Any Willing Provider Law – COLORADO

COLORADO SUMMARY OF EXISTING LAW

No “provider of pharmaceutical services” who meets the terms and conditions for participation established by the state department and contracting Medicaid health maintenance organizations shall be excluded from contracting for the provision of pharmaceutical services to Medicaid recipients. Note, however, that a PBM shall not be prohibited from contracting with exclusive pharmacy networks if, sixty days before the termination or effective date of an exclusive pharmacy network contract, notice of such termination of or the effective date of an exclcusive pharmacy network contract is published in one or more newspapers of general circulation in the affected contract service area.

Link to Existing Law: C.R.S.A. § 25.5-5-504; C.R.S.A. 10-16-22(3)

PRACTICAL NOTE FOR EXSISTING LAW

This is a broad statute that does benefit pharmacies and physician dispensers in the context of Colorado Medicaid plans only, but is limited by the ability to create exclusive pharmacy networks.