Connecticut Senate Bill SB00036

Connecticut 2019 Regular Session

• Introduced: 1/15/19
• Refer: 1/15/19
• Refer: 3/8/19

Caption

An Act Prohibiting Health Carriers From Requiring The Use Of Step Therapy For Drugs Prescribed To Treat Disabling, Chronic Or Life-threatening Diseases Or Conditions.

Impact

If enacted, SB00036 will amend existing statutes related to health insurance policies and change how step therapy is implemented. The bill specifically prevents insurers from imposing step therapy for longer durations than sixty days for patients requiring urgent care, and it outlines provisions for circumstances where an insured's medical provider deems such a regimen clinically ineffective. This could significantly alter the current practices of insurance companies and their protocols for medication management, ensuring that patients receive appropriate treatments without unnecessary delays.

Summary

Senate Bill 00036 aims to prohibit health carriers from requiring step therapy protocols for drugs prescribed to treat disabling, chronic, or life-threatening diseases or conditions. Step therapy is a managed care technique used by health insurers to require patients to try one or more medications before covering the prescribed medication. The rationale behind this bill is to ensure that patients have timely access to the medications that their healthcare providers deem necessary, especially when dealing with serious health issues.

Sentiment

The discussion surrounding SB00036 has shown a generally supportive sentiment among patient advocacy groups and healthcare providers, who argue that step therapy can hinder patient access to necessary treatments. They highlight the importance of allowing doctors to make treatment decisions based on individual patient needs rather than insurer policies. However, some insurance companies have expressed concerns that the bill may lead to increased costs and undermine their ability to manage medication expenses effectively.

Contention

A notable point of contention in the debate revolves around the implications for cost management within health insurance. Opponents of the bill argue that step therapy can be a valuable tool in managing pharmaceutical costs while ensuring patient safety. They are concerned that restricting step therapy could lead to higher overall drug costs and insurance premiums. Advocates for the bill, however, emphasize patient rights and access to necessary medications as paramount, stating that the potential for improved health outcomes justifies the changes proposed in SB00036.