OFFICE OF FISCAL ANALYSIS
Legislative Office Building, Room 5200
Hartford, CT 06106 (860) 240-0200
http://www.cga.ct.gov/ofa
HB-6003
AN ACT CONCERNING DIABETES AND HIGH DEDUCTIBLE
HEALTH PLANS.
As Amended by House "A" (LCO 3784), House "B" (LCO 3805)
OFA Fiscal Note
State Impact:
Agency Affected Fund-Effect FY 21 $ FY 22 $
Consumer Protection, Dept. GF Cost 12,000 None
Consumer Protection, Dept. GF - Potential Up to 50,000 Up to 15,000
Cost
Social Services, Dept. GF - Potential None 100,000
Cost
Note: GF=General Fund
Municipal Impact:
Municipalities Effect FY 21 $ FY 22 $
Various Municipalities STATE None See Below
MANDATE1
- Potential
Cost
Explanation
The bill as amended requires the Department of Social Services
(DSS) to develop a referral system for diabetes treatment, establishes
new reporting and prescription guidelines for pharmacies related to
diabetes, and caps the out-of-pocket cost for diabetes treatments under
most health insurance policies.
Section 1 could result in a cost to DSS in FY 22 associated with a
1State mandate is defined in Sec. 2-32b(2) of the Connecticut General Statutes, "state
mandate" means any state initiated constitutional, statutory or executive action that
requires a local government to establish, expand or modify its activities in such a
way as to necessitate additional expenditures from local revenues.
Primary Analyst: AN 7/23/20
Contributing Analyst(s): ME, ES
2020HB-06003-R01-FN.DOCX Page 2 of 3
program to refer individuals with diabetes to federally-qualified health
centers and other covered entities for treatment, regardless of health
coverage. If such a program is established, DSS would incur costs
associated with managing client information and referrals via a web
site to collect information from and provide information to each
individual in the state who has been diagnosed with diabetes. This
would result in increased contract costs of at least $100,000 to develop
the interactive website, as well as ongoing maintenance costs.
DSS may determine the program is better implemented by applying
for a federal section 1115 demonstration project, under which federal
Medicaid expenditures must be budget neutral.
There is no fiscal impact associated with the working group
established in this section.
Sections 2-8 list prescribing and reporting requirements for
pharmacies dispensing diabetes supplies or equipment and result in a
cost to the Department of Consumer Protection of $12,000 in FY 21 and
a potential cost of up to $50,000 in FY 21 and up to $15,000 annually
thereafter for upgrading and maintaining the Prescription Drug
Monitoring Program (PDMP) with the requirements in the bill.
The PDMP will be upgraded to add the pharmacist as a prescriber
which will cost $12,000 in FY 21. It will also be upgraded to track the
reporting of the dispensation of insulin or glucagon products and
medical devices associated with diabetes and has a potential cost of up
to $50,000 in FY 21 and up to $15,000 annually thereafter. The
potential cost is dependent on if the products and devices associated
with insulin and diabetes have National Drug Codes (NDC). If these
products and devices do not have NDC's funding will be required to
process them in the PDMP.
The diabetes cost-sharing requirements in the bill as amended are
not anticipated to result in a cost to the state employee and retiree
health plan or to municipalities which participate in the Partnership
Plan administered by the Office of the State Comptroller as the plans
2020HB-06003-R01-FN.DOCX Page 3 of 3
do not require cost sharing for diabetes related prescriptions or
services as defined in the bill, in excess of the limits. The state plan
and the Partnership Plans Health Enhancement Program (HEP) do not
require cost sharing for diabetes medication. While there are some
employees who are not currently enrolled in the HEP program, the
impact from non-HEP enrollees is not anticipated to materially impact
the plan as they represent less than 1% of the total covered population.
The bill as amended may result in a cost to fully-insured
municipalities who require cost sharing in excess of the bills limits.
The impact will be reflected in premiums for plan years effective on
and after January 1, 2022.
Pursuant to federal law self-insured plans are exempt from state
health mandates.
House "A" makes clarifying changes to section 3 of the bill as
amended and has no fiscal impact.
House "B" allows the Commissioner of Public Health to make
regulatory changes to reduce the spread of COVID-19 and to provide
telehealth services to residents and results in no fiscal impact.
The Out Years
The annualized ongoing fiscal impact identified above would
continue into the future subject to inflation.
The preceding Fiscal Impact statement is prepared for the benefit of the members of the General Assembly,
solely for the purposes of information, summarization and explanation and does not represent the intent of the
General Assembly or either chamber thereof for any purpose. In general, fiscal impacts are based upon a variety
of informational sources, including the analysts professional knowledge. Whenever applicable, agency data is
consulted as part of the analysis, however final products do not necessarily reflect an assessment from any
specific department.


Statutes affected:
New Bill: 20-571, 20-616