Proposed Bill No. 446 aims to reform the practices of pharmacy benefits managers (PBMs) in Connecticut by introducing several key provisions. The bill prohibits PBMs from imposing post-transaction fees or implementing reimbursement clawbacks on pharmacies. It mandates that any rebates, discounts, or financial incentives from drug manufacturers to PBMs be passed directly to covered persons at the point of sale. Additionally, the bill seeks to decouple PBM compensation from medication costs, prohibits fees for formulary placement or tier-level access, and requires that any group purchasing organization contracting with PBMs be U.S.-incorporated and disclose all associated fees and administrative costs.

Furthermore, the bill prohibits PBMs from prioritizing more expensive medications over less expensive, 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 establish a duty of care owed by PBMs. Overall, the proposed legislation aims to enhance transparency and accountability in the operations of pharmacy benefits managers, ultimately benefiting consumers.