Connecticut 2016 Regular Session

Connecticut Senate Bill SB00373 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1	1		General Assembly Raised Bill No. 373
2	2		February Session, 2016 LCO No. 2131
3		-	_____~~SB00373INS~~__~~_031716____~~
	3	+	02131_______INS
4	4		Referred to Committee on INSURANCE AND REAL ESTATE
5	5		Introduced by:
6	6		(INS)
7	7
8	8		General Assembly
9	9
10	10		Raised Bill No. 373
11	11
12	12		February Session, 2016
13	13
14	14		LCO No. 2131
15	15
16		-	_____~~SB00373INS~~__~~_031716____~~
	16	+	02131_______INS
17	17
18	18		Referred to Committee on INSURANCE AND REAL ESTATE
19	19
20	20		Introduced by:
21	21
22	22		(INS)
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24	24		AN ACT LIMITING CHANGES TO HEALTH INSURERS' PRESCRIPTION DRUG FORMULARIES.
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26	26		Be it enacted by the Senate and House of Representatives in General Assembly convened:
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28	28		Section 1. Section 38a-492f of the general statutes is repealed and the following is substituted in lieu thereof (Effective January 1, 2017):
29	29
30	30		Each individual health insurance policy providing coverage of the type specified in subdivisions (1), (2), (4), (11), [and] (12) and (16) of section 38a-469 delivered, issued for delivery, renewed, amended or continued in this state that provides coverage for outpatient prescription drugs shall not [deny coverage for an insured for any drug that the insurer removes from its list of covered drugs, or otherwise ceases to provide coverage for, if (1) the insured was using the drug for the treatment of a chronic illness prior to the removal or cessation of coverage, (2) the insured was covered under the policy for the drug prior to the removal or cessation of coverage, and (3) the insured's attending health care provider states in writing, after the removal or cessation of coverage, that the drug is medically necessary and lists the reasons why the drug is more medically beneficial than the drugs on the list of covered drugs. Such benefits shall be subject to the same terms and conditions applicable to all other benefits under such policies] remove any covered prescription drug from its list of covered drugs or reclassify or place such drug in a higher cost-sharing tier for the duration of the policy term, except a covered prescription drug may be removed from such list if such drug is identified as no longer safe and effective by the federal Food and Drug Administration or by peer-reviewed medical literature generally recognized by the relevant medical community. Nothing in this section shall be construed to prohibit the addition of prescription drugs to such policy's list of covered drugs during a policy term, provided such addition shall not affect the covered prescription drugs, or the classification or cost-sharing tier of such drugs, already on such list during such policy term.
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32	32		Sec. 2. Section 38a-518f of the general statutes is repealed and the following is substituted in lieu thereof (Effective January 1, 2017):
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34	34		Each group health insurance policy providing coverage of the type specified in subdivisions (1), (2), (4), (11), [and] (12) and (16) of section 38a-469 delivered, issued for delivery, renewed, amended or continued in this state that provides coverage for outpatient prescription drugs shall not [deny coverage for an insured for any drug that the insurer removes from its list of covered drugs, or otherwise ceases to provide coverage for, if (1) the insured was using the drug for the treatment of a chronic illness prior to the removal or cessation of coverage, (2) the insured was covered under the policy for the drug prior to the removal or cessation of coverage, and (3) the insured's attending health care provider states in writing, after the removal or cessation of coverage, that the drug is medically necessary and lists the reasons why the drug is more medically beneficial than the drugs on the list of covered drugs. Such benefits shall be subject to the same terms and conditions applicable to all other benefits under such policies] remove any covered prescription drug from its list of covered drugs or reclassify or place such drug in a higher cost-sharing tier for the duration of the policy term, except a covered prescription drug may be removed from such list if such drug is identified as no longer safe and effective by the federal Food and Drug Administration or by peer-reviewed medical literature generally recognized by the relevant medical community. Nothing in this section shall be construed to prohibit the addition of prescription drugs to such policy's list of covered drugs during a policy term, provided such addition shall not affect the covered prescription drugs, or the classification or cost-sharing tier of such drugs, already on such list during such policy term.
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36	36
37	37
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39	39		This act shall take effect as follows and shall amend the following sections:
40	40		Section 1 January 1, 2017 38a-492f
41	41		Sec. 2 January 1, 2017 38a-518f
42	42
43	43		This act shall take effect as follows and shall amend the following sections:
44	44
45	45		Section 1
46	46
47	47		January 1, 2017
48	48
49	49		38a-492f
50	50
51	51		Sec. 2
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53	53		January 1, 2017
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55	55		38a-518f
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	57	+	Statement of Purpose:
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	59	+	To limit when health insurance policies may change prescription drug formularies during a policy term.
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59		-	INS Joint Favorable
60		-
61		-	INS
62		-
63		-	Joint Favorable
	61	+	[Proposed deletions are enclosed in brackets. Proposed additions are indicated by underline, except that when the entire text of a bill or resolution or a section of a bill or resolution is new, it is not underlined.]