The latest legislative prescription to curb high health care costs comes with a side effect of supporting small pharmacies that are critical to small towns in Colorado.

House Bill 1078 applies rules to how and when pharmacy benefit managers can charge fees to drugstores, which can land as a former of surprise billing months after a prescription is filled, adding up to tens of thousands of dollars each year, said Rep. Sonya Jaquez Lewis, D-Longmont, who is a pharmacist and one of the two Democratic sponsors of the bill.

“These fees put many pharmacies at risk of going out of business,” she said on the House floor Wednesday.

The other House sponsor, Rep. Kyle Mullica of Northglenn, is an emergency room nurse.

“This is a bill that brings consistency to our pharmacies,” he said.

Rep. Mark Baisley, a Republican from Roxborough Park, urged passage of the bill, as well.

“Smaller pharmacies are going to be able to be more predictive with their accounting and cash flow,” he said. “I think this is an issue that’s been plaguing that industry for a long time.”

The bill had no opposition on the House floor Wednesday. The measure must still pass a roll call vote in the House before it advances to the Senate.

 The bill passed unanimously out of the House Health and Insurance Committee last week.

 Jaquez Lewis said such fees are among the reasons health care costs are skyrocketing in the U.S.

Pharmacy benefit managers are basically businesses that process insurance claims on prescriptions. Colorado proposed legislation would crack down on unexpected retroactive fees charged online to pharmacies without much transparency, Jaquez Leis said in committee.

“The PBMs just take it,” she said. 

Patrick Boyle of the Pharmaceutical Care Management Association said the industry had worked on compromises with the bill’s sponsors, though he still testified in opposition to it.

“Our interest is in preserving the model of performance-based contracts, because it rewards pharmacies for cost control, and we think those are values that need preserving in the health care system,” he told the committee.

Emily Zadvorny, a pharmacist and executive director of the Colorado Pharmacists Society, said the issue is critical, as well.

“Retroactive fees are definitely are one largest threats to a pharmacy practice in Colorado,” she told the lawmakers. “But, really, the true issue here is for us to be able to continue to provide care to the communities we serve in our state.”

On Wednesday, the House also gave preliminary approval to House Bill 1050 to allow smaller pharmacies to resell unused drugs or share orders to control costs and reduce waste.

“It’s a good, common-sense way to get some of the red tape out of the way, and it will save money for both the  businesses and consumers,” said Rep. Colin Larson, a Republican from Littleton, who is one of its sponsors.

Both bills are scheduled for final passage in the House Thursday before advancing to the Senate to start over.