Connecticut House Bill HB05517

Connecticut 2016 Regular Session

• Introduced: 3/2/16
• Refer: 3/2/16

Caption

An Act Concerning Cost-sharing For Prescription Drugs.

Impact

If passed, HB 05517 will significantly amend existing laws affecting health insurance policies related to prescription drugs. It seeks to restrict practices that could lead to increased costs for patients, such as requiring the use of mail order pharmacies or placing all drugs within a certain class into the highest cost-sharing tier. Furthermore, the bill stipulates that health insurance providers must provide a clear process for obtaining overrides for step therapy protocols that may not be effective for certain patients after a specified duration.

Summary

House Bill 05517, titled 'An Act Concerning Cost-sharing For Prescription Drugs,' aims to regulate the cost-sharing practices of health insurance providers regarding prescription medications. The bill specifies that insurance entities must not impose excessive out-of-pocket expenses for covered prescription drugs, restricting such costs to a maximum of one hundred dollars per thirty-day supply. This regulation is intended to alleviate the financial burden on insured individuals when accessing necessary medications.

Contention

The bill has generated discussions regarding the appropriateness of imposing limits on cost-sharing activities of health insurers. Supporters advocate that this legislation is critical for enhancing the affordability of healthcare, particularly for individuals who rely on ongoing prescriptions. Conversely, some industry stakeholders may contest the measure, arguing that it could disrupt the existing pricing structures and lead to unintended consequences for healthcare pricing and availability. These differing viewpoints underscore the bill's potential impact on both patient accessibility to medication and the operational framework of health insurance providers.