Substitute House Bill No. 7192 aims to enhance the regulation of pharmacy benefits managers (PBMs) and improve transparency in the healthcare system. The bill establishes a fiduciary duty for PBMs to health carriers, requiring them to disclose any conflicts of interest and prohibiting contracts that violate this duty. Key provisions include the prohibition of "spread pricing" arrangements, which allow PBMs to charge health plans more than what they pay pharmacies, and restrictions on fees based on wholesale acquisition costs or savings from business practices. Any contract provisions that violate these stipulations will be deemed void and classified as unfair trade practices under the Connecticut Unfair Trade Practices Act. Additionally, the bill mandates that the insurance commissioner audit pharmacy services contracts for compliance.

The legislation also expands annual reporting requirements for health carriers to include detailed information on rebate practices and pricing strategies with PBMs. A new 15-member task force will be established to study prescription drug shortages and recommend mitigation strategies, with annual reports starting January 1, 2026. The Department of Economic and Community Development will expand its Strategic Supply Chain Initiative to address these shortages. The bill includes several insertions, such as the establishment of fiduciary duties and reporting requirements, while repealing outdated provisions related to pharmacy services contracts. The effective dates for various provisions range from immediate upon passage to January 1, 2026, ultimately aiming to enhance consumer protection and ensure fair practices within the pharmacy benefits management sector.

Statutes affected:
Raised Bill:
HS Joint Favorable:
File No. 414:
INS Joint Favorable:
APP Joint Favorable Substitute:
File No. 916: