LCO No. 2507 1 of 2
General Assembly Proposed Bill No. 821
January Session, 2025
LCO No. 2507
Referred to Committee on INSURANCE AND REAL ESTATE
Introduced by:
SEN. MARTIN, 31st Dist.
AN ACT CONCERNING PHARMACY BENEFITS MANAGER REFORM
AND PRICE GOUGING IN THE HEALTH CARE SECTOR.
Be it enacted by the Senate and House of Representatives in General
Assembly convened:
That title 38a of the general statutes be amended to: (1) Prohibit any 1
pharmacy benefits manager from imposing post-transaction fees or 2
implementing reimbursement clawbacks on pharmacies; (2) require that 3
any rebate, discount or financial incentive provided by any drug 4
manufacturer to any pharmacy benefits manager be passed directly to 5
the covered person at the point of sale; (3) decouple any pharmacy 6
benefits manager compensation from the cost of medications; (4) 7
prohibit any pharmacy benefits manager from charging fees for 8
formulary placement or tier-level access; (5) require that any group 9
purchasing organization that contracts with any pharmacy benefits 10
manager in this state be incorporated in the United States and that such 11
group purchasing organization disclose all fees and administrative costs 12
associated with such contracts; (6) prohibit any pharmacy benefits 13
manager from prioritizing more expensive medications over less 14
expensive and clinically appropriate medications; (7) prohibit any 15 Proposed Bill No. 821
LCO No. 2507 2 of 2
pharmacy benefits manager from preventing pharmacists from 16
informing patients about lower-priced prescription drugs; (8) require 17
that cash payments for prescription drugs be applied toward any 18
coinsurance, copayment, deductible or other out-of-pocket expense; (9) 19
require that the Attorney General oversee pharmacy benefits manager 20
operations in this state to ensure compliance with rebate transparency 21
and clawback prohibitions and to establish a duty of care owed by 22
pharmacy benefits managers; and (10) allow the Attorney General to 23
investigate, intervene in or bring a civil or administrative action in the 24
name of the state, seeking injunctive or declaratory relief, damages and 25
any other relief that may be available under law, whenever any person 26
in the insurance, pharmaceutical, pharmacy benefits management or 27
utility sector is or has engaged in a practice or pattern of conduct that 28
constitutes price gouging. 29
Statement of Purpose:
To reform pharmacy benefits manager practices in this state, establish a
duty of care for pharmacy benefits managers and regulate health care
price gouging in this state.