Substitute House Bill No. 7192, also known as Public Act No. 25-167, introduces significant reforms for pharmacy benefits managers (PBMs) and health carriers in Connecticut, set to take effect between October 1, 2025, and January 1, 2026. The bill requires PBMs to act in good faith, disclose conflicts of interest, and offer health plans the option to be charged the same price for prescription drugs as pharmacies. It repeals certain existing provisions related to pharmacy service contracts, including restrictions on pharmacists disclosing medication costs and the recoupment of claims by health carriers or PBMs. Additionally, the bill establishes a task force to study emergency preparedness for prescription drug shortages and mandates enhanced reporting requirements for health carriers regarding rebate practices and their effects on premiums.

The legislation also aims to improve drug accessibility and affordability by requiring health carriers to credit enrollees for out-of-pocket expenses for out-of-network prescription drug purchases, contingent on proof of payment. It introduces a Canadian prescription drug importation program to potentially lower drug costs, with the Commissioner of Consumer Protection overseeing its implementation and compliance. Furthermore, the bill facilitates bulk price negotiations for prescription drugs on behalf of various state agencies and establishes an Advisory Council on Pharmaceutical Procurement to guide these negotiations. The Commissioner of Social Services is also tasked with advocating for generic, lower-cost prescription drugs for specific health conditions. Overall, the bill seeks to enhance transparency, accountability, and affordability in the pharmacy benefits management sector while addressing potential drug shortages.

Statutes affected:
Raised Bill:
HS Joint Favorable:
File No. 414:
INS Joint Favorable:
APP Joint Favorable Substitute:
File No. 916:
Public Act No. 25-167: