HB 6436 — AN ACT CONCERNING REVISIONS TO THE HEALTH INSURANCE STATUTES.

Substitute House ofBill Representatives General Assembly File No.

536436 JanuaryPublic Session,Act 2025 Substitute House Bill No.

643625-132 HouseAN ofACT Representatives,CONCERNING MarchREVISIONS 6,TO 2025THE TheHEALTH CommitteeINSURANCE onSTATUTES. Insurance and Real Estate reported through REP.

WOOD of the 29th Dist., Chairperson of the Committee on the part of the House, that the substitute bill ought to pass.

AN ACT CONCERNING REVISIONS TO THE HEALTH INSURANCE STATUTES.

Subsection (b) of section 38a-21 of the general statutes is repealedandthefollowingissubstitutedinlieuthereof(EffectiveOctoberrepealed andthefollowing issubstituted inlieuthereof(EffectiveOctober 1, 2025):

The commissioner shall deposit all paymentspaymentsmade made under thissection withtheState Treasurer.The moneys depositedshallbecreditedtotheInsuranceFundandshallbeaccounted for asexpensesrecovered frominsurance companies.Suchmoneysshall be expended by the commissioner to carry out the provisions of this section withand thesection State2 Treasurer.of public act 09-179.

TheSubstitute moneysHouse sHB6436Bill / File No.

536436 1(2) sHB6436The Filecommissioner No.[shall contract with The University of Connecticut Center forPublicHealthandHealthPolicy to conduct]may engage the services of any actuary, actuarial firm, quality improvement clearinghouse, health policy research organization or any other independent expert as the commissioner deems necessary to assist the commissioner in the review and evaluation of any mandated health benefit review requested pursuant to subsection (c) of this section.

53 depositedshallbecreditedtotheInsuranceFundandshallbeaccounted forasexpensesrecoveredfrominsurancecompanies.Suchmoneysshall be expended by the commissioner to carry out the provisions of this section and section 2 of public act 09-179.

(2) The commissioner [shall contract with The University of ConnecticutCenter for Public HealthandHealthPolicytoconduct] may engage the services of any actuary, actuarial firm, quality improvement clearinghouse, health policy research organization or any other independent expert as the commissioner deems necessary to assist the commissioner in the review and evaluation of any mandated health benefit review requested pursuant to subsection (c) of this section.

(1) The aggregate dollar amount of all rebates concerning drug formularies used by such health carriers that such manager collected from pharmaceutical manufacturers that manufactured outpatient prescription drugs that (A) were covered by such health carriers during such calendar year, and (B) are attributable to patient utilization of such sHB6436drugs /during Filesuch No.calendar year;

53and 2Public sHB6436Act File No.

5325-132 drugs2 duringof such4 calendarSubstitute year;House Bill No.

and6436 (2) The aggregate dollar amount of all rebates, excluding any portion of the rebates received by such health carriers, concerning drug formularies that such manager collected from pharmaceutical manufacturersthatmanufacturedoutpatientprescriptiondrugsthat(A) were covered by such health carriers during such calendar year, and (B) are attributable to patient utilization of such drugs by covered persons under such health care plans during such calendar year.

The report shall contain (1) an aggregation of the information submitted to the commissionerPublic pursuantAct to subsection (a) of this section for the sHB6436 / File No.

5325-132 3 sHB6436of File4 Substitute House Bill No.

536436 commissioner pursuant to subsection (a) of this section for the immediately preceding calendar year, and (2) such other information as the commissioner, in the commissioner's discretion, deems relevant for the purposes of this section.

(e) The commissioner may impose a penalty of not more than seven thousandfive hundred dollarsondollarsonapharmacy apharmacybenefitsmanagerforbenefitsmanager for each violation of this section.

ThisGovernor's actAction: shall take effect as follows and shall amend the following sections:

SectionApproved 1July October8, 1, 2025 38a-21(b)Public Sec.Act No.

225-132 from4 passageof 38a-479ppp4 Sec.

3 from passage 38a-492w(c) Sec.

4 from passage 38a-518w(c) sHB6436 / File No.

53 4 sHB6436 File No.

53 Statement of Legislative Commissioners:

In Section 1(b)(2), "said commissioner" was changed to "the commissioner", for accuracy.

INS Joint Favorable Subst.

-LCO sHB6436 / File No.

53 5 sHB6436 File No.

53 The following Fiscal Impact Statement and Bill Analysis are prepared for the benefit of the members of the General Assembly, solely for purposes of information, summarization and explanation and do 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 analyst’s 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.

OFA Fiscal Note State Impact:

None Municipal Impact:

None There is no fiscal impact to the state or municipalities anticipated from the bill.

Section 1 allows, instead of requires, the Insurance Department to engage third-party services for the review of mandated health benefits (including proposals), and it is anticipated the department will continue to seek such services.

Section 2 delays until FY 26 requirements regarding annual reporting concerning pharmacy benefits manager (PBM) rebates, which has no fiscal impact because the Insurance Department will use existing resources to complete its report.

The bill makes other procedural changes which have no fiscal impact.

The Out Years State Impact: