The proposed Bill No. 446 aims to reform the practices of pharmacy benefits managers (PBMs) in Connecticut by introducing several key provisions. It prohibits PBMs from imposing post-transaction fees or implementing reimbursement clawbacks on pharmacies. Additionally, the bill mandates that any rebates, discounts, or financial incentives from drug manufacturers to PBMs must be passed directly to the covered person at the point of sale. Other significant changes include decoupling PBM compensation from medication costs, prohibiting fees for formulary placement or tier-level access, and ensuring that any group purchasing organization contracting with PBMs is U.S.-incorporated and transparent about fees and administrative costs.

Furthermore, the bill prohibits PBMs from prioritizing more expensive medications over less costly, clinically appropriate options. It also establishes oversight by the Attorney General to ensure compliance with the new transparency and clawback prohibitions, as well as to enforce a duty of care owed by PBMs. Overall, the bill seeks to enhance transparency and fairness in the pharmacy benefits management sector, ultimately benefiting consumers.