Insurance and Real Estate Committee
HOUSE FAVORABLE REPORT
Bill No.: HB-5254
AN ACT REQUIRING HEALTH INSURANCE COVERAGE FOR MEDICATION-
Title: ASSISTED TREATMENT FOR OPIOID USE DISORDER.
Vote Date: 3/10/2020
Vote Action: JOINT FAVORABLE
PH Date: 2/27/2020
File No.:
Disclaimer: The following HOUSE FAVORABLE Report is prepared for the benefit of the
members of the General Assembly, solely for purposes of information, summarization and
explanation and does not represent the intent of the General Assembly or either chamber
thereof for any purpose.
SPONSORS OF BILL:
Insurance and Real Estate Committee
REASONS FOR BILL:
This bill will require health insurance coverage for medication-assisted treatment for opioid use
disorder.
RESPONSE FROM ADMINISTRATION/AGENCY:
None Expressed
NATURE AND SOURCES OF SUPPORT:
Kimberly Beauregard, LCSW, President/CEO, InterCommunity Inc stated their goal is to
safely detox clients from alcohol and/or drugs and to provide education and motivation to
referral. Despite the increased attention to opioid overdoses, according to the Chief Medical
Examiner Connecticut accidental intoxication deaths jumped 18% to hit a record high 1,200 in
2019. Unfortunately, too many residents are not getting the services they need in a timely
manner. Providing additional coverage for these necessary services will provide more people
with opportunities to get the necessary treatment.
Sheila Cooperman, MD, President, CT Psychiatric Society stated Connecticut remains in
the midst of an opiate crisis with more than 1,000 deaths this last year due to opiate
overdoses. There is evidence based on treatment available for those struggling with an
opiate use disorder. The Federal Drug Administration has approved 3 medications that in
combination with counseling have been shown to help people gain better control over their
life while they focus on their recovery. These medications, Methadone, Naltrexone and
Buprenorphine, have been shown to decrease cravings for opiates and at the correct dose,
allow continued mental and physical functioning. Furthermore, it does not change who they
are as a person or affect their IQ. Although Medicaid and some private insurance
prescription plans cover the cost of some formulations of Buprenorphine, the film form is not
covered by all insurers. This consists of a thin film that patients can place under their
tongues, which dissolves and delivers the medication. The pill form often is substituted as it is
less expensive. But is the opinion of some Addiction Psychiatrists that this form is more easily
diverted. This is problematic for two reasons: 1. A number of physicians are reluctant to
prescribe Buprenorphine as they are concerned about diversion. 2. Many patients are more
likely to comply if they receive a certain medication in a format that they are comfortable with
and that can use in a manner that makes it easier to conduct their lives.
Kathleen Flaherty, Esq., Executive Director, CT Legal Rights Project, Inc. this legislature
passed, on a bipartisan basis, legislation aimed at ensuring health insurers treat mental
health conditions the same way any other health conditions are treated. That mental health
parity law is now effective. This bill will simply ensure that insurers subject to regulation by
the State of CT cover these behavioral health services.
Kelly McConney Moore, Policy Counsel, American Civil Liberties Union of CT
expressed that Connecticut is currently in the midst of an opioid epidemic which is worsening,
not improving. Connecticut residents are more likely to die from unintentional drug overdose
than a motor vehicle accident. We need to respond with public health and epidemic
responses to combat the rising number of deaths. House Bill 5254 recognizes that drug use
and addiction disorders are, indeed, health concerns, rather than criminal problems, and
require them to be addressed as such by health insurers. Community-based solutions often
cost far less, and they use strategies that work, including individualized treatment plans with,
long-term counseling and support with public health and epidemic responses to combat the
rising number of deaths.
Ben Shaiken, Manager Advocacy & Public Policy, The Alliance stated MAT uses FDA-
approved medications to treat Opioid Use Disorder. There are three drugs that are FDA-
approved: Methadone, Buprenorphine (commonly known as Suboxone) and Naltrexone
(commonly known as Vivitrol). In study after study, MAT is shown to reduce illicit opioid use
and improve retention in opioid treatment. Simply put: MAT saves lives in Connecticut every
single day. The three different medications act and are administered differently. In most
cases, Methadone is dispensed at a clinic every day, while Buprenorphine and Naltrexone
are prescribed by a doctor or APRN and can be long-acting injectable medications. Many
providers of substance abuse services offer all three medications, and people in recovery
should have the ability to choose which medication is right for them.
Opioid overdose deaths in Connecticut increased 20% in 2019. Now is the time to expand
access to treatment, as H.B. 5254 would do. Because the three medications are so different,
and because access to them can mean the difference between life and death, they should
not be subject to prior authorization or step therapy.
The following individuals expressed strong support for this bill saying this is one of
the most successful ways to help those recovering from addiction:
Ronald Abell
Sally Arbott
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Anna Assad
Annie Atwood
Nicole Baier
Aleska Bembnista
Rhiannon Benedetto
Tammy Binnette
Linda Bishop
Michele Brabant
Jennifer Bradshaw
Julianne Bregler
Deborah Brown
Colleen Buckley
Barbara Bunk, PhD CPA
Jennifer Cederberg
Shah Chirayu
Aprille Coutts
Sharon Dean
Terri-Lynne DeFino
Matt DeSimone
Emily Dionne
Traci Eburg
Emily Elander
Melissa Florio
AnnaMarie Fraioli
Allie Frano
Heather Franklin
Cynthia Fusco
Evan Gale, MD
Mihirkumar Gosrani
Melissa Grandinetti
Michael Grube
Morgan Grube
Nicole Grube
Brianna Herbest
DelVina Herbest
Thomas Herr
Cheryl Hill
Julie Hulse
Alyssa Kassimis
Christopher Keeler
Jennifer Kelley
Jennifer Kocenko
Lynn Kovack
Tracey Kurjiaka
Patrice Lago, RN EMT
Sandra Lasher-Pelton
Susan Leonard
Lindsey Foolsby
Tiffani Little
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Strongbow Lone Eagle
Mandi MacDonald
Frank Manni
Scott Martin
Mariah Martirano
Erin Mccauley
Ann Metzger
Rebecca Miller
Patrick Mitchell
Anthony Morrissey
Rachel Morrissey
Heidi Norcross
Michelle Palermo
Amy Plude
Elizabeth Poller
Sachs Randi
Hailey Ranson
Cathy Renzulli Valente
Ted Roman
Terry Sachs
Cynthia Samokar
Joy Scozzafava
Alison Sherman
Makayla Showalter
Melissa Silva
Cathy Somer
Destiney Stackhouse
Leanne Pinedo Swanson
Nadine Tannous
Amanda Tarallo
Tyler Ulisse
Austin Ulisse
Noami Ulisse
Casey Villa
Miranda Villa
Brittany Waldron
Danielle Walker
Donovan Ward
Margaret Watt
Steven Wolf, MD, FACEP
Patricia Zelno
NATURE AND SOURCES OF OPPOSITION:
CT Association of Health Plans stated in the face of the growing opioid epidemic, health
insurance carriers have actively worked to provide expanded access to substance use
disorder treatment by eliminating copays for Narcan and by developing programs to ensure
early identification of inappropriate opioid prescription and potentially life-threatening drug
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interaction and opioid misuse and abuse. The carriers have worked with providers and digital
technology companies to enhance access to Medication Assisted Treatment developing
programs to better equip primary care providers with the necessary resources, focusing on
non-opioid pain management strategies and removing prior authorization for most FDA
approved forms of Medication Assisted Treatment.
Given the depth of the initiatives already underway, we would advise against putting in place
a statutory mandate as the standard of care may change with time.
Michelle Rakebrand, Asst Counsel, CBIA stated Mandates drive up costs because with
each new requirement, insurers must expand coverage to include additional services or
devices. This in turn increases the cost of health insurance premiums, and those increases
are passed directly onto enrollees. Each year, Connecticut residents pay an additional
$2,085.48 in premium costs because of the 68 health benefit mandates that are codified in
our states statutes. These increases are especially detrimental to small employers (defined
as under 50 FTE), who are not required to offer health insurance pursuant to the Affordable
Care Act, but choose to do so.
Reported by: Diane Kubeck Date: April 27,2020
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