Colorado Code § 12-280-140

Emergency prescription insulin supply - eligibility - record keeping - penalty
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(1) (a) Effective January 1, 2022, an individual who meets the requirements of
subsection (2) of this section may receive one emergency thirty-day supply of prescription
insulin within a twelve-month period. The pharmacy may charge the individual an amount not to
exceed thirty-five dollars for the thirty-day supply.
(b) By January 1, 2022, each manufacturer shall establish procedures to make insulin
available in accordance with this section to eligible individuals who need access to an
emergency prescription insulin supply.
(2) To be eligible for an emergency prescription insulin supply, an individual must:
(a) Have a valid prescription for insulin or be eligible for an emergency supply as
provided in section 12-280-125.5;
(b) Have less than a seven-day supply of insulin available;
(c) Be required to pay more than one hundred dollars out of pocket each month for the
individual's insulin; and
(d) Be a resident of Colorado.
(3) (a) The board shall create and make available to the public an application form for
individuals seeking an emergency prescription insulin supply pursuant to this section.
(b) At a minimum, the application form must require the individual to show proof that
the individual meets the requirements of subsection (2) of this section.
(c) Each pharmacy in the state shall make the application form available at the
pharmacy.
(4) (a) Upon receipt of an individual's completed application form demonstrating that the
individual is eligible pursuant to subsection (2) of this section and the individual's proof of
residency, a pharmacist shall dispense the prescribed insulin in an amount that will provide the
individual with a thirty-day supply.
(b) If the individual is under eighteen years of age, the individual's parent or legal
guardian may provide the pharmacist with proof of residency.
(5) Each pharmacy shall keep the application form for each individual who receives an
emergency prescription insulin supply pursuant to this section for two years following the date
on which the insulin was dispensed.
(6) (a) Except as provided in subsection (6)(d) of this section, unless the manufacturer
agrees to send to the pharmacy a replacement supply of the same insulin dispensed in the amount
dispensed through the program, the pharmacy may submit to the manufacturer of the dispensed
insulin, directly or through the manufacturer's delegated representative, subcontractor, or other
vendor, an electronic claim for payment that is made in accordance with the National Council for
Prescription Drug Programs' standards for electronic claims processing.
(b) By January 1, 2022, each manufacturer shall develop a process for a pharmacy to
submit an electronic claim for reimbursement as provided in subsection (6)(a) of this section.
(c) If the pharmacy submits an electronic claim to the manufacturer pursuant to
subsection (6)(a) of this section, the manufacturer or the manufacturer's delegated representative,
subcontractor, or other vendor shall, within thirty days after receipt of the claim, either:
(I) Reimburse the pharmacy in an amount that covers the pharmacy's wholesale
acquisition cost for the insulin dispensed pursuant to this section; or
(II) Send the pharmacy a replacement supply of the same insulin in an amount equal to
or greater than the amount that covers the pharmacy's wholesale acquisition cost for the insulin
dispensed pursuant to this section.
(d) A pharmacy shall not submit a claim for payment for insulin with a wholesale
acquisition cost of eight dollars or less per milliliter, adjusted annually based on the annual
percentage change in the consumer price index.
(7) The board shall promote the availability of the emergency prescription insulin supply
to Coloradans. The promotional material must include information about each manufacturer's
consumer insulin programs. The board may seek and accept gifts, grants, and donations to fulfill
the requirements of this subsection (7).
(8) A manufacturer's reimbursement pursuant to subsection (6)(b) of this section is not a
kickback.
(9) (a) A manufacturer that fails to comply with the requirements of this section:
(I) Is subject to a fine in an amount and frequency that is equal to the amount and
frequency of the fine permitted under the "Colorado Consumer Protection Act", part 1 of article
1 of title 6; and
(II) Engages in a deceptive trade practice under section 6-1-105 (1)(ffff).
(b) The attorney general is authorized to enforce this section.

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