House Bill No. 6588
Public Act No. 21-125
AN ACT CONCERNING PSYCHOTROPIC DRUGS AND MENTAL
HEALTH SERVICES.
Be it enacted by the Senate and House of Representatives in General
Assembly convened:
Section 1. (NEW) (Effective January 1, 2022) Notwithstanding any
provision of the general statutes, no individual health insurance policy
providing coverage of the type specified in subdivisions (1), (2), (4), (11),
(12) and (16) of section 38a-469 of the general statutes delivered, issued
for delivery, renewed, amended or continued in this state on or after
January 1, 2022, that provides coverage for outpatient prescription
drugs shall: (1) Require a prescribing health care provider to prescribe a
supply of a covered outpatient psychotropic drug that is larger than the
supply of such drug that such provider deems clinically appropriate; or
(2) if a prescribing health care provider deems a ninety-day supply of a
covered outpatient psychotropic drug to be clinically inappropriate and
prescribes less than a ninety-day supply of such drug, impose a
coinsurance, copayment, deductible or other out-of-pocket expense for
the prescribed supply of such drug in an amount that exceeds the
amount of the coinsurance, copayment, deductible or other out-of-
pocket expense for a ninety-day supply of such drug reduced pro rata
in proportion to such prescribed supply of such drug.
Sec. 2. (NEW) (Effective January 1, 2022) Notwithstanding any House Bill No. 6588
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provision of the general statutes, no group health insurance policy
providing coverage of the type specified in subdivisions (1), (2), (4), (11),
(12) and (16) of section 38a-469 of the general statutes delivered, issued
for delivery, renewed, amended or continued in this state on or after
January 1, 2022, that provides coverage for outpatient prescription
drugs shall: (1) Require a prescribing health care provider to prescribe a
supply of a covered outpatient psychotropic drug that is larger than the
supply of such drug that such provider deems clinically appropriate; or
(2) if a prescribing health care provider deems a ninety-day supply of a
covered outpatient psychotropic drug to be clinically inappropriate and
prescribes less than a ninety-day supply of such drug, impose a
coinsurance, copayment, deductible or other out-of-pocket expense for
the prescribed supply of such drug in an amount that exceeds the
amount of the coinsurance, copayment, deductible or other out-of-
pocket expense for a ninety-day supply of such drug reduced pro rata
in proportion to such prescribed supply of such drug.
Sec. 3. Section 38a-476b of the general statutes is repealed and the
following is substituted in lieu thereof (Effective January 1, 2022):
Notwithstanding any provision of the general statutes or the
regulations of Connecticut state agencies, no mental health care benefit
provided under state law, or with state funds or to state employees may,
through the use of a drug formulary, list of covered drugs or any other
means: (1) Limit the availability of psychotropic drugs that are the most
effective therapeutically indicated pharmaceutical treatment with the
least probability of adverse side effects; [or] (2) require utilization of
psychotropic drugs that are not the most effective therapeutically
indicated pharmaceutical treatment with the least probability of adverse
side effects; or (3) require a prescribing health care provider to prescribe
a supply of an outpatient psychotropic drug that is larger than the
supply of such drug that such provider deems clinically appropriate.
Nothing in this section shall be construed to limit the authority of a House Bill No. 6588
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physician to prescribe a drug that is not the most recent pharmaceutical
treatment. Nothing in this section shall be construed to prohibit
differential copays among pharmaceutical treatments or to prohibit
utilization review.
Sec. 4. (Effective from passage) (a) There is established a task force to
study methods available to this state, and health carriers doing business
in this state, to encourage health care providers providing mental health
services to participate in provider networks.
(b) The task force shall consist of the following members:
(1) One appointed by the speaker of the House of Representatives,
who is a representative of the Connecticut Health Insurance Exchange
established pursuant to section 38a-1081 of the general statutes;
(2) One appointed by the president pro tempore of the Senate;
(3) One appointed by the majority leader of the House of
Representatives;
(4) One appointed by the majority leader of the Senate, who is a
representative of a health carrier offering or selling a qualified health
plan through the Connecticut Health Insurance Exchange established
pursuant to section 38a-1081 of the general statutes;
(5) One appointed by the minority leader of the House of
Representatives;
(6) One appointed by the minority leader of the Senate, who has
experience working for a health carrier offering or selling health
insurance coverage in the large group market;
(7) The Insurance Commissioner, or the commissioner's designee;
(8) The executive director of the Office of Health Strategy, or the House Bill No. 6588
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executive director's designee; and
(9) Two appointed by the Governor, both of whom are licensed health
care providers and one of whom has experience working within a health
care provider network.
(c) Any member of the task force appointed under subdivision (1),
(2), (3), (4), (5) or (6) of subsection (b) of this section may be a member
of the General Assembly.
(d) All initial appointments to the task force shall be made not later
than thirty days after the effective date of this section. Any vacancy shall
be filled by the appointing authority.
(e) The speaker of the House of Representatives and the president pro
tempore of the Senate shall select the chairpersons of the task force from
among the members of the task force. Such chairpersons shall schedule
the first meeting of the task force, which shall be held not later than sixty
days after the effective date of this section.
(f) The administrative staff of the joint standing committee of the
General Assembly having cognizance of matters relating to insurance
shall serve as administrative staff of the task force.
(g) Not later than January 1, 2022, the task force shall submit a report
on its findings and recommendations to the joint standing committee of
the General Assembly having cognizance of matters relating to
insurance, in accordance with the provisions of section 11-4a of the
general statutes. The task force shall terminate on the date that it
submits such report or January 1, 2022, whichever is later.