HB 6622 Summary

• Health carriers offering plans with pharmacy benefits in Connecticut cannot remove prescription drugs from formularies or move drugs to higher cost-sharing tiers during a plan year, effective January 1, 2022.

• Health carriers may remove drugs only with 90 days' advance notice if the FDA issues safety warnings or if the drug becomes available over-the-counter, unless the treating physician certifies medical necessity.

• Health carriers may move brand-name drugs to higher cost-sharing tiers only if they add a therapeutically equivalent FDA-approved generic alternative to the formulary at a lower cost-sharing tier.

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

• The Office of Health Strategy must conduct annual studies on the impact of these requirements on health plan costs and submit reports to the Insurance Commissioner and legislature starting January 31, 2023.