Connecticut Senate Bill SB00766

Connecticut 2021 Regular Session

• Introduced: 1/29/21
• Refer: 1/29/21

Caption

An Act Concerning Required Health Insurance And Medicaid Coverage For Brand-name Prescription Drugs.

Impact

The implementation of SB00766 is likely to modify existing health insurance policies and Medicaid coverage regulations. By ensuring that brand-name drugs prescribed are covered without substitution, the bill aims to improve access for patients who genuinely require these medications for their health. This change could potentially lead to increased costs for insurance companies and Medicaid programs if the volume of brand-name prescriptions rises. However, advocates of the bill argue it is crucial for safeguarding patient health and ensuring that individuals receive the most suitable treatment options as determined by their healthcare providers.

Summary

SB00766, titled 'An Act Concerning Required Health Insurance and Medicaid Coverage for Brand-Name Prescription Drugs,' mandates that health carriers and Medicaid must provide coverage for brand-name prescription drugs deemed medically necessary by a prescribing practitioner, without allowing substitutions for generic equivalent drugs. The bill's provisions highlight the necessity for the prescriber to indicate in writing that the brand-name drug is essential, thereby protecting patients who may require a specific medication despite the availability of a generic option.

Contention

Discussions surrounding SB00766 may reveal contention regarding cost implications and the balance between patient care and financial sustainability for health insurers. Some stakeholders might argue that the bill could lead to higher overall spending on prescription drugs, prompting concerns about sustainability in regards to Medicaid funding. Conversely, advocates are likely to emphasize patient choice and the importance of medically necessary treatments, arguing that the patient's health should take precedence over cost considerations. This dialogue reflects ongoing tensions between healthcare affordability and the need for effective patient-centered care.