Connecticut 2021 Regular Session

Connecticut House Bill HB06588 Compare Versions

Version 1 (Old)

Version 2 (New)

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	7	+	General Assembly Raised Bill No. 6588
	8	+	January Session, 2021
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	11	+
	12	+	Referred to Committee on INSURANCE AND REAL ESTATE
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	14	+
	15	+	Introduced by:
	16	+	(INS)
1	17
2	18
3	19
4		-	House Bill No. 6588
5		-
6		-	Public Act No. 21-125
7		-
8		-
9		-	AN ACT CONCERNING PSYCHOTROPIC DRUGS AND MENTAL
10		-	HEALTH SERVICES.
	20	+	AN ACT CONCERNING ME NTAL HEALTH CARE AND SUBSTANCE
	21	+	ABUSE SERVICES.
11	22		Be it enacted by the Senate and House of Representatives in General
12	23		Assembly convened:
13	24
14		-	Section 1. (NEW) (Effective January 1, 2022) Notwithstanding any
15		-	provision of the general statutes, no individual health insurance policy
16		-	providing coverage of the type specified in subdivisions (1), (2), (4), (11),
17		-	(12) and (16) of section 38a-469 of the general statutes delivered, issued
18		-	for delivery, renewed, amended or continued in this state on or after
19		-	January 1, 2022, that provides coverage for outpatient prescription
20		-	drugs shall: (1) Require a prescribing health care provider to prescribe a
21		-	supply of a covered outpatient psychotropic drug that is larger than the
22		-	supply of such drug that such provider deems clinically appropriate; or
23		-	(2) if a prescribing health care provider deems a ninety-day supply of a
24		-	covered outpatient psychotropic drug to be clinically inappropriate and
25		-	prescribes less than a ninety-day supply of such drug, impose a
26		-	coinsurance, copayment, deductible or other out-of-pocket expense for
27		-	the prescribed supply of such drug in an amount that exceeds the
28		-	amount of the coinsurance, copayment, deductible or other out-of-
29		-	pocket expense for a ninety-day supply of such drug reduced pro rata
30		-	in proportion to such prescribed supply of such drug.
31		-	Sec. 2. (NEW) (Effective January 1, 2022) Notwithstanding any House Bill No. 6588
	25	+	Section 1. (NEW) (Effective January 1, 2022) Notwithstanding any 1
	26	+	provision of the general statutes, no individual health insurance policy 2
	27	+	providing coverage of the type specified in subdivisions (1), (2), (4), (11), 3
	28	+	(12) and (16) of section 38a-469 of the general statutes delivered, issued 4
	29	+	for delivery, renewed, amended or continued in this state on or after 5
	30	+	January 1, 2022, that provides coverage for outpatient prescription 6
	31	+	drugs shall: (1) Require a prescribing health care provider to prescribe a 7
	32	+	supply of a covered outpatient psychotropic drug that is larger than the 8
	33	+	supply of such drug that such provider deems clinically appropriate; or 9
	34	+	(2) if a prescribing health care provider deems a ninety-day supply of a 10
	35	+	covered outpatient psychotropic drug to be clinically inappropriate and 11
	36	+	prescribes less than a ninety-day supply of such drug, impose a 12
	37	+	coinsurance, copayment, deductible or other out-of-pocket expense for 13
	38	+	the prescribed supply of such drug in an amount that exceeds the 14
	39	+	amount of the coinsurance, copayment, deductible or other out-of-15 Raised Bill No. 6588
32	40
33		-	Public Act No. 21-125 2 of 4
34	41
35		-	provision of the general statutes, no group health insurance policy
36		-	providing coverage of the type specified in subdivisions (1), (2), (4), (11),
37		-	(12) and (16) of section 38a-469 of the general statutes delivered, issued
38		-	for delivery, renewed, amended or continued in this state on or after
39		-	January 1, 2022, that provides coverage for outpatient prescription
40		-	drugs shall: (1) Require a prescribing health care provider to prescribe a
41		-	supply of a covered outpatient psychotropic drug that is larger than the
42		-	supply of such drug that such provider deems clinically appropriate; or
43		-	(2) if a prescribing health care provider deems a ninety-day supply of a
44		-	covered outpatient psychotropic drug to be clinically inappropriate and
45		-	prescribes less than a ninety-day supply of such drug, impose a
46		-	coinsurance, copayment, deductible or other out-of-pocket expense for
47		-	the prescribed supply of such drug in an amount that exceeds the
48		-	amount of the coinsurance, copayment, deductible or other out-of-
49		-	pocket expense for a ninety-day supply of such drug reduced pro rata
50		-	in proportion to such prescribed supply of such drug.
51		-	Sec. 3. Section 38a-476b of the general statutes is repealed and the
52		-	following is substituted in lieu thereof (Effective January 1, 2022):
53		-	Notwithstanding any provision of the general statutes or the
54		-	regulations of Connecticut state agencies, no mental health care benefit
55		-	provided under state law, or with state funds or to state employees may,
56		-	through the use of a drug formulary, list of covered drugs or any other
57		-	means: (1) Limit the availability of psychotropic drugs that are the most
58		-	effective therapeutically indicated pharmaceutical treatment with the
59		-	least probability of adverse side effects; [or] (2) require utilization of
60		-	psychotropic drugs that are not the most effective therapeutically
61		-	indicated pharmaceutical treatment with the least probability of adverse
62		-	side effects; or (3) require a prescribing health care provider to prescribe
63		-	a supply of an outpatient psychotropic drug that is larger than the
64		-	supply of such drug that such provider deems clinically appropriate.
65		-	Nothing in this section shall be construed to limit the authority of a House Bill No. 6588
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67		-	Public Act No. 21-125 3 of 4
	46	+	pocket expense for a ninety-day supply of such drug reduced pro rata 16
	47	+	in proportion to such prescribed supply of such drug. 17
	48	+	Sec. 2. (NEW) (Effective January 1, 2022) Notwithstanding any 18
	49	+	provision of the general statutes, no group health insurance policy 19
	50	+	providing coverage of the type specified in subdivisions (1), (2), (4), (11), 20
	51	+	(12) and (16) of section 38a-469 of the general statutes delivered, issued 21
	52	+	for delivery, renewed, amended or continued in this state on or after 22
	53	+	January 1, 2022, that provides coverage for outpatient prescription 23
	54	+	drugs shall: (1) Require a prescribing health care provider to prescribe a 24
	55	+	supply of a covered outpatient psychotropic drug that is larger than the 25
	56	+	supply of such drug that such provider deems clinically appropriate; or 26
	57	+	(2) if a prescribing health care provider deems a ninety-day supply of a 27
	58	+	covered outpatient psychotropic drug to be clinically inappropriate and 28
	59	+	prescribes less than a ninety-day supply of such drug, impose a 29
	60	+	coinsurance, copayment, deductible or other out-of-pocket expense for 30
	61	+	the prescribed supply of such drug in an amount that exceeds the 31
	62	+	amount of the coinsurance, copayment, deductible or other out-of-32
	63	+	pocket expense for a ninety-day supply of such drug reduced pro rata 33
	64	+	in proportion to such prescribed supply of such drug. 34
	65	+	Sec. 3. Section 38a-476b of the general statutes is repealed and the 35
	66	+	following is substituted in lieu thereof (Effective January 1, 2022): 36
	67	+	Notwithstanding any provision of the general statutes or the 37
	68	+	regulations of Connecticut state agencies, no mental health care benefit 38
	69	+	provided under state law, or with state funds or to state employees may, 39
	70	+	through the use of a drug formulary, list of covered drugs or any other 40
	71	+	means: (1) Limit the availability of psychotropic drugs that are the most 41
	72	+	effective therapeutically indicated pharmaceutical treatment with the 42
	73	+	least probability of adverse side effects; [or] (2) require utilization of 43
	74	+	psychotropic drugs that are not the most effective therapeutically 44
	75	+	indicated pharmaceutical treatment with the least probability of adverse 45
	76	+	side effects; or (3) require a prescribing health care provider to prescribe 46
	77	+	a supply of an outpatient psychotropic drug that is larger than the 47
	78	+	supply of such drug that such provider deems clinically appropriate. 48 Raised Bill No. 6588
68	79
69		-	physician to prescribe a drug that is not the most recent pharmaceutical
70		-	treatment. Nothing in this section shall be construed to prohibit
71		-	differential copays among pharmaceutical treatments or to prohibit
72		-	utilization review.
73		-	Sec. 4. (Effective from passage) (a) There is established a task force to
74		-	study methods available to this state, and health carriers doing business
75		-	in this state, to encourage health care providers providing mental health
76		-	services to participate in provider networks.
77		-	(b) The task force shall consist of the following members:
78		-	(1) One appointed by the speaker of the House of Representatives,
79		-	who is a representative of the Connecticut Health Insurance Exchange
80		-	established pursuant to section 38a-1081 of the general statutes;
81		-	(2) One appointed by the president pro tempore of the Senate;
82		-	(3) One appointed by the majority leader of the House of
83		-	Representatives;
84		-	(4) One appointed by the majority leader of the Senate, who is a
85		-	representative of a health carrier offering or selling a qualified health
86		-	plan through the Connecticut Health Insurance Exchange established
87		-	pursuant to section 38a-1081 of the general statutes;
88		-	(5) One appointed by the minority leader of the House of
89		-	Representatives;
90		-	(6) One appointed by the minority leader of the Senate, who has
91		-	experience working for a health carrier offering or selling health
92		-	insurance coverage in the large group market;
93		-	(7) The Insurance Commissioner, or the commissioner's designee;
94		-	(8) The executive director of the Office of Health Strategy, or the House Bill No. 6588
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96		-	Public Act No. 21-125 4 of 4
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98		-	executive director's designee; and
99		-	(9) Two appointed by the Governor, both of whom are licensed health
100		-	care providers and one of whom has experience working within a health
101		-	care provider network.
102		-	(c) Any member of the task force appointed under subdivision (1),
103		-	(2), (3), (4), (5) or (6) of subsection (b) of this section may be a member
104		-	of the General Assembly.
105		-	(d) All initial appointments to the task force shall be made not later
106		-	than thirty days after the effective date of this section. Any vacancy shall
107		-	be filled by the appointing authority.
108		-	(e) The speaker of the House of Representatives and the president pro
109		-	tempore of the Senate shall select the chairpersons of the task force from
110		-	among the members of the task force. Such chairpersons shall schedule
111		-	the first meeting of the task force, which shall be held not later than sixty
112		-	days after the effective date of this section.
113		-	(f) The administrative staff of the joint standing committee of the
114		-	General Assembly having cognizance of matters relating to insurance
115		-	shall serve as administrative staff of the task force.
116		-	(g) Not later than January 1, 2022, the task force shall submit a report
117		-	on its findings and recommendations to the joint standing committee of
118		-	the General Assembly having cognizance of matters relating to
119		-	insurance, in accordance with the provisions of section 11-4a of the
120		-	general statutes. The task force shall terminate on the date that it
121		-	submits such report or January 1, 2022, whichever is later.
	85	+	Nothing in this section shall be construed to limit the authority of a 49
	86	+	physician to prescribe a drug that is not the most recent pharmaceutical 50
	87	+	treatment. Nothing in this section shall be construed to prohibit 51
	88	+	differential copays among pharmaceutical treatments or to prohibit 52
	89	+	utilization review. 53
	90	+	Sec. 4. (Effective from passage) (a) There is established a task force to 54
	91	+	study methods available to this state, and health carriers doing business 55
	92	+	in this state, to encourage health care providers providing mental health 56
	93	+	services to participate in provider networks. 57
	94	+	(b) The task force shall consist of the following members: 58
	95	+	(1) Two appointed by the speaker of the House of Representatives; 59
	96	+	(2) Two appointed by the president pro tempore of the Senate; 60
	97	+	(3) One appointed by the majority leader of the House of 61
	98	+	Representatives; 62
	99	+	(4) One appointed by the majority leader of the Senate; 63
	100	+	(5) One appointed by the minority leader of the House of 64
	101	+	Representatives; 65
	102	+	(6) One appointed by the minority leader of the Senate; 66
	103	+	(7) The Insurance Commissioner, or the commissioner's designee; 67
	104	+	and 68
	105	+	(8) Two appointed by the Governor. 69
	106	+	(c) Any member of the task force appointed under subdivision (1), 70
	107	+	(2), (3), (4), (5) or (6) of subsection (b) of this section may be a member 71
	108	+	of the General Assembly. 72
	109	+	(d) All initial appointments to the task force shall be made not later 73
	110	+	than thirty days after the effective date of this section. Any vacancy shall 74 Raised Bill No. 6588
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	117	+	be filled by the appointing authority. 75
	118	+	(e) The speaker of the House of Representatives and the president pro 76
	119	+	tempore of the Senate shall select the chairpersons of the task force from 77
	120	+	among the members of the task force. Such chairpersons shall schedule 78
	121	+	the first meeting of the task force, which shall be held not later than sixty 79
	122	+	days after the effective date of this section. 80
	123	+	(f) The administrative staff of the joint standing committee of the 81
	124	+	General Assembly having cognizance of matters relating to insurance 82
	125	+	shall serve as administrative staff of the task force. 83
	126	+	(g) Not later than January 1, 2022, the task force shall submit a report 84
	127	+	on its findings and recommendations to the joint standing committee of 85
	128	+	the General Assembly having cognizance of matters relating to 86
	129	+	insurance, in accordance with the provisions of section 11-4a of the 87
	130	+	general statutes. The task force shall terminate on the date that it 88
	131	+	submits such report or January 1, 2022, whichever is later. 89
	132	+	Sec. 5. (Effective from passage) (a) There is established a task force to 90
	133	+	study health insurance coverage for peer support services in this state. 91
	134	+	Such study shall include, but need not be limited to, an examination of 92
	135	+	any means available to increase health insurance coverage for peer 93
	136	+	support services provided to individuals in this state. 94
	137	+	(b) The task force shall consist of the following members: 95
	138	+	(1) Two appointed by the speaker of the House of Representatives, 96
	139	+	one of whom is a recovery support specialist and one of whom is a 97
	140	+	member of the Connecticut Certification Board; 98
	141	+	(2) Two appointed by the president pro tempore of the Senate, one of 99
	142	+	whom is a recovery coach and one of whom is a representative of the 100
	143	+	Connecticut Hospital Association; 101
	144	+	(3) One appointed by the majority leader of the House of 102
	145	+	Representatives, who is a representative of a program overseen by the 103 Raised Bill No. 6588
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	152	+	Department of Children and Families; 104
	153	+	(4) One appointed by the majority leader of the Senate, who is a 105
	154	+	representative of an organization that trains recovery coaches or 106
	155	+	recovery support specialists; 107
	156	+	(5) One appointed by the minority leader of the House of 108
	157	+	Representatives, who is a supervisor of peers from a provider agency 109
	158	+	that employs peers; 110
	159	+	(6) One appointed by the minority leader of the Senate, who is a 111
	160	+	representative of an organization that provides services to Medicaid 112
	161	+	beneficiaries; 113
	162	+	(7) One appointed by the Insurance Commissioner, who is a 114
	163	+	representative of a health carrier; and 115
	164	+	(8) Two appointed by the Governor, one of whom is a young adult 116
	165	+	with experience in various forms of peer support and one of whom has 117
	166	+	perspective concerning community reentry. 118
	167	+	(c) Any member of the task force appointed under subdivision (1), 119
	168	+	(2), (3), (4), (5) or (6) of subsection (b) of this section may be a member 120
	169	+	of the General Assembly. 121
	170	+	(d) All initial appointments to the task force shall be made not later 122
	171	+	than thirty days after the effective date of this section. Any vacancy shall 123
	172	+	be filled by the appointing authority. 124
	173	+	(e) The speaker of the House of Representatives and the president pro 125
	174	+	tempore of the Senate shall select the chairpersons of the task force from 126
	175	+	among the members of the task force. Such chairpersons shall schedule 127
	176	+	the first meeting of the task force, which shall be held not later than sixty 128
	177	+	days after the effective date of this section. 129
	178	+	(f) The administrative staff of the joint standing committee of the 130
	179	+	General Assembly having cognizance of matters relating to insurance 131 Raised Bill No. 6588
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	185	+
	186	+	shall serve as administrative staff of the task force. 132
	187	+	(g) Not later than December 31, 2021, the task force shall submit a 133
	188	+	report on its findings and recommendations to the joint standing 134
	189	+	committee of the General Assembly having cognizance of matters 135
	190	+	relating to insurance, in accordance with the provisions of section 11-4a 136
	191	+	of the general statutes. The task force shall terminate on the date that it 137
	192	+	submits such report or December 31, 2021, whichever is later. 138
	193	+	This act shall take effect as follows and shall amend the following
	194	+	sections:
	195	+
	196	+	Section 1 January 1, 2022 New section
	197	+	Sec. 2 January 1, 2022 New section
	198	+	Sec. 3 January 1, 2022 38a-476b
	199	+	Sec. 4 from passage New section
	200	+	Sec. 5 from passage New section
	201	+
	202	+	INS Joint Favorable
122	203