10-16-1408. Colorado prescription drug affordability review board - judicial review.

Statute text

(1) The following board functions are not final agency actions subject to judicial review under the "State Administrative Procedure Act", article 4 of title 24:

(a) Identification of eligible prescription drugs pursuant to section 10-16-1406 (1);

(b) Selection of a prescription drug pursuant to section 10-16-1406 (2); and

(c) Determination that a prescription drug is unaffordable pursuant to section 10-16-1406 (3).

(2) A rule of the board establishing an upper payment limit is a final agency action subject to judicial review under the "State Administrative Procedure Act", article 4 of title 24. A party seeking judicial review of a rule establishing an upper payment limit may seek review of whether the prescription drug satisfies the necessary criteria in section 10-16-1406 to be eligible for an upper payment limit.

(3) Repealed.

(4) Notwithstanding any provision of law to the contrary:

(a) An individual may request an expedited review, as described in section 10-16-113.5, of access to a prescription drug that is unavailable to the individual because a manufacturer refuses to make the drug available as a result of an upper payment limit established for the prescription drug by the board; and

(b) A carrier may disregard the upper payment limit if the independent external review entity that performs the expedited review determines pursuant to such review that the prescription drug should be covered for and available to that individual.

History

Source: L. 2021: Entire part added, (SB 21-175), ch. 240, p. 1270, 2, effective June 16. L. 2023: (1) and (2) amended and (3) repealed, (HB 23-1225), ch. 162, p. 707, 6, effective August 7.