifthisbill passes third reading in the house of introduction, a bill summary that applies to the reengrossed version of this bill will be available at http://leg.colorado.gov.) Thebillspecifiestheamountthatapharmacybenefitmanagement firm (PBM) is required to reimburse a pharmacy for clean claims and reasonable dispensing fees.
Bill Summary d (Note:
ThebillalsoprohibitsPBMsfromretroactivelyreducingpayment i 2 a 2 on a clean claim submitted by a pharmacy unless the PBM determines, S R 5 O n r Shading denotes HOUSE amendment.
This summary applies to this bill as introduced and does d 0 notreflectanyamendmentsthatmaybesubsequentlyadopted.Ifthisbill e 0 E a , passes third reading in the house of introduction, a bill summary that S U 6 applies to the reengrossed version of this bill will be available at O i a H a r http://leg.colorado.gov.) R e r F Thebillspecifiestheamountthatapharmacybenefitmanagement firm (PBM) is required to reimburse a pharmacy for clean claims and reasonable dispensing fees.
n 0 ThebillalsoprohibitsPBMsfromretroactivelyreducingpayment d 0 on a clean claim submitted by a pharmacy unless the PBM determines, E e , U d y O 2 a Shading denotes HOUSE amendment.
H 2 r Capital letters or bold & italic numbers indicate new material to be added to existidg statute.
H d b Capital letters or bold & italic numbers indicate new material to be added to existing statude.F Dashes through the words indicate deletions from existing statute.
Dashes through the words indicate deletions from existing statute.
e m A through an audit conducted in accordance with state law, that the claim was not a clean claim.
e F m A through an audit conducted in accordance with state law, that the claim was not a clean claim.
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Amendments

1 amendment

Click Show changes on an amendment above to see how it modifies the bill.

Action History

  1. Governor Signed

  2. Sent to the Governor

  3. Signed by the President of the Senate

  4. Signed by the Speaker of the House

  5. House Considered Senate Amendments - Result was to Concur - Repass

  6. Senate Third Reading Passed with Amendments - Floor

  7. Senate Third Reading Laid Over Daily - No Amendments

  8. Senate Second Reading Passed with Amendments - Floor

  9. Senate Committee on Health & Human Services Refer Unamended to Senate Committee of the Whole

  10. Introduced In Senate - Assigned to Health & Human Services

  11. House Third Reading Passed - No Amendments

  12. House Second Reading Passed with Amendments - Committee, Floor

  13. House Second Reading Laid Over Daily - No Amendments

  14. House Committee on Health & Insurance Refer Amended to House Committee of the Whole

  15. Introduced In House - Assigned to Health & Insurance

Sponsors

Sponsorship breakdown

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3 sponsors · 0 co-sponsors · 99 not signed on · 6 voted No

Sponsors (3)

Co-sponsors (0)

None.

Not signed on (99)

99 members have not signed on to this bill.

Show all 99 →

"Not signed on" means a member has not sponsored or co-sponsored this bill — it does not imply opposition. Members flagged Voted No have a recorded No vote on this bill.

Whip count is in markup. Polling the chamber and every recorded vote this session. Only the first open is slow. It’s instant for you after this. Calling the roll · Tallying · Engrossing

Votes

REPASS

Passed 44 Yea · 18 Nay · 3 Other
Party YeaNayPresentNot Voting
Unaffiliated 271402
Republican 1401
Democrat 16000
Total 441803
% of votes cast 68%28%0%5%
How each member voted (65)
Member Party Vote
Arndt — Yea
Bird — Yea
Bockenfeld — Nay
Buck — Nay
Buckner — Yea
Buentello — Yea
Caraveo — Yea
Carver — Yea
Champion — Nay
Esgar — Yea
Garnett — Yea
Geitner — Nay
Gonzales-Gutierrez — Yea
Gray — Yea
Herod — Yea
Holtorf — Yea
Hooton — Yea
Humphrey — Nay
Kraft-Tharp — Yea
Landgraf — Not Voting
Larson — Nay
Lontine — Yea
McKean — Nay
McLachlan — Yea
Melton — Yea
Neville — Nay
Pelton — Yea
Ransom — Nay
Saine — Nay
Sandridge — Nay
Singer — Yea
Tipper — Yea
Valdez A. — Yea
Will — Nay
Young — Yea
Becker — Yea
Adrienne Benavidez — Yea
Jaquez Lewis — Yea
Michaelson Jenet — Not Voting
Valdez D. — Yea
Van Winkle — Nay
Williams D. — Nay
deGruy Kennedy — Yea
Brianna Titone Democrat Yea
Cathy Kipp Democrat Yea
Dylan Roberts Democrat Yea
Emily Sirota Democrat Yea
James Coleman Democrat Yea
Jamie Jackson Democrat Yea
Julie McCluskie Democrat Yea
Kyle Mullica Democrat Yea
Lisa Cutter Democrat Yea
Marc Snyder Democrat Yea
Meg Froelich Democrat Yea
Mike Weissman Democrat Yea
Monica Duran Democrat Yea
Steven Woodrow Democrat Yea
Tom Sullivan Democrat Yea
Tony Exum Democrat Yea
Janice Rich Republican Nay
Larry Liston Republican Nay
Lynda Zamora Wilson Republican Nay
Marc Catlin Republican Yea
Mark Baisley Republican Nay
Matt Soper Republican Not Voting

CONCUR

Passed 58 Yea · 4 Nay · 3 Other
Party YeaNayPresentNot Voting
Unaffiliated 37402
Republican 5001
Democrat 16000
Total 58403
% of votes cast 89%6%0%5%
How each member voted (65)
Member Party Vote
Arndt — Yea
Bird — Yea
Bockenfeld — Yea
Buck — Yea
Buckner — Yea
Buentello — Yea
Caraveo — Yea
Carver — Yea
Champion — Yea
Esgar — Yea
Garnett — Yea
Geitner — Nay
Gonzales-Gutierrez — Yea
Gray — Yea
Herod — Yea
Holtorf — Yea
Hooton — Yea
Humphrey — Nay
Kraft-Tharp — Yea
Landgraf — Not Voting
Larson — Yea
Lontine — Yea
McKean — Yea
McLachlan — Yea
Melton — Yea
Neville — Yea
Pelton — Yea
Ransom — Yea
Saine — Yea
Sandridge — Nay
Singer — Yea
Tipper — Yea
Valdez A. — Yea
Will — Yea
Young — Yea
Becker — Yea
Adrienne Benavidez — Yea
Jaquez Lewis — Yea
Michaelson Jenet — Not Voting
Valdez D. — Yea
Van Winkle — Yea
Williams D. — Nay
deGruy Kennedy — Yea
Brianna Titone Democrat Yea
Cathy Kipp Democrat Yea
Dylan Roberts Democrat Yea
Emily Sirota Democrat Yea
James Coleman Democrat Yea
Jamie Jackson Democrat Yea
Julie McCluskie Democrat Yea
Kyle Mullica Democrat Yea
Lisa Cutter Democrat Yea
Marc Snyder Democrat Yea
Meg Froelich Democrat Yea
Mike Weissman Democrat Yea
Monica Duran Democrat Yea
Steven Woodrow Democrat Yea
Tom Sullivan Democrat Yea
Tony Exum Democrat Yea
Janice Rich Republican Yea
Larry Liston Republican Yea
Lynda Zamora Wilson Republican Yea
Marc Catlin Republican Yea
Mark Baisley Republican Yea
Matt Soper Republican Not Voting

AMEND

Passed 34 Yea · 0 Nay · 1 Other
Party YeaNayPresentNot Voting
Democrat 5001
Unaffiliated 28000
Republican 1000
Total 34001
% of votes cast 97%0%0%3%
How each member voted (35)
Member Party Vote
Cooke — Yea
Coram — Yea
Crowder — Yea
Donovan — Yea
Fenberg — Yea
Fields — Yea
Foote — Yea
Gardner — Yea
Ginal — Yea
Hansen — Yea
Hill — Yea
Hisey — Yea
Holbert — Yea
Lee — Yea
Lundeen — Yea
Marble — Yea
Moreno — Yea
Pettersen — Yea
Priola — Yea
Rankin — Yea
Scott — Yea
Smallwood — Yea
Sonnenberg — Yea
Tate — Yea
Todd — Yea
Williams A. — Yea
Woodward — Yea
Zenzinger — Yea
Jeff Bridges Democrat Not Voting
Jessie Danielson Democrat Yea
Julie Gonzales Democrat Yea
Lorena Garcia Democrat Yea
Robert Rodriguez Democrat Yea
Tammy Story Democrat Yea
Ty Winter Republican Yea

BILL

Passed 24 Yea · 10 Nay · 1 Other
Party YeaNayPresentNot Voting
Democrat 5001
Unaffiliated 181000
Republican 1000
Total 241001
% of votes cast 69%29%0%3%
How each member voted (35)
Member Party Vote
Cooke — Nay
Coram — Yea
Crowder — Yea
Donovan — Yea
Fenberg — Yea
Fields — Yea
Foote — Yea
Gardner — Nay
Ginal — Yea
Hansen — Yea
Hill — Nay
Hisey — Yea
Holbert — Nay
Lee — Yea
Lundeen — Nay
Marble — Nay
Moreno — Yea
Pettersen — Yea
Priola — Yea
Rankin — Nay
Scott — Nay
Smallwood — Nay
Sonnenberg — Yea
Tate — Nay
Todd — Yea
Williams A. — Yea
Woodward — Yea
Zenzinger — Yea
Jeff Bridges Democrat Not Voting
Jessie Danielson Democrat Yea
Julie Gonzales Democrat Yea
Lorena Garcia Democrat Yea
Robert Rodriguez Democrat Yea
Tammy Story Democrat Yea
Ty Winter Republican Yea

BILL

Passed 49 Yea · 12 Nay · 2 Other
Party YeaNayPresentNot Voting
Unaffiliated 301002
Republican 4200
Democrat 15000
Total 491202
% of votes cast 78%19%0%3%
How each member voted (63)
Member Party Vote
Arndt — Not Voting
Bird — Yea
Bockenfeld — Nay
Buck — Nay
Buckner — Yea
Buentello — Yea
Caraveo — Yea
Carver — Yea
Esgar — Yea
Garnett — Yea
Geitner — Nay
Gonzales-Gutierrez — Yea
Gray — Yea
Herod — Yea
Holtorf — Nay
Hooton — Yea
Humphrey — Nay
Kraft-Tharp — Yea
Landgraf — Yea
Larson — Nay
Lontine — Yea
McKean — Yea
McLachlan — Yea
Melton — Yea
Neville — Nay
Pelton — Yea
Ransom — Nay
Saine — Nay
Sandridge — Nay
Singer — Yea
Tipper — Yea
Valdez A. — Yea
Will — Yea
Young — Yea
Becker — Yea
Adrienne Benavidez — Yea
Jaquez Lewis — Yea
Michaelson Jenet — Yea
Valdez D. — Yea
Van Winkle — Yea
Williams D. — Not Voting
deGruy Kennedy — Yea
Brianna Titone Democrat Yea
Cathy Kipp Democrat Yea
Dylan Roberts Democrat Yea
Emily Sirota Democrat Yea
James Coleman Democrat Yea
Jamie Jackson Democrat Yea
Julie McCluskie Democrat Yea
Kyle Mullica Democrat Yea
Lisa Cutter Democrat Yea
Marc Snyder Democrat Yea
Meg Froelich Democrat Yea
Mike Weissman Democrat Yea
Monica Duran Democrat Yea
Tom Sullivan Democrat Yea
Tony Exum Democrat Yea
Janice Rich Republican Nay
Larry Liston Republican Yea
Lynda Zamora Wilson Republican Nay
Marc Catlin Republican Yea
Mark Baisley Republican Yea
Matt Soper Republican Yea

Subjects

healthcare health-insurance
Cross-referencing the record. Reading this bill against every other bill in the corpus by meaning, not keywords. Only the first open is slow. It’s instant for you after this. Matching · Ranking · Engrossing

Frequently asked questions

What does HB 20-1078 do?
Beginning January 1, 2021, the act: Prohibits a pharmacy benefit management firm (PBM) from reimbursing a pharmacy in an amount less than the amount that the PBM reimburses any affiliate for the same pharmacy services; Prohibits PBMs from retroactively reducing payment on a clean claim submitted by a pharmacy unless as the result of an audit conducted in accordance with state law; and Requires health insurers that contract with PBMs to ensure that the PBMs are complying with this prohibition. The division of insurance is authorized to promulgate rules to establish the manner in which carriers and pharmacy benefit management firms are required to show compliance with the act. (Note: This summary applies to this bill as enacted.)
Who sponsors HB 20-1078?
HB 20-1078 is sponsored by Kyle Mullica (Democrat), Jaquez Lewis, and Ty Winter (Republican).
What is the current status of HB 20-1078?
This bill has been enacted into law. Introduced January 08, 2020. Enacted.
Where can I track HB 20-1078?
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Last checked for changes 3 months ago · updated continuously

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