An Act Concerning Prescription Drug Formularies And Lists Of Covered Drugs.
The bill places new regulations on health carriers, specifically around the handling of prescription drugs in terms of additions, removals, and tier changes in drug formularies. This means that any significant changes to a patient's medications would require prior notification and must align with the safety communications from the FDA, which provides additional protections for patients. Furthermore, the Office of Health Strategy is tasked with annually studying the implications of these requirements on health benefit plan costs and reporting the findings.
House Bill 06622, effective January 1, 2022, addresses the management of prescription drug formularies and lists of covered drugs within health benefit plans. The bill prohibits health carriers from removing prescription drugs from these formularies during a plan year or changing their cost-sharing tier unless certain conditions are met, such as providing prior notice to the covered person and their treating physician. The aim is to enhance stability and predictability for patients in their access to necessary medications throughout the year.
Overall sentiment towards HB06622 appears to be positive, particularly among advocates for patient rights and healthcare stability. Supporters argue that this legislation will empower patients by ensuring continued access to vital medications without the threat of disruptive changes mid-year. They believe that these protections will contribute to better health outcomes. However, some concerns were raised regarding the impact on health carriers' ability to manage costs and their flexibility in responding to market changes.
The primary points of contention surrounding HB06622 include concerns from health carriers about potential increases in costs and administrative burdens due to the required notifications and the stricter handling of formularies. Critics argue that the regulations may limit their ability to effectively manage drug costs and ensure formulary efficiency. Additionally, the debate touches upon broader healthcare discussions regarding the balance of patient protection measures against the operational needs of insurance providers.