CT HB06096

Health carriers offering health benefit plans in Connecticut on or after January 1, 2020, are prohibited from removing prescription drugs from formularies or moving drugs to higher cost-sharing tiers during a plan year.

Health carriers may remove a prescription drug from a formulary only if the drug is not FDA-approved, the FDA issues a safety warning about it, or the drug is approved for over-the-counter use.

Health carriers may move brand name drugs to higher cost-sharing tiers only if they simultaneously add an FDA-approved generic alternative in a lower cost-sharing tier.

Health carriers may add new prescription drugs to formularies at any time without restriction.

The act applies to health benefit plans with pharmacy benefits that use drug formularies or lists of covered drugs, excluding grandfathered health plans, and takes effect January 1, 2020.