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SB 25-301

Remove Authorization Requirement Adjust Chronic Prescription

2025 Regular Session Introduced by Judy Amabile and 52 co-sponsors

Allows prescribing providers to adjust dose or dosing frequency of a chronic maintenance drug without prior authorization for up to two changes, if evidence-based and non-opioid.

Governor Signed
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Bill Summary · SB 25-301

SB 25-301 — Remove Authorization Requirement; Adjust Chronic Prescription

Status: Governor signed (May 29, 2025)
Introduced: April 21, 2025

Purpose

To allow prescribing health‑care providers to adjust the dose or frequency of an insured person’s chronic maintenance prescription medication to meet the patient’s clinical needs without first obtaining (or triggering subsequent) prior authorization or utilization‑management review from the insurer or pharmacy benefit manager (PBM), subject to specified limits and safeguards.

Key provisions

  • Adds subsection (6.2) to Colorado Rev. Stat. § 10‑16‑124.5.
  • Permits a prescribing provider to change dose or dosing frequency for a covered person’s prescription drug without prior authorization or subsequent utilization management when all of the following apply:
    • The change is consistent with available evidence‑based guidelines.
    • The drug is a “chronic maintenance drug” as defined at § 12‑280‑103(9.5) and was previously approved for coverage by the carrier or PBM for the patient’s chronic or debilitating disease, and the provider continues to prescribe it for the same condition.
    • The drug is not an opioid and is not a scheduled controlled substance.
    • The dose or frequency has not already been adjusted more than two times without prior authorization (i.e., the provider may make up to two such adjustments without prior authorization).
  • Cross‑references:
    • “Utilization management” meaning is as provided in § 10‑16‑1002(10).
    • “Chronic maintenance drug” is defined in § 12‑280‑103(9.5).

Who is affected

  • Patients covered by health plans subject to Colorado insurance law and PBM contracts governed by § 10‑16‑124.5.
  • Prescribing providers (physicians, advanced practice clinicians) who manage chronic medication regimens.
  • Insurers and PBMs, which must permit limited provider‑initiated adjustments without prior authorization and track the number of such adjustments.
  • Pharmacies and dispensing staff may experience procedural changes when fulfilling adjusted prescriptions.

Practical effect and limits

  • Aims to reduce treatment delays caused by prior authorization for minor, clinically appropriate dose/frequency changes for chronic drugs.
  • Does not apply to opioids or scheduled controlled substances.
  • Limits potential bypassing of utilization review to two adjustments per drug without authorization; subsequent changes require prior authorization.
  • Requires consistency with evidence‑based guidelines, implying clinical justification and documentation are expected.

Effective date and referendum

  • Effective at 12:01 a.m. the day after the 90‑day period following final adjournment of the General Assembly, unless a referendum petition is filed under Colo. Const. art. V, §1(3). If a referendum is timely filed, the act (or affected parts) will not take effect unless approved by voters at the November 2026 general election and then takes effect on the date the governor officially declares the vote.

Legislative history highlights

  • Introduced in the Senate April 21, 2025; passed both chambers with amendments; sent to the Governor May 12, 2025; Governor signed May 29, 2025.

Compiled from official sources — confirm details with the bill’s official record.

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