Pharmacy benefit - mental health and substance use disorders - legislative declaration

(1) (a) The general assembly finds and declares that: (I) It is estimated that over one million Coloradans experience a mental health or substance use disorder each year, yet less than half of the adult population in this state receives the care it needs; (II) It is well documented that access to appropriate treatments, including medication, can lead to better outcomes for individuals dealing with these diagnoses; (III) For this reason, policies that restrict access to medications lead to poorer outcomes and increased health-care costs; (IV) Pharmacists also play an important role in improving access to treatments for serious mental illness and substance use disorders; and (V) The use of extended-release injectable medications for serious mental illness and substance use disorders has research-proven clinical benefits compared to oral medications, including medication adherence and significant delay and reduction in relapse, which decreases criminal recidivism and emergency room visits for patients from vulnerable populations, particularly those experiencing homelessness. (b) Therefore, the general assembly declares that access to these treatments through a pharmacy benefit under the medical assistance program will improve access to mental health providers by allowing pharmacists to dispense, administer, and be reimbursed for these important and effective medications. (2) A pharmacist or pharmacy that dispenses or administers extended-release injectable medications for the treatment of mental health or substance use disorders may seek reimbursement for those medications under the medical assistance program either as a pharmacy benefit or as a medical benefit.