Researcher: AR Page 1 5/3/22
OLR Bill Analysis
SB 364 (File 315, as amended by Senate “A”)*
AN ACT CONCERNING HEALTH INSURANCE.
SUMMARY
This bill expands a prohibition against insurers requiring the use of
step therapy for certain prescription drugs. “Step therapy” establishes a
sequence for prescribing drugs for specific medical conditions, which,
in practice, generally requires patients to try less expensive drugs before
higher cost drugs.
Existing law prohibits certain individual and group health insurance
policies from requiring an insured to use step therapy for any prescribed
drugs for more than 60 days. Current law also bars these policies from
requiring the use of step therapy for any period for cancer drugs
prescribed to treat stage IV metastatic cancer. The bill instead more
broadly prohibits step therapy use for drugs prescribed to treat
behavioral health conditions or chronic, disabling, or life-threatening
conditions or diseases. As is the case under current law for the stage IV
metastatic cancer drugs, the bill’s prohibition only applies to drugs that
comply with approved federal Food and Drug Administration
indications.
The bill applies to individual and group health insurance policies
delivered, issued, renewed, amended, or continued by an insurer,
hospital service corporation, medical service corporation, health care
center (i.e., HMO), or other entity that provides coverage for
prescription drugs.
Lastly, the bill makes technical changes.
*Senate Amendment “A” replaces the underlying bill, which
required the Insurance Department to study health insurance issues in
Connecticut and report its results to the Insurance and Real Estate 2022SB-00364-R01-BA.DOCX
Researcher: AR Page 2 5/3/22
Committee.
EFFECTIVE DATE: January 1, 2023
COMMITTEE ACTION
Insurance and Real Estate Committee
Joint Favorable
Yea 17 Nay 0 (03/22/2022)
Appropriations Committee
Joint Favorable
Yea 32 Nay 14 (04/29/2022)