SB 25-124: Reducing Costs of Health Care for Patients - Colorado

Revised (05/05/2025) → PA1 (03/20/2025) · 4 edits

MODERATE

The bill was amended to clarify that 340B profits must be used to reduce out-of-pocket costs for low-income patients, rather than just decreasing overall costs. The definition of eligible entities was expanded to include Federally Qualified Health Centers and Ryan White Clinics in reporting requirements, while non-profit hospitals are now explicitly exempt from this requirement. The reporting threshold for hospitals was increased from 80% to 35% of total annual compensation or expense reimbursement for board members, and the reporting deadline was set to begin July 1, 2026.

Scope change

The bill's scope was narrowed by clarifying that the primary focus is on reducing out-of-pocket costs for low-income patients, and the reporting requirement now specifically applies to Federally Qualified Health Centers and Ryan White Clinics rather than all 340B covered entities.

DEFINITION

Added a new legislative declaration stating that 340B profits should be used to decrease out-of-pocket costs for low-income patients, replacing the previous language about decreasing out-of-pocket costs generally.

ELIGIBILITY

Expanded the reporting requirement to include Federally Qualified Health Centers, Ryan White Clinics, State AIDS Drug Assistance Programs, and Children's Hospitals, while explicitly stating that non-profit hospitals are not similarly required.

REQUIREMENT

Changed the prohibited use of 340B profits from requiring hospitals to spend at least 80% on direct patient services to prohibiting more than 35% of total annual compensation or expense reimbursement for the board of directors.

TIMELINE

Established a specific reporting deadline beginning July 1, 2026, with annual submissions due by July 1 each year thereafter.

Rerevised (05/06/2025) → Revised (05/05/2025) · 4 edits

MODERATE

The bill was revised to update its version status from 'Rerevised' to 'Revised' and changed the House sponsorship list, removing several sponsors while adding 'Brown and Garcia Sander.' Substantively, new requirements were added mandating that nonprofit reporting hospitals spend at least 80% of their 340B net revenue on direct patient services or capital improvements that maintain or increase access for low-income populations.

Scope change

The bill's scope was expanded to include specific financial spending requirements for nonprofit hospitals classified as reporting hospitals under existing state law.

REQUIREMENT

New requirement added mandating nonprofit reporting hospitals spend at least 80% of 340B net revenue on direct patient services or capital improvements that maintain or increase access for low-income populations.

DEFINITION

New subsection added to define what constitutes direct patient services for purposes of the spending requirement.

ELIGIBILITY

House sponsorship list was modified by removing multiple sponsors (Bird, Clifford, Duran, Garcia, Gilchrist, Martinez, Mauro, McCluskie, McCormick, Ricks) and adding 'Brown and Garcia Sander'.

TECHNICAL

Version status text was changed from 'REREVISED' to 'REVISED' and the description of amendments adopted was updated from 'Adopted in the Second House' to 'Adopted on Second Reading in the Second House'.

PA2 (05/03/2025) → Rerevised (05/06/2025) · 3 edits

MINOR

This bill revision reorganizes and clarifies the definitions and restrictions on how nonprofit hospitals can use net revenue from the federal 340B drug pricing program. The changes primarily involve renumbering and restructuring the definitions section to better organize terms like '340B Net Revenue' and 'Nonprofit Hospital,' while also expanding the list of excluded facilities. The restrictions on how hospitals can spend this revenue remain largely the same, prohibiting use for executive compensation, lobbying, or marketing.

Scope change

The definition of 'Nonprofit Hospital' was expanded to explicitly exclude sole community hospitals, critical access hospitals, independent nonprofit hospitals with fewer than 50 beds, and specific Colorado facilities like Denver Health and Children's Hospitals in Colorado.

DEFINITION

Restructured the definitions section to renumber items and add new definitions for '340B Net Revenue' and 'Contract Pharmacy' to clarify how the program works.

ELIGIBILITY

Expanded the list of facilities excluded from the 'Nonprofit Hospital' definition to include sole community hospitals, critical access hospitals, small independent nonprofits, and specific Colorado health centers.

TECHNICAL

Added new sponsors to the House sponsorship list and updated the bill status to reflect amendments adopted in the Second House.

Reengrossed (03/26/2025) → PA2 (05/03/2025) · 4 edits

MODERATE

The bill was renumbered from Senate Bill 25-124 to LLS No. 25-0153.01 and changed from a 'Reengrossed' version to a 'Preamended' version, indicating it is in an earlier legislative stage with committee amendments not yet adopted. The core policy content regarding 340B drug revenue restrictions for nonprofit hospitals was substantially reorganized and renumbered, with definitions and prohibited uses of funds being restructured but not fundamentally altered in substance.

Scope change

The bill's scope remains focused on regulating how nonprofit hospitals in Colorado can use profits from the 340B drug pricing program, with no change to the overall applicability or target audience.

TECHNICAL

Bill was renumbered from Senate Bill 25-124 to LLS No. 25-0153.01 and changed from 'Reengrossed' to 'Preamended' status, indicating it is in an earlier legislative stage.

DEFINITION

The definitions section was reorganized and renumbered, with '340B Drug' and '340B Net Revenue' being newly defined terms replacing the previous '340B Profits' terminology.

REQUIREMENT

The section prohibiting use of 340B funds was renumbered from 25.5-2.5-304 to 25.5-2.5-303 and restructured, though the prohibited uses (compensation, lobbying, advertising, etc.) remain substantially the same.

The spending requirement for nonprofit hospitals was changed from a 35% limit on executive compensation to an 80% minimum spending requirement on direct patient services or capital improvements for low-income populations.

Engrossed (03/25/2025) → Reengrossed (03/26/2025) · 3 edits · Mar 26, 2025

MINOR

The bill was reengrossed to incorporate amendments adopted in the House of Introduction, updating the official version to reflect all changes made during the legislative process. The bill summary now indicates this is the 3rd Reading Unamended version as of March 26, 2025, and a new summary for the reengrossed version will be available online.

Scope change

The bill's scope remains unchanged; this is a procedural update to reflect legislative amendments and formatting changes.

TECHNICAL

Header text changed from 'ENGROSSED' to 'REENGROSSED' to indicate this version includes all amendments adopted in the House of Introduction.

Bill summary note updated to clarify that the current summary applies to the bill as introduced and that a new summary for the reengrossed version will be posted online.

Removed section 25.5-2.5-305 regarding hospital transparency reporting requirements, which appears to have been deleted or superseded in the amendment process.

Introduced (02/04/2025) → Engrossed (03/25/2025) · 3 edits · Mar 26, 2025

MINOR

The bill was amended to add a legislative declaration explaining the intent to ensure 340B program profits benefit low-income patients and communities. The core definitions and reporting requirements remain largely unchanged, though the legislative declaration was inserted to clarify the General Assembly's findings and responsibilities regarding nonprofit hospital oversight.

Scope change

The scope of applicability remains the same, but the legislative declaration adds context about the state's interest in monitoring nonprofit hospitals and ensuring parity in 340B profit use.

REQUIREMENT

Added a legislative declaration (Section 302) stating that nonprofit hospitals must use 340B profits to decrease out-of-pocket costs for low-income patients, and that the state has a responsibility to monitor these hospitals to ensure they serve their communities and taxpayer interests.

DEFINITION

Reorganized the definitions section by moving the legislative declaration to a new section (302) and renumbering the definitions to Section 303, while keeping the actual definitions of terms like '340B drug' and 'nonprofit hospital' consistent.

TECHNICAL

Added formatting and markup indicating that this version includes all amendments adopted on second reading in the House of Introduction, dated March 25, 2025.

Reducing Costs of Health Care for Patients

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