Substitute House Bill No. 6436 proposes significant revisions to health insurance statutes, particularly concerning the operations of the Insurance Department and pharmacy benefits managers (PBMs). A key feature of the bill is the establishment of a health benefit review program within the Insurance Department, which will assess mandated health benefits as requested by the General Assembly's insurance committee. This program will be funded by the Insurance Fund, and the commissioner will now have the authority to engage independent experts for the review process, replacing the previous requirement to contract specifically with The University of Connecticut Center for Public Health and Health Policy, which has been removed from the law.

The bill also modifies the reporting requirements for PBMs by extending the deadline for their annual reports from February 1, 2025, to March 1, 2026, and each year thereafter. These reports will include detailed information on rebates from pharmaceutical manufacturers related to outpatient prescription drugs. Furthermore, the bill allows the Insurance Commissioner to adopt regulations regarding medically necessary wheelchair repairs and replacements on a permissive basis rather than as a requirement. The effective date for these changes is upon passage, except for the health benefit review program, which will take effect on October 1, 2025. Overall, the bill aims to enhance the efficiency of health benefit evaluations and improve transparency in PBM reporting without imposing additional fiscal burdens on the state or municipalities.

Statutes affected:
Raised Bill:
INS Joint Favorable:
File No. 53: