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General Assembly Raised Bill No. 7261
January Session, 2019
LCO No. 4615
Referred to Committee on INSURANCE AND REAL ESTATE
Introduced by:
(INS)
AN ACT PROHIBITING REQUIREMENTS FOR PRESCRIBING
CLINICALLY INAPPROPR IATE QUANTITIES OF OUTPATIENT
PSYCHOTROPIC DRUGS.
Be it enacted by the Senate and House of Representatives in General
Assembly convened:
Section 1. (NEW) (Effective January 1, 2020) Notwithstanding any 1
provision of the general statutes, no individual health insurance policy 2
providing coverage of the type specified in subdivisions (1), (2), (4), 3
(11), (12) and (16) of section 38a-469 of the general statutes delivered, 4
issued for delivery, renewed, amended or continued in this state on or 5
after January 1, 2020, that provides coverage for outpatient 6
prescription drugs shall require a prescribing health care provider to 7
prescribe an outpatient psychotropic drug in a quantity that such 8
provider deems clinically inappropriate. 9
Sec. 2. (NEW) (Effective January 1, 2020) Notwithstanding any 10
provision of the general statutes, no group health insurance policy 11
providing coverage of the type specified in subdivisions (1), (2), (4), 12
(11), (12) and (16) of section 38a-469 of the general statutes delivered, 13
issued for delivery, renewed, amended or continued in this state on or 14 Raised Bill No. 7261
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after January 1, 2020, that provides coverage for outpatient 15
prescription drugs shall require a prescribing health care provider to 16
prescribe an outpatient psychotropic drug in a quantity that such 17
provider deems clinically inappropriate. 18
Sec. 3. Section 38a-476b of the general statutes is repealed and the 19
following is substituted in lieu thereof (Effective January 1, 2020): 20
Notwithstanding any provision of the general statutes or the 21
regulations of Connecticut state agencies, no mental health care benefit 22
provided under state law, or with state funds or to state employees 23
may, through the use of a drug formulary, list of covered drugs or any 24
other means: (1) Limit the availability of psychotropic drugs that are 25
the most effective therapeutically indicated pharmaceutical treatment 26
with the least probability of adverse side effects; [or] (2) require 27
utilization of psychotropic drugs that are not the most effective 28
therapeutically indicated pharmaceutical treatment with the least 29
probability of adverse side effects; or (3) require a prescribing health 30
care provider to prescribe an outpatient psychotropic drug in a 31
quantity that such provider deems clinically inappropriate. Nothing in 32
this section shall be construed to limit the authority of a physician to 33
prescribe a drug that is not the most recent pharmaceutical treatment. 34
Nothing in this section shall be construed to prohibit differential 35
copays among pharmaceutical treatments or to prohibit utilization 36
review. 37
This act shall take effect as follows and shall amend the following
sections:
Section 1 January 1, 2020 New section
Sec. 2 January 1, 2020 New section
Sec. 3 January 1, 2020 38a-476b
Statement of Purpose:
To prohibit health insurance policies providing coverage for outpatient
prescription drugs, and mental health care benefits provided under
state law, with state funds or to state employees, from requiring a Raised Bill No. 7261
LCO No. 4615 3 of 3
prescribing health care provider to prescribe an outpatient
psychotropic drug in a quantity that such provider deems clinically
inappropriate.
[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.]