O F F I C E O F L E G I S L A T I V E R E S E A R C H
P U B L I C A C T S U M M A R Y
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PA 21-125—HB 6588
Insurance and Real Estate Committee
AN ACT CONCERNING PS YCHOTROPIC DRUGS AND MENTAL
HEALTH SERVICES
SUMMARY: This act prohibits certain health insurance policies that cover
outpatient prescription drugs from:
1. requiring a health care provider to prescribe a supply of outpatient
psychotropic drugs greater than that which he or she deems clinically
appropriate or
2. imposing a cost-sharing amount (i.e., coinsurance, copayment, deductible,
or out-of-pocket expense) for a less than 90-day supply of these drugs that
exceeds the 90-day, reduced pro-rata cost-sharing amount, provided the
prescriber deems a 90-day supply clinically inappropriate.
These provisions apply to individual or group health insurance policies
delivered, issued, renewed, amended, or continued in Connecticut on or after
January 1, 2022, that cover (1) basic hospital expenses; (2) basic medical-surgical
expenses; (3) major medical expenses; (4) hospital or medical services, including
those provided under an HMO plan; or (5) single service ancillary health
coverage, including vision, dental, or prescription drug coverage. Because of the
federal Employee Retirement Income Security Act (ERISA), certain state
insurance requirements do not apply to self-insured benefit plans.
The act also prohibits mental health care benefits provided under state law,
with state funds, or to state employees, from requiring a health care provider to
prescribe an outpatient psychotropic drug in a quantity greater than that which the
provider deems clinically appropriate.
Lastly, the act establishes a 10-member task force to study mental health
service provider networks.
EFFECTIVE DATE: January 1, 2022, except the task force provision is effective
upon passage.
MENTAL HEALTH SERVIC E PROVIDER NETWORK TASK FORCE
The act establishes a 10-member task force to study ways to encourage mental
health service providers to participate in provider networks. The task force must
report its findings and recommendations to the Insurance and Real Estate
Committee by January 1, 2022. It terminates on the date when it submits the
report or on January 1, 2022, whichever is later.
The task force consists of the insurance commissioner, or his designee, and
the following members:
1. one appointed by the House speaker, who represents the Connecticut
Health Insurance Exchange (i.e., “the exchange”); O L R P U B L I C A C T S U M M A R Y
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2. one appointed by the Senate president pro tempore;
3. one appointed by the House majority leader;
4. one appointed by the House minority leader;
5. one appointed by the Senate majority leader, who represents a carrier
offering or selling a qualified health plan through the exchange;
6. one appointed by the Senate minority leader, who has experience working
for a carrier offering or selling health insurance in the large group market;
7. the Office of Health Strategy’s executive director or her designee; and
8. two appointed by the governor, both of whom must be licensed healthcare
providers, one of whom must also have experience working within a
provider network.
Under the act, the legislatively-appointed members may be members of the
General Assembly. Appointing authorities must make their initial appointments
by August 6, 2021, and fill any vacancies.
The House speaker and the Senate president pro tempore pick the task force’s
chairpersons. The chairpersons must schedule the first meeting, which must be
held by September 5, 2021.
The act requires the Insurance and Real Estate Committee’s administrative
staff to serve as the task force’s staff.