LCO 4615 \\PRDFS1\HCOUSERS\BARRYJN\WS\2019HB-07261-R01- HB.docx 1 of 2 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 PRES CRIBING 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 LCO 4615 {\\PRDFS1\HCOUSERS\BARRYJN\WS\2019HB-07261- R01-HB.docx } 2 of 2 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 Section 38a-476b of the general statutes is repealed and the 19 following is substituted in lieu thereof (Effective January 1, 2020): 20 Notwithstanding any provision of the general statutes or the 21 regulations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 INS Joint Favorable