CO SB 167

enacted

Prescription Drug Out-of-Pocket Expense Credit

Colorado · 2026 Regular Session · upper

Description

Beginning on January 1, 2028, a health insurance carrier (carrier) of an individual or group health benefit plan in Colorado (plan) shall, when calculating a covered person's contribution to an out-of-pocket maximum or cost-sharing requirement under the plan, account for and credit to the covered person's contribution an out-of-pocket expense that the covered person incurs by purchasing a prescription drug directly from a pharmacy or direct-to-consumer platform (contribution credit). The carrier shall apply the contribution credit to the out-of-pocket maximum or cost-sharing requirement that is applicable in the plan year in which the out-of-pocket expense was incurred. To receive a contribution credit, a covered person must provide to the carrier proof of payment for a direct purchase of a prescription drug, such as an itemized receipt or pharmacy record, within 90 days after making the purchase (proof of payment). The carrier may request additional information or documentation if the proof of payment is insufficient or incomplete. The carrier shall not apply a contribution credit in the following circumstances:For an amount of a covered person's out-of-pocket expense incurred by the direct purchase of a prescription drug that is greater than the amount the covered person would have incurred if they had obtained the same prescription drug in the same plan year from an in-network pharmacy and pursuant to the terms of their plan;If the covered person does not provide proof of payment;If the covered person incurred the out-of-pocket expense by purchasing a prescription drug that is not covered under the formulary of the covered person's plan, unless the carrier grants an exception; orIf the covered person does not comply with the carrier's utilization management processes, including prior authorization and step therapy protocols required under the covered person's plan.(Note: This summary applies to this bill as enacted.)

Introduced: 2026-04-16
Status date: —
Latest action: 2026-06-03 — Governor Signed
Bill type: bill
Last updated: —

Subjects

Health Care & Health Insurance

Committees

Not provided by source.

Action timeline

2026-06-03
Governor Signed
executive-signature
2026-05-21
Sent to the Governor
executive-receipt
2026-05-21
Signed by the Speaker of the House
passage
2026-05-21
Signed by the President of the Senate
passage
2026-05-09
House Third Reading Passed - No Amendments
passage,reading-3
2026-05-08
House Second Reading Special Order - Passed - No Amendments
2026-05-08
House Committee on Health & Human Services Refer Unamended to House Committee of the Whole
committee-passage,referral-committee
2026-05-06
Introduced In House - Assigned to Health & Human Services
introduction
2026-05-06
Senate Third Reading Passed - No Amendments
passage,reading-3
2026-05-05
Senate Second Reading Special Order - Passed with Amendments - Committee
2026-05-05
Senate Committee on Appropriations Refer Unamended to Senate Committee of the Whole
committee-passage,referral-committee
2026-04-30
Senate Committee on Health & Human Services Refer Amended to Appropriations
referral-committee
2026-04-16
Introduced In Senate - Assigned to Health & Human Services
introduction

Versions

Introduced — 2026-04-16Compare
Engrossed — 2026-05-05Compare
Reengrossed — 2026-05-06Compare
Revised — 2026-05-08Compare
Rerevised — 2026-05-09Compare
Final Act — 2026-05-20Compare
Signed Act — 2026-06-04Compare
(document, no version)Compare

Documents

Votes

Refer Senate Bill 26-167, as amended, to the Committee on Appropriations.
2026-04-30 · pass · 0-0
Member-level votes (7)
- Scott Bright: yes
- Lisa Cutter: excused
- Lindsey Daugherty: yes
- Lisa Frizell: yes
- Mike Weissman: yes
- Iman Jodeh: yes
- Kyle Mullica: yes
Adopt amendment L.001 (Attachment B).
2026-04-30 · pass · 0-0
Refer Senate Bill 26-167 to the Committee of the Whole.
2026-05-05 · pass · 0-0
Member-level votes (7)
- Julie Gonzales: yes
- Barbara Kirkmeyer: no
- Chris Kolker: yes
- Larry Liston: yes
- Byron Pelton: no
- Jeff Bridges: yes
- Judy Amabile: yes
Refer Senate Bill 26-167 to the Committee of the Whole.
2026-05-08 · pass · 0-0
Member-level votes (13)
- Carlos Barron: no
- Mary Bradfield: no
- Brandi Bradley: no
- Regina English: yes
- Lori Goldstein: yes
- Eliza Hamrick: yes
- Dusty Johnson: no
- Karen McCormick: yes
- Gretchen Rydin: yes
- Katie Stewart: yes
- Dan Woog: no
- Sheila Lieder: yes
- Lindsay Gilchrist: yes
BILL
2026-05-09 · pass · 0-0
Member-level votes (65)
- Bacon: yes
- Barron: no
- Boesenecker: yes
- Bottoms: excused
- Bradfield: excused
- Bradley: no
- Brooks: no
- Brown: yes
- Caldwell: yes
- Camacho: yes
- Carter: yes
- Clifford: yes
- DeGraaf: no
- Duran: yes
- English: yes
- Espenoza: yes
- Feret: yes
- Flanell: no
- Froelich: yes
- Garcia: yes
- Garcia Sander: no
- Gilchrist: yes
- Goldstein: yes
- Gonzalez R.: yes
- Hamrick: yes
- Hartsook: no
- Jackson: yes
- Johnson: no
- Joseph: yes
- Keltie: no
- Lieder: yes
- Lindsay: yes
- Luck: no
- Lukens: yes
- Mabrey: yes
- Marshall: yes
- Martinez: yes
- Mauro: yes
- McCormick: yes
- Nguyen: yes
- Paschal: yes
- Phillips: yes
- Richardson: no
- Ricks: yes
- Rutinel: yes
- Rydin: yes
- Sirota: yes
- Slaugh: no
- Smith: yes
- Soper: yes
- Stewart K.: yes
- Stewart R.: yes
- Story: yes
- Suckla: no
- Taggart: yes
- Titone: yes
- Valdez: yes
- Velasco: yes
- Weinberg: no
- Willford: yes
- Winter T.: yes
- Woodrow: yes
- Woog: no
- Zokaie: yes
- McCluskie: yes

Related bills

No related bills recorded for this bill.

Official source

https://leg.colorado.gov/bills/SB26-167

Attribution

Data from openstates_bulk_csv, retrieved 2026-07-24T03:52:26.466301Z

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