LCO 1 of 16
General Assembly Substitute Bill No. 7192
January Session, 2025
AN ACT IMPLEMENTING RECOMMENDATIONS OF THE BIPARTISAN
DRUG TASK FORCE.
Be it enacted by the Senate and House of Representatives in General
Assembly convened:
Section 1. (NEW) (Effective October 1, 2025) (a) Any pharmacy benefits 1
manager shall owe a fiduciary duty to any health carrier, as defined in 2
section 38a-591a of the general statutes, or other health benefit plan 3
sponsor. 4
(b) Any pharmacy benefits manager shall notify the health carrier or 5
other health benefit plan sponsor, in writing, of any activity, policy or 6
practice of such pharmacy benefits manager that directly or indirectly 7
presents any conflict of interest with the duties imposed by this section. 8
(c) Any pharmacy benefits manager shall have an obligation of good 9
faith and fair dealing in performing such pharmacy benefits manager's 10
duties with all parties, including, but not limited to, a health carrier or 11
other health benefit plan sponsor with whom such pharmacy benefits 12
manager interacts in the performance of pharmacy benefit management 13
services. 14
(d) Notwithstanding any provision of title 38a of the general statutes 15
and to the maximum extent permitted by applicable law, no contract 16
entered into or amended after October 1, 2025, by a health carrier shall 17
contain any provision that permits or requires any party to such contract 18 Substitute Bill No. 7192
LCO 2 of 16
to violate the fiduciary duty that such health carrier owes to such health 19
carrier's covered persons. 20
(e) Any violation of the provisions of this section shall constitute a 21
violation of sections 38a-815 to 38a-819, inclusive, of the general statutes. 22
(f) The Insurance Commissioner may adopt regulations, in 23
accordance with the provisions of chapter 54 of the general statutes, to 24
implement the provisions of this section. 25
Sec. 2. Section 38a-477cc of the general statutes is repealed and the 26
following is substituted in lieu thereof (Effective January 1, 2026): 27
(a) No contract for pharmacy services entered into in the state 28
between a health carrier, as defined in section 38a-591a, or pharmacy 29
benefits manager, as defined in section 38a-479aaa, and a pharmacy or 30
pharmacist shall: 31
(1) On and after January 1, 2018, contain a provision prohibiting or 32
penalizing, including through increased utilization review, reduced 33
payments or other financial disincentives, a pharmacist's disclosure to 34
an individual purchasing prescription medication of information 35
regarding: 36
(A) The cost of the prescription medication to the individual; or 37
(B) The availability of any therapeutically equivalent alternative 38
medications or alternative methods of purchasing the prescription 39
medication, including, but not limited to, paying a cash price, that are 40
less expensive than the cost of the prescription medication to the 41
individual; [and] 42
(2) On and after January 1, 2020, contain a provision permitting the 43
health carrier or pharmacy benefits manager to recoup, directly or 44
indirectly, from a pharmacy or pharmacist any portion of a claim that 45
such health carrier or pharmacy benefits manager has paid to the 46
pharmacy or pharmacist, unless such recoupment is permitted under 47
section 38a-479iii or required by applicable law; 48 Substitute Bill No. 7192
LCO 3 of 16
(3) On and after January 1, 2026, contain a provision permitting the 49
pharmacy benefits manager to charge a health benefit plan in this state 50
a contracted price for any pharmacy services that differs from the 51
amount such pharmacy benefits manager, directly or indirectly, pays 52
the pharmacy for such pharmacy services; and 53
(4) On and after January 1, 2026, contain a provision permitting the 54
pharmacy benefits manager to charge a health benefit plan, directly or 55
indirectly, a fee that is conditioned on the (A) wholesale acquisition cost 56
or any other price metric for a prescription drug, (B) amount of savings, 57
rebates or other fees charged, realized, collected by or generated based 58
on the business practices of such pharmacy benefits manager, or (C) 59
amount of premiums charged or cost-sharing requirements pursuant to 60
such health benefit plan that are realized or collected by such pharmacy 61
benefits manager from covered persons. For the purposes of this 62
subdivision, "wholesale acquisition cost" means the price of a 63
medication set by a pharmaceutical manufacturer in the United States 64
when selling to a wholesaler. 65
(b) (1) On and after January 1, 2018, no health carrier or pharmacy 66
benefits manager shall require an individual to make a payment at the 67
point of sale for a covered prescription medication in an amount greater 68
than the lesser of: 69
(A) The applicable copayment for such prescription medication; 70
(B) The allowable claim amount for the prescription medication; or 71
(C) The amount an individual would pay for the prescription 72
medication if the individual purchased the prescription medication 73
without using a health benefit plan, as defined in section 38a-591a, or 74
any other source of prescription medication benefits or discounts. 75
(2) For the purposes of this subsection, "allowable claim amount" 76
means the amount the health carrier or pharmacy benefits manager has 77
agreed to pay the pharmacy for the prescription medication. 78 Substitute Bill No. 7192
LCO 4 of 16
(c) Any provision of a contract that violates the provisions of this 79
section shall be void and unenforceable. Any general business practice 80
that violates the provisions of this section shall constitute an unfair trade 81
practice pursuant to chapter 735a. The invalidity or unenforceability of 82
any contract provision under this subsection shall not affect any other 83
provision of the contract. 84
(d) The Insurance Commissioner may: 85
(1) Enforce the provisions of this section pursuant to chapter 697; and 86
(2) Upon request, audit a contract for pharmacy services for 87
compliance with the provisions of this section. 88
Sec. 3. Section 38a-479ttt of the general statutes is repealed and the 89
following is substituted in lieu thereof (Effective October 1, 2025): 90
Not later than March 1, 2021, and annually thereafter, the 91
commissioner shall prepare a report, for the immediately preceding 92
calendar year, describing the rebate practices of health carriers. The 93
report shall contain (1) an explanation of the manner in which health 94
carriers accounted for rebates in calculating premiums for health care 95
plans delivered, issued for delivery, renewed, amended or continued 96
during such year, (2) a statement disclosing whether, and describing the 97
manner in which, health carriers made rebates available to insureds at 98
the point of purchase during such year, (3) any other manner in which 99
health carriers applied rebates during such year, (4) the percentage of 100
rebate dollars used by health carriers to reduce cost-sharing 101
requirements during such year, (5) an evaluation of rebate practices to 102
reduce cost-sharing for health care plans delivered, issued for delivery, 103
renewed, amended or continued during such year, and [(4)] (6) such 104
other information as the commissioner, in the commissioner's 105
discretion, deems relevant for the purposes of this section. The 106
commissioner shall publish a copy of the report on the department's 107
Internet web site. 108
Sec. 4. (NEW) (Effective July 1, 2025) (a) The Insurance Commissioner 109 Substitute Bill No. 7192
LCO 5 of 16
shall require any health carrier, as defined in section 38a-591a of the 110
general statutes, to report to the commissioner annually on pricing 111
offered to and profit generated between such carrier and any pharmacy 112
benefits manager or mail-order pharmacy doing business with such 113
carrier. 114
(b) The commissioner shall post a link on the Internet web site of the 115
Insurance Department to the reports filed pursuant to subsection (a) of 116
this section. 117
Sec. 5. (Effective July 1, 2025) For the purposes of this section and 118
sections 6 to 14, inclusive, of this act, unless the context otherwise 119
requires: 120
(1) "Canadian supplier" means a manufacturer or wholesale drug 121
distributor that is licensed or permitted under applicable Canadian law 122
to manufacture or distribute prescription drugs; 123
(2) "Canadian prescription drug importation program" or "program" 124
means a program under which the state would seek federal approval to 125
import prescription drugs from Canada that have the highest potential 126
for cost savings in the state; 127
(3) "Department" means the Department of Consumer Protection; 128
(4) "Drug" means an article that is (A) recognized in the official United 129
States Pharmacopoeia, official Homeopathic Pharmacopoeia of the 130
United States or official National Formulary, or any supplement thereto, 131
(B) intended for use in the diagnosis, cure, mitigation, treatment or 132
prevention of disease in humans, (C) not food and intended to affect the 133
structure or any function of the human body, and (D) not a device and 134
intended for use as a component of any article specified in 135
subparagraphs (A) to (C), inclusive, of this subdivision; 136
(5) "Drug Quality and Security Act" means the federal Drug Quality 137
and Security Act, 21 USC 351, et seq., as amended from time to time; 138
(6) "Food, Drug and Cosmetic Act" means the federal Food, Drug and 139 Substitute Bill No. 7192
LCO 6 of 16
Cosmetic Act, 21 USC 301, et seq., as amended by the Drug Quality and 140
Security Act, as both may be amended from time to time; 141
(7) "Qualifying laboratory" has the same meaning as provided in 21 142
CFR 251.2; 143
(8) "Laboratory testing" means a quantitative and qualitative analysis 144
of a drug consistent with the applicable provisions of the official United 145
States Pharmacopoeia; 146
(9) "Participating Canadian supplier" means a Canadian supplier that 147
is exporting prescription drugs, in the manufacturer's original 148
container, to a participating wholesaler for distribution in this state 149
under the program; 150
(10) "Participating wholesaler" means a wholesaler that is (A) 151
designated by the Department of Consumer Protection to distribute 152
prescription drugs in the manufacturer's original container, obtained 153
from a participating Canadian supplier, and (B) participating in the 154
program; 155
(11) "Recall" means a person's removal or correction of a marketed 156
product that the department determines is in violation of this section, 157
but "recall" does not include a market withdrawal or a stock recovery, 158
as such terms are defined in 21 CFR 7.3; 159
(12) "Relabeler" has the same meaning as provided in 21 CFR 207.1; 160
(13) "Repacker" has the same meaning as provided in 21 CFR 207.1; 161
(14) "Track-and-trace" means the product tracing process for the 162
components of the pharmaceutical distribution supply chain as 163
described in Title II of the Drug Quality and Security Act; and 164
(15) "Wholesaler" means a wholesaler, as defined in section 21a-70 of 165
the general statutes, that has received a certificate of registration from 166
the Commissioner of Consumer Protection pursuant to said section. 167 Substitute Bill No. 7192
LCO 7 of 16
Sec. 6. (Effective July 1, 2025) The Commissioner of Consumer 168
Protection shall hire, within available resources, a consultant to study 169
the feasibility of establishing a Canadian prescription drug importation 170
program to reduce prescription drug costs in the state. Not later than 171
October 1, 2027, the commissioner shall file a report, in accordance with 172
the provisions of section 11-4a of the general statutes, with the joint 173
standing committees of the General Assembly having cognizance of 174
matters relating to appropriations and the budgets of state agencies, 175
general law and human services and the Office of Policy and 176
Management on the results of the feasibility study. 177
Sec. 7. (Effective October 1, 2027) (a) If after completion of the study 178
described in section 6 of this act, the Commissioner of Consumer 179
Protection, in consultation with the Secretary of the Office of Policy and 180
Management, determines a Canadian prescription drug importation 181
program is feasible, the Commissioner of Consumer Protection may 182
submit a request to the federal Food and Drug Administration seeking 183
approval for the program under Section 804 of the federal Food, Drug 184
and Cosmetic Act, 21 USC 384(b) to 21 USC 384(h), inclusive, as 185
amended from time to time. If submitted, such request shall, at a 186
minimum: 187
(1) Describe the state's plans for operating the program and describe 188
any opportunities to coordinate or operate the program in coordination 189
with other states; 190
(2) Demonstrate that any prescription drug that is imported and 191
distributed in this state under the program would: 192
(A) Meet all applicable federal and state standards for safety and 193
effectiveness; and 194
(B) Comply with all federal tracing procedures; and 195
(3) State the estimated costs of implementing the program. 196
(b) If the federal Food and Drug Administration approves the 197 Substitute Bill No. 7192
LCO 8 of 16
request, the Commissioner of Consumer Protection shall: 198
(1) Submit to the Secretary of the Office of Policy and Management, 199
and the Commissioners of Social Services and Health Strategy, a notice 200
disclosing that the federal Food and Drug Administration approved 201
such request; and 202
(2) Submit to the joint standing committees of the General Assembly 203
having cognizance of matters relating to appropriations and the budgets 204
of state agencies, general law, human services and public health a notice 205
disclosing that the federal Food and Drug Administration approved 206
such request. 207
(c) The Commissioner of Consumer Protection shall not operate the 208
program unless the federal Food and Drug Administration approves the 209
request. Notwithstanding the provisions of this subsection, the 210
department may expend resources in advance of such approval to 211
ensure efficient implementation. 212
Sec. 8. (Effective October 1, 2027) If the Canadian prescription drug 213
importation program is established, each participating wholesaler may 214
import and distribute a prescription drug in this state from a 215
participating Canadian supplier under the program if: 216
(1) Such drug meets the federal Food and Drug Administration's 217
standards concerning drug safety, effectiveness, misbranding and 218
adulteration; 219
(2) Importing such drug would not violate federal patent laws; and 220
(3) Such drug is not: 221
(A) A controlled substance, as defined in 21 USC 802, as amended 222
from time to time; 223
(B) A biological product, as defined in 42 USC 262, as amended from 224
time to time; 225 Substitute Bill No. 7192
LCO 9 of 16
(C) An infused drug; 226
(D) An intravenously injected drug; 227
(E) A drug that is inhaled during surgery; or 228
(F) A drug that is a parenteral drug, the importation of which is 229
determined by the federal Secretary of Health and Human Services to 230
pose a threat to the public health. 231
Sec. 9. (Effective October 1, 2027) If a Canadian prescription drug 232
importation program is established, participating wholesalers may, 233
subject to the provisions of sections 10 and 11 of this act, import and 234
distribute drugs in this state from a participating Canadian supplier 235
under the program to: 236
(1) A pharmacy or institutional pharmacy, as defined in section 20-237
571 of the general statutes; and 238
(2) A qualifying laboratory. 239
Sec. 10. (Effective October 1, 2027) If a Canadian prescription drug 240
importation program is established, the Commissioner of Consumer 241
Protection shall require that each participating Canadian supplier and 242
participating wholesaler (1) comply with all applicable track-and-trace 243
requirements, and shall not distribute, dispense or sell outside of this 244
state any prescription drug that is imported into this state under the 245
program, and (2) make available to the commissioner all track-and-trace 246
records not later than forty-eight hours after the commissioner requests 247
such records. 248
Sec. 11. (Effective October 1, 2027) (a) A participating wholesaler in any 249
approved Canadian prescription drug importation program shall 250
ensure the safety and quality of all drugs that may be imported and 251
distributed in this state under the program. The participating 252
wholesaler shall, if such program is established: 253
(1) For each initial shipment of a drug that is imported into this state 254 Substitute Bill No. 7192
LCO 10 of 16
by a participating wholesaler, ensure that a qualifying laboratory 255
engaged by the participating wholesaler tests a statistically valid sample 256
size for each batch of each drug in such shipment for authenticity and 257
degradation in a manner that is consistent with the Food, Drug and 258
Cosmetic Act; 259
(2) For each shipment of a drug that is imported into this state by a 260
participating wholesaler and has been sampled and tested pursuant to 261
subdivision (1) of this subsection, ensure that a qualifying laboratory 262
engaged by the participating wholesaler tests a statistically valid sample 263
of such shipment for authenticity and degradation in a manner that is 264
consistent with the Food, Drug and Cosmetic Act; 265
(3) Only import drugs into this state that are (A) approved for 266
marketing in the United States, (B) not adulterated or misbranded, and 267
(C) meet all of the labeling requirements under 21 USC 352, as amended 268
from time to time; 269
(4) Maintain qualifying laboratory records, including, but not limited 270
to, complete data derived from all tests necessary to ensure that each 271
drug imported into this state under any approved Canadian 272
prescription drug importation program is in compliance with the 273
requirements of this section; and 274
(5) Maintain documentation demonstrating that the testing required 275
by this section was conducted at a qualifying laboratory in accordance 276
with the Food, Drug and Cosmetic Act and all other applicable federal 277
and state laws and regulations concerning qualifying laboratory 278
qualifications. 279
(b) The participating wholesaler shall maintain all information and 280
documentation pursuant to this section for a period of not less than three 281
years from the date of submission of such information and 282
documentation to the participating wholesaler by a qualifying 283
laboratory. 284
(c) Each participating wholesaler shall maintain all of the following 285 Substitute Bill No. 7192
LCO 11 of 16
information for each drug that such participating wholesaler imports 286
and distributes in this state under the program, and submit such 287
information to the Commissioner of Consumer Protection upon request 288
by the commissioner: 289
(1) The name and quantity of the active ingredient of such drug; 290
(2) A description of the dosage form of such drug; 291
(3) The date on which such participating wholesaler received such 292
drug; 293
(4) The quantity of such drug that such participating wholesaler 294
received; 295
(5) The point of origin and destination of such drug; 296
(6) The price paid by such participating wholesaler for such drug; 297
(7) A report regarding any drug that fails qualifying laboratory 298
testing; and 299
(8) Such additional information and documentation that the 300
commissioner deems necessary to ensure the protection of the public 301
health. 302
(d) The Commissioner of Consumer Protection shall require each 303
participating Canadian supplier in any approved Canadian prescription 304
drug importation program to maintain the following information and 305
documentation and, upon request by the commissioner, submit such 306
information and documentation to the commissioner for each drug that 307
such participating Canadian supplier exports into this state under the 308
program: 309
(1) The original source of such drug, including, but not limited to: 310
(A) The name of the manufacturer of such drug; 311
(B) The date on which such drug was manufactured; and 312 Substitute Bill No. 7192
LCO 12 of 16
(C) The location where such drug was manufactured; 313
(2) The date on which such drug was shipped; 314
(3) The quantity of such drug that was shipped; 315
(4) The quantity of each lot of such drug originally received and the 316
source of such lot; 317
(5) The lot or control number and the batch number assigned to such 318
drug by the manufacturer; and 319
(6) Such additional information and documentation that the 320
Commissioner of Consumer Protection deems necessary to ensure the 321
protection of the public health. 322
Sec. 12. (Effective October 1, 2027) (a) If the Commissioner of Consumer 323
Protection determines that public health, safety or welfare requires 324
emergency action, the commissioner may order a participating 325
Canadian supplier, participating wholesaler, relabeler, repacker and 326
qualifying laboratory to cease and desist from actions specified in the 327
order that create the need for such emergency action pending 328
administrative proceedings. Such cease and desist order shall be (1) in 329
writing; (2) signed by the Commissioner of Consumer Protection; and 330
(3) effective upon delivery to the respondent. An administrative 331
proceeding in accordance with chapter 54 of the general statutes shall 332
be promptly instituted following a cease and desist order. The 333
commissioner may impose a civil penalty, in an amount not to exceed 334
ten thousand dollars, after a hearing conducted pursuant to chapter 54 335
of the general statutes. 336
(b) The commissioner may require the recall, embargo or destruction, 337
pursuant to section 21a-96 of the general statutes, of any drug that was 338
imported and distributed under the program and has been identified as 339
adulterated, within the meaning of section 21a-105 of the general 340
statutes, or misbranded. 341
(c) In the event of a cease and desist, recall, embargo or destruction 342 Substitute Bill No. 7192
LCO 13 of 16
order, the person adversely impacted by such order shall provide 343
written notice to all other businesses participating in the program, 344
informing them of the order. 345
Sec. 13. (Effective October 1, 2027) If a Canadian prescription drug 346
importation program is established, the Commissioner of Consumer 347
Protection may adopt regulations in accordance with the provisions of 348
chapter 54 of the general statutes to implement the provisions of sections 349
5 to 12, inclusive, of this act. 350
Sec. 14. (Effective October 1, 2027) Not later than one hundred eighty 351
days after the first importation of any Canadian prescription drug under 352
the importation program begins, and biannually thereafter, the 353
Commissioner of Consumer Protection shall submit a report, in 354
accordance with the provisions of section 11-4a of the general statutes, 355
to the joint standing committees of the General Assembly having 356
cognizance of matters relating to appropriations and the budgets of state 357
agencies, general law, human services and public health. Such report 358
shall describe (1) the operation of the program, if established, and (2) 359
any violation of sections 5 to 13, inclusive, of this act that resulted in any 360
action taken by the commissioner pursuant to section 12 of this act and 361
the status of the investigation into such violation. 362
Sec. 15. (NEW) (Effective from passage) (a) There is established a task 363
force to study emergency preparedness and mitigation strategies for 364
prescription drug shortages. The task force shall identify prescription 365
drugs at risk of shortage in this state and make recommendations 366
pursuant to subsection (g) of this section. 367
(b) The task force shall consist of the following members: 368
(1) Two appointed by the speaker of the House of Representatives, 369
one of whom has expertise in prescription drug supply chains and one 370
of whom has expertise in federal law concerning prescription drug 371
shortages; 372
(2) Two appointed by the president pro tempore of the Senate, one of 373 Substitute Bill No. 7192
LCO 14 of 16
whom represents hospitals and one of whom represents health care 374
providers who treat patients with rare diseases; 375
(3) One appointed by the majority leader of the House of 376
Representatives, who represents one of the two federally recognized 377
Indian tribes in the state; 378
(4) One appointed by the majority leader of the Senate, who 379
represents one of the two federally recognized Indian tribes in the state; 380
(5) One appointed by the minority leader of the House of 381
Representatives; 382
(6) One appointed by the minority leader of the Senate; 383
(7) The Commissioner of Health Strategy, or the commissioner's 384
designee; 385
(8) The Commissioner of Consumer Protection, or the commissioner's 386
designee; 387
(9) The Commissioner of Social Services, or the commissioner's 388
designee; 389
(10) The Commissioner of Public Health, or the commissioner's 390
designee; 391
(11) The chief executive officer of The University of Connecticut 392
Health Center, or the chief executive officer's designee; 393
(12) The Insurance Commissioner, or the commissioner's designee; 394
and 395
(13) The Commissioner of Economic and Community Development, 396
or the commissioner's designee. 397
(c) Any member of the task force appointed under subdivision (1), 398
(2), (3), (4), (5) or (6) of subsection (b) of this section may be a member 399
of the General Assembly. 400 Substitute Bill No. 7192
LCO 15 of 16
(d) All initial appointments to the task force shall be made not later 401
than thirty days after the effective date of this section. Any vacancy shall 402
be filled by the appointing authority. 403
(e) The speaker of the House of Representatives and the president pro 404
tempore of the Senate shall select the chairpersons of the task force from 405
among the members of the task force. Such chairpersons shall schedule 406
the first meeting of the task force, which shall be held not later than sixty 407
days after the effective date of this section. 408
(f) The administrative staff of the joint standing committee of the 409
General Assembly having cognizance of matters relating to general law 410
shall serve as administrative staff of the task force. 411
(g) Not later than January 1, 2026, and annually thereafter, the task 412
force shall submit a report on its findings and recommendations to the 413
joint standing committees of the General Assembly having cognizance 414
of matters relating to general law, human services, insurance and real 415
estate and public health, in accordance with the provisions of section 11-416
4a of the general statutes, including, but not limited to, identification of 417
prescription drugs the task force determines are at risk of shortage and 418
strategies that would mitigate these shortages, including methods to 419
increase in-state production of such drugs deemed both at risk of 420
shortage and critically necessary for the provision of health care within 421
the state. 422
Sec. 16. (NEW) (Effective July 1, 2025) (a) As used in this section, 423
"Strategic Supply Chain Initiative" means a program administered by 424
the Department of Economic and Community Development to help 425
state-based companies to increase their production capacity to win new 426
business and attract out-of-state and international supply chain 427
operations. 428
(b) The Commissioner of Economic and Community Development 429
shall expand the Strategic Supply Chain Initiative to include efforts to 430
prevent or mitigate prescription drug shortages, including, but not 431
limited to, incorporating recommendations to prevent or mitigate 432 Substitute Bill No. 7192
LCO 16 of 16
prescription drug shortages by the task force established pursuant to 433
section 15 of this act. 434
This act shall take effect as follows and shall amend the following
sections:
Section 1 October 1, 2025 New section
Sec. 2 January 1, 2026 38a-477cc
Sec. 3 October 1, 2025 38a-479ttt
Sec. 4 July 1, 2025 New section
Sec. 5 July 1, 2025 New section
Sec. 6 July 1, 2025 New section
Sec. 7 October 1, 2027 New section
Sec. 8 October 1, 2027 New section
Sec. 9 October 1, 2027 New section
Sec. 10 October 1, 2027 New section
Sec. 11 October 1, 2027 New section
Sec. 12 October 1, 2027 New section
Sec. 13 October 1, 2027 New section
Sec. 14 October 1, 2027 New section
Sec. 15 from passage New section
Sec. 16 July 1, 2025 New section
HS Joint Favorable Subst. -LCO
INS Joint Favorable