(1) On and after January 1, 2022, it is unlawful for any person to purchase or reimburse a payer for a prescription drug for which the board has established an upper payment limit pursuant to section 10-16-1407 at an amount that exceeds the upper payment limit established by the board for that prescription drug, regardless of whether the prescription drug is dispensed or distributed in person, by mail, or by other means.
(2) On and after January 1, 2023, each state entity, carrier, and optional participating plan shall require compliance with an upper payment limit established by the board.
(3) The attorney general is authorized to enforce this part 14 on behalf of any state entity or any consumer of prescription drugs.
(4) Notwithstanding any provision of this part 14 to the contrary, as used in this section, person does not include an individual who acquires a prescription drug for the individual's own use or for a family member's use.
(5) Notwithstanding any provision of this section to the contrary, a carrier or state agency that is required pursuant to state or federal law to purchase or reimburse a payer for a prescription drug for which the board has established an upper payment limit pursuant to section 10-16-1407 is not subject to an enforcement action for a violation of subsection (1) or (2) of this section for that particular prescription drug.
Source: L. 2021: Entire part added, (SB 21-175), ch. 240, p. 1273, � 2, effective June 16.
10-16-1412. Notice of withdrawal of prescription drugs with upper payment limits required - rules - penalty. (1) Any manufacturer that intends to withdraw from sale or distribution within the state a prescription drug for which the board has established an upper payment limit pursuant to section 10-16-1407 shall provide a notice of withdrawal in writing at least one hundred eighty days before the withdrawal to:
(a) The commissioner;
(b) The attorney general; and
(c) Each entity in the state with which the manufacturer has contracted for the sale or distribution of the prescription drug.
(2) The board shall promulgate rules to notify consumers of the intent of any manufacturer to withdraw a prescription drug from sale or distribution within the state, as described in subsection (1) of this section.
(3) After providing notice and a hearing as described in section 24-4-105, the commissioner may require a manufacturer to pay a penalty not to exceed five hundred thousand dollars if the commissioner determines that the manufacturer failed to provide the notice required by subsection (1) of this section before withdrawing from sale or distribution within the state a prescription drug for which the board has established an upper payment limit pursuant to section 10-16-1407.
Source: L. 2021: Entire part added, (SB 21-175), ch. 240, p. 1274, � 2, effective June 16.
10-16-1413. Optional participating plans - notice of election to participate required. An optional participating plan that elects to subject its purchases of or payer reimbursements for prescription drugs in Colorado to the requirements of this part 14 shall notify the commissioner in writing within thirty days after such election.
Source: L. 2021: Entire part added, (SB 21-175), ch. 240, p. 1274, � 2, effective June 16.