Public Policy Priorities
SUBSTANCE USE DISORDER TREATMENT AND PREVENTION
Overview: Curbing an epidemic
A priority of Colorado’s General Assembly this session is addressing the opioid crisis. The 2017 Interim Study Committee on Opioids and Other Substance Abuse Disorders drafted several pieces of legislation aimed at addressing the cause, prevention, and treatment of substance use disorders.
The committee consulted physicians from across Colorado as well as data from other state-implemented programs and legislation in the U.S.
Four bills drafted by the Interim Committee are currently before the General Assembly this session.
Issue #1 Opioids
SB18-022 Clinical Practice for Opioid Prescribing
This bill would apply only to acute conditions and only to patients who have not been prescribed an opioid by this prescriber in the last 12 months.
In these cases, the initial prescription would be limited to seven days with the option to allow for one seven-day second fill. This limit would apply to the prescribing practices of physicians, physician assistants, podiatrists, dentists, advance practice nurses, optometrists and veterinarians.
The bill allows for certain exceptions to this mandate, to be determined at the prescriber’s discretion, that relate to chronic pain.
This bill also would mandate that the prescriber check the PDMP on the second fill for a patient.
The bill would provide liability protections for a prescriber in that any failure to follow these mandates would not constitute negligence per se.
HB18-1003 Opioid Misuse Prevention
This bill is aimed at maintaining the momentum of the Interim Study Committee by creating a committee to evaluate current date, statistics, policy, education, and other relevant information related to the opioid crisis.
HB18-1007 Substance Use Disorder Payment and Coverage
This bill prohibits insurance plans from penalizing physicians for having poor pain scores and prohibit the requirement that a covered person or Medicaid recipient undergo step therapy. Certain medications would be required to be covered and pharmacists would be authorized to inject naltrexone.
HB18-1136 Substance Use Disorder Treatment
This bill would add substance use disorder services to the Colorado medical assistance program. If this goes into effect and Colorado receives the necessary federal approval, money would be allocated from the marijuana tax cash fund to assist individuals not otherwise covered by insurance.
Issue #2 Malpractice Caps
Colorado’s current statutory protections help to rein in costs and minimize access difficulties. Litigation fails to achieve patient safety goals and, without malpractice caps, physicians would be unable to practice in Colorado, limiting patient choice and access.
Issue #3 Professional Review
Professional Review is essential to physician practice. It is a priority to maintain all of the protections and immunities associated with professional review in order to maintain standards of care in all health care fields.
Professional Review and the Medical Practice Act are undergoing sunset reviews in 2019.
Issue #4 Out-Of-Network
A bill regarding this issue would ensure that insurance carriers cover emergency services rendered by out-of-network providers and that those providers and facilities that are out of network disclose specific information in regards to patient cost and the status of a provider as out of network.
Issue #5 Scope of Practice
Scope of practice issues in 2018 revolve around avoiding expansion of practice for Physical Therapists (undergoing sunset review) and Naturopathic Doctors. There is also a bill to implement appropriate licensure of Genetic Counselors.