HB 7192 — AN ACT IMPLEMENTING RECOMMENDATIONS OF THE BIPARTISAN DRUG TASK FORCE.

(6) One appointed by the minority leader of the Senate;

(10) The Commissioner of Public Health,Act orNo. the commissioner's designee;

25-167 5 of 24 Substitute House Bill No.

7192 (10) The Commissioner of Public Health, or the commissioner's designee;

and (13) The Commissioner of Economic and Community Development, or the commissioner's designee.designee;

and (14) Any other members as deemed necessary by the chairpersons of the task force.

Such chairpersons shall schedule sHB7192thefirst /meeting Fileofthe No.task force, whichshall beheld not later thansixty days after the effective date of this section.

916 6 sHB7192 File No.

916 thefirst meeting ofthe task force, whichshall beheld not later thansixty days after the effective date of this section.

(g) Not later than January 1, 2026, and annually thereafter, the task force shall submit a report on its findings and recommendations to the joint standing committees of the General Assembly having cognizance of matters relating to general law, human services, insurance and real estatePublic andAct publicNo. health, in accordance with the provisions of section 11- 4a of the general statutes, including, but not limited to, identification of prescription drugs the task force determines are at risk of shortage and strategies that would mitigate these shortages, including methods to increase in-state production of such drugs deemed both at risk of shortage and critically necessary for the provision of health care within the state.

25-167 6 of 24 Substitute House Bill No.

7192 estate and public health, in accordance with the provisions of section 11- 4a of the general statutes, including, but not limited to, identification of prescription drugs the task force determines are at risk of shortage and strategies that would mitigate these shortages, including methods to increase in-state production of such drugs deemed both at risk of shortage and critically necessary for the provision of health care within the state.

(NEW) (Effective July 1, 2025) (a)The AsCommissioner usedof inEconomic thisand section,Community "StrategicDevelopment Supplymay Chainutilize Initiative"bond meansproceeds apursuant programto administeredsection by32-235 of the Departmentgeneral ofstatutes Economicto andsupport Communityprescription Developmentdrug toproduction helpcapacity state-basedin companiesthe state, provided the commissioner may give preference to increasefinancial theirassistance productionapplications capacitythat incorporate recommendations by the task force established pursuant to winsection new5 businessof andthis attractact out-of-stateto andprevent internationalor supplymitigate chainprescription operations.drug shortages.

(b)Sec. The Commissioner of Economic and Community Development shall expand the Strategic Supply Chain Initiative to include efforts to prevent or mitigate prescription drug shortages, including, but not limited to, incorporating recommendations to prevent or mitigate prescription drug shortages by the task force established pursuant to section 5 of this act.

This7. act shall take effect as follows and shall amend the following sections:

Section(Effective 1from Octoberpassage) (a) Not later than July 1, 20252025, Newthe sectionchairpersons sHB7192of /the Filejoint No.standing committee of the General Assembly having cognizance of matters relating to insurance, or their designees, shallconvenea working groupto study andmake recommendationsfor legislation related to the compensation of pharmacists licensed under chapter 400j of the general statutes, who provide certain health care services, including, but not limited to, vaccine administration, HIV- related tests, influenza-related tests and the prescribing of contraceptive devices or products approved by the federal Food and Drug Administration.

916For 7the sHB7192purposes Fileof this section, (1) "chain pharmacy" means any community pharmacy that is publicly traded or has not less than six stores located in this state, (2) "HIV-related test" and "influenza- related test" have the same meanings as provided in section 20-633f of the general statutes, (3) "independent pharmacy" means any privately owned pharmacy that has not more than five stores located in this state, (4) "pharmacist" has the same meaning as provided in section 20-571 of the general statutes, and (5) "pharmacy benefits manager" has the same Public Act No.

91625-167 Sec.7 of 24 Substitute House Bill No.

27192 Januarymeaning 1,as 2026provided 38a-477ccin Sec.section 38a-479aaa of the general statutes.

3(b) OctoberThe 1,working 2025group 38a-479tttconvened Sec.pursuant to subsection (a) of this section shall consist of the following members:

4(1) JulyThe 1,chairpersons 2025of Newthe sectionjoint Sec.standing committee of the General Assembly having cognizance of matters relating to insurance, or their designees;

5(2) fromThe passageranking Newmembers sectionof Sec.the joint standing committee of the General Assembly having cognizance of matters relating to insurance, or their designees;

6(3) JulyThe 1,Insurance 2025Commissioner, Newor sectionthe APPcommissioner's Jointdesignee; Favorable Subst.

sHB7192(4)The /Commissioner FileofConsumer No.Protection,orthecommissioner's designee;

916(5) 8One sHB7192pharmacist Filelicensed No.under chapter 400j of thegeneralstatutes who is employed by any independent pharmacy;

916(6) TheOne followingpharmacist Fiscallicensed Impactunder Statementchapter and400j Bill Analysis are prepared for the benefit of thethegeneralstatutes memberswho ofis theemployed Generalby 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.chain pharmacy;

In(7) general,One fiscalpharmacist impactslicensed areunder basedchapter upon400j aof varietythegeneralstatutes ofwho informationalis sources,employed includingby theany analyst’shealth professionalsystem knowledge.pharmacy;

Whenever(8) applicable,One agencyrepresentative data is consulted as part of theany analysis,organization howeverrepresenting finalpharmacy productsbenefits domanagers; not necessarily reflect an assessment from any specific department.

OFA(9) FiscalOne Noterepresentative Stateof Impact:any health insurance company doing business in this state;

Agency(10) AffectedOne Fund-Effectrepresentative FYof 26any $pharmaceutical FYcompany 27doing $business Treasurer,in Debtthis Serv.state;

GF(11) -One Potentialfaculty Seemember Belowof Seea Belowschool Costof Note:pharmacy in this state;

GF=GeneralPublic FundAct MunicipalNo. Impact:

None25-167 Explanation8 Theof bill24 makesSubstitute variousHouse prescriptionBill drugNo. and health care related changes which are noted below.

Sections7192 1(12) -One 4representative makeof numerousa changessmall thatemployer result in nothis fiscalstate impactthat toemploys theless Insurancethan Department.fifty employees;

The(13) billOne makesrepresentative severalof changesa regardinglarge pharmacyemployer benefitsin managersthis (PBMs)state andthat rebateemploys practicesmore ofthan healthone carriers,hundred andemployees; health carrier reporting on these topics.

No(14) fiscalOne impactrepresentative isof expected, as the departmentConnecticut doesHealth notInsurance anticipateExchange; a meaningful increase in workload and compliance by PBMs and health carriers is expected.

Section 5 establishes a task force to study emergency preparedness and mitigation(15) strategiesAny forother prescriptionmembers drugas shortagesdeemed resultingnecessary inby no fiscal impact to the statechairpersons becauseof the taskjoint forcestanding hascommittee of the expertiseGeneral toAssembly meethaving thecognizance requirements of thematters bill.relating to insurance.

Section(c) 6All expandsinitial theappointments Strategicto Supplythe Chainworking Initiativegroup program,shall whichbe ismade fundednot bylater Generalthan Obligationthirty (GO)days bondafter funds,the toeffective includedate effortsof tothis preventsection. or mitigate prescription drug shortages.

FutureAny Generalvacancy Fundshall debt service costs may be incurredfilled soonerby under the billappointing toauthority. the degree that it causes authorized GO bond funds to sHB7192 / File No.

916(d) 9Working sHB7192group Filemembers No.shall be appointed by the chairpersons of the joint standing committee of the General Assembly having cognizance of matters relating to insurance.

916The beadministrative expendedstaff moreof rapidlythe thanjoint theystanding otherwisecommittee wouldof havethe been.General Assembly having cognizance of matters relating to insurance shall serve as administrative staff of the working group.

As(e) ofNot Maylater than February 1, 2025,2026, therethe isworking $25group millionshall insubmit previouslya allocatedreport bondon fundsits fromfindings theand Manufacturinglegislative Assistancerecommendations Actto programthe thatjoint havestanding beencommittee setof asidebythe theDepartmentGeneral ofEconomicandAssembly Communityhaving Developmentcognizance of matters relating to fundinsurance, in accordance with the Strategicprovisions Supplyof Chainsection Initiative11-4a program.of the general statutes.

The billworking doesgroup notshall changeterminate GOon bondthe authorizationsdate relevantthe toworking thegroup program.submits such report or February 1, 2026, whichever is later.

TheSec. Out Years The annualized ongoing fiscal impact identified above would continue into the future subject to the terms of any bonds issued.

sHB71928. / File No.

916(NEW) 10(Effective sHB7192July File1, No.2026) (a) As used in this section:

916(1) OLR"Enrollee" Billhas Analysisthe sHBsame 7192meaning ANas ACTprovided IMPLEMENTINGin RECOMMENDATIONSsection OF38a-478 THEof BIPARTISANPublic DRUGAct TASKNo. FORCE.

SUMMARY25-167 This9 billof makes24 variousSubstitute changesHouse relatedBill toNo. prescription drugs, pharmacy benefits managers (PBMs), health carriers, and other related matters.

Specifically,7192 the billgeneral doesstatutes; the following:

1.(2) "Health benefit plan" has the same meaning as provided in section 38a-472f of the general statutes;

specifiesand that(3) PBMs"Health owecarrier" ahas fiduciarythe dutysame tomeaning healthas carriersprovided orin othersection health38a- plan591a sponsorsof and generally prohibits carrier contracts from allowing or requiring a party to violate the carrier’sgeneral fiduciarystatutes. duty to insureds (§ 1);

2.(b) Each insurer, health care center, hospital service corporation, medical service corporation, fraternal benefit society or other entity that delivers, issues for delivery, renews, amends or continues an individual or a group health insurance policy or health benefit plan in this state on or after January 1, 2026, providing coverage of the type specified in subdivisions (1), (2), (4), (11) and (12) of section 38a-469 of the general statutes in this state, shall, when calculating an insured's or enrollee's in-network liability for such insured's or enrollee's annual coinsurance, copayment, deductible or other in-network out-of-pocket expense, give credit for any out-of-pocket expense such insured or enrollee pays directly to any pharmacy licensed pursuant to section 20-594 of the general statutes, or health care provider licensed in this state, for any prescription drug, provided (1) no claim for such prescription drug was submitted to such insurer, center, corporation, society or other entity, and (2) such out-of-pocket expense paid by such insured or enrollee to such pharmacy or health care provider is less than the average discounted rate for such prescription drug paid to an in-network health care provider pursuant to the terms of such health insurance policy or health benefit plan.

prohibits(c) certainIf provisionsany ininsured pharmacyor servicesenrollee contracts,purchases sucha asprescription thosedrug allowingfrom aany PBMout-of-network tohealth chargecare provider for a healthlower planamount athan contractedthe priceaverageamountpaidbysuchinsured'sorenrollee'shealthcarriertoany thatin-network differshealth fromcare whatprovider for the PBMsame paysprescription thedrug, pharmacysuch health carrier, when calculating such insured's or enrollee's liability for thesuch servicesinsured's (§or 2);enrollee's in-network annual coinsurance, copayment, Public Act No.

3.25-167 10 of 24 Substitute House Bill No.

expands7192 thedeductible contentsor ofother theout-of-pocket insuranceexpense, commissioner’sshall annualgive reportcredit onfor such purchase, provided such insured or enrollee provides such health carrier rebateswith toproof includeof certainpayment informationfor onsuch howprescription rebatesdrug affectedin costaccordance sharingwith (§the 3);provisions of subsection (d) of this section.

4.Nothing in this subsection shall be construed to restrict any health insurance policy or health benefit plan from requiring a prior authorization or precertification otherwise provided for in the insured's or enrollee's health insurance policy or health benefit plan.

requires(d) theEach insurancehealth commissionercarrier toshall require(1) carriersdevelop toa annuallyproof reportof payment form and publish such form on pricingsuch offeredhealth to,carrier's Internet web site for insureds and profitenrollees generatedto between,submit theproof carrierof andpayment for any PBMout-of-network prescription drug purchase pursuant to subsection (c) of this section, and (2) annually provide to such insureds and enrollees written notice of, and instructions for downloading or mail-orderelectronic pharmacysubmission (§of, 4);such proof of payment form.

5.(e)Uponreceipt ofany such proofofpayment formsubmitted by any insuredor enrollee pursuant to subsection(d) ofthissection,eachhealth carrier shall give credit for any out-of-pocket payments that such insured or enrollee paid to any out-of-network pharmacy or health care provider in accordance with the provisions of subsection (c) of this section, provided (1) the prescription drug purchased by such insured or enrollee is included under such insured's or enrollee's health insurance policy or health benefit plan, and (2) such insured or enrollee purchased such prescription drug for a lower price than the average amount paid by such insured or enrollee's health carrier to an in- network health care provider for the same prescription drug.

creates(f) aThe 15-membertotal taskamount forcecredited toward any insured's or enrollee's annual coinsurance, copayment, deductible or other out-of-pocket expense pursuant to studysubsection prescription(e) drugof shortagethis preparednesssection andshall mitigationnot (§(1) 5);exceed the total amount that such insured or enrollee is required to pay out-of- pocket under the terms of the health insurance policy or health benefit Public Act No.

and25-167 6.11 of 24 Substitute House Bill No.

requires7192 theplan Departmentduring ofa Economicpolicy period, and Community(2) sHB7192carry /over Fileto No.a new policy period.

916Sec. 11 sHB7192 File No.

9169. Development (DECD) to incorporate prescription drug shortage prevention or mitigation into its Strategic Supply Chain Initiative (§ 6).

EFFECTIVE(Effective DATE:July 1, 2025) For the purposes of this section and sections 10 to 18, inclusive, of this act, unless the context otherwise requires:

Various;(1) "Canadian supplier" means a manufacturer or wholesale drug distributor that is licensed or permitted under applicable Canadian law to manufacture or distribute prescription drugs;

see(2) below."Canadian prescription drug importation program" or "program" means a program under which the state would seek federal approval to import prescription drugs from Canada that have the highest potential for cost savings in the state;

§(3) 1"Department" —means PHARMACY BENEFITS MANAGER FIDUCIARY DUTY AND HEALTH CARRIER CONTRACTS The bill specifies that PBMs owe a fiduciary duty to heath carriers (e.g., insurers) or other health benefit plan sponsors (in other words, have the legalDepartment dutyof toConsumer actProtection; in the carriers’ or sponsors’ interests).

It(4)"Drug"meansanarticlethatis(A)recognizedintheofficialUnited alsoStates specifiesPharmacopoeia, thatofficial PBMsHomeopathic havePharmacopoeia anof obligationthe ofUnitedStatesor goodofficialNationalFormulary,or faithany andsupplement fairthereto, dealing(B) intended for use in performingthe theirdiagnosis, dutiescure, withmitigation, alltreatment parties,or includingprevention carriersof disease in humans, (C) not food and intended to affect the structure or otherany planfunction sponsorsof theythe interacthuman withbody, and (D) not a device and intended for use as a component of any article specified in performingsubparagraphs their(A) pharmacyto benefit(C), managementinclusive, services.of this subdivision;

Under(5) the"Drug bill,Quality aand PBMSecurity mustAct" notifymeans the carrierfederal orDrug otherQuality planand sponsor,Security inAct, writing,21 ifUSC any351, ofet theseq., PBM’sas activities,amended policies,from ortime practicesto directlytime; or indirectly present a conflict of interest with its duties under the bill.

The(6) bill"Food, alsoDrug prohibitsand anyCosmetic healthAct" carriermeans contractsthe enteredfederal intoFood, orDrug amendedand afterCosmetic OctoberAct, 1,21 2025,USC from301, allowinget orseq., requiringas aamended partyby tothe violateDrug theQuality fiduciaryand dutySecurity thatAct, theas carrierboth owesmay tobe itsamended coveredfrom personstime (i.e.to time;

insureds).(7) "Qualifying laboratory" has the same meaning as provided in 21 CFR 251.2;

ThisPublic appliesAct despiteNo. any contrary provisions in the state’s insurance laws and to the maximum extent allowed by law.

Under25-167 the12 bill, a violation of any24 ofSubstitute theseHouse provisionsBill isNo. an unfair insurance practice (see BACKGROUND).

The7192 bill(8) allows"Laboratory testing" means a quantitative and qualitative analysis of a drug consistent with the insuranceapplicable commissionerprovisions toof adoptthe implementingofficial regulations.United States Pharmacopoeia;

EFFECTIVE(9) DATE:"Participating Canadian supplier" means a Canadian supplier that is exporting prescription drugs, in the manufacturer's original container, to a participating wholesaler for distribution in this state under the program;

October(10) 1,"Participating 2025wholesaler" §means 2a —wholesaler PHARMACYthat SERVICESis CONTRACTS(A) Startingdesignated Januaryby 1, 2026, the billDepartment prohibitsof aConsumer pharmacyProtection servicesto contractdistribute betweenprescription adrugs pharmacistin orthe pharmacymanufacturer's andoriginal healthcontainer, carrierobtained or PBM from allowinga theparticipating PBMCanadian tosupplier, chargeand an(B) in-stateparticipating healthin benefitthe planprogram; a sHB7192 / File No.

916(11) 12"Recall" sHB7192means Filea No.person's removal or correction of a marketed product that the department determines is in violation of this section, but "recall" does not include a market withdrawal or a stock recovery, as such terms are defined in 21 CFR 7.3;

916(12) contracted"Relabeler" pricehas for any pharmacy services that differs from what the PBMsame paysmeaning theas pharmacyprovided (directlyin or21 indirectly)CFR for207.1; these services (sometimes called a “spread pricing” arrangement).

It(13) further"Repacker" prohibitshas these contracts from allowing the PBMsame tomeaning chargeas aprovided healthin benefit21 plan,CFR directly207.1; or indirectly, a fee that depends on any of the following:

1.(14) "Track-and-trace" means the product tracing process for the components of the pharmaceutical distribution supply chain as described in Title II of the Drug Quality and Security Act;

and (15) "Wholesaler" means a prescriptionwholesaler, drug’sas wholesaledefined acquisitionin costsection or21a-70 anotherof pricethe metricgeneral forstatutes, thesethat drugs;has received a certificate of registration from the Commissioner of Consumer Protection pursuant to said section.

2.Sec.

the10. amount of savings, rebates, or other fees charged, collected, or generated based on the PBM’s business practices;

or(Effective 3.July 1, 2025) The Commissioner of Consumer Protection shall hire, within available resources, a consultant to study the feasibility of establishing a Canadian prescription drug importation Public Act No.

the25-167 amount13 of charged24 premiumsSubstitute orHouse cost-sharingBill requirementsNo. under the plan that the PBM collects from covered persons.

As7192 underprogram existingto lawreduce forprescription prohibiteddrug provisionscosts in thesethe contracts:state.

1.Not later thansix months after the date of final execution of a consultant contract with the Department ofConsumer Protection,theconsultant shallrecommendto the commissioner whether it is more likely than not that a prescription drug importation program is feasible and will result in cost savings to the state.

anyIf contractthe provisionconsultant thatdetermines violatessuch program is not likely to result in a significant cost savings, the billconsultant isshall voidprovide a written justification for such determination and unenforceable,may butcommence aprovisionrenderedinvalidora unenforceablefeasibility doesreviewofCanadianprescriptiondrug notprice affectbenchmarking;anddevelop remainingpolicy provisions;recommendations for implementing an upper payment limit for prescription drugs in the state based on the Canadian price benchmarking.

2.Not later than October 1, 2027, the commissioner shall file a report, in accordance with the provisions of section 11-4a of the general statutes, with the joint standing committees of the General Assembly having cognizance of matters relating to appropriations and the budgets of state agencies, general law and human services and the Office of Policy and Management on the results of the feasibility study.

anySec. general business practice that violates the bill’s provisions is an unfair trade practice under the Connecticut Unfair Trade Practices Act (CUTPA, see BACKGROUND);

and11. 3.

(Effective October 1, 2027) (a) If after completion of the insurancestudy commissionerdescribed mayin enforcesection 10 of this act, the bill’sCommissioner provisionsof and,Consumer uponProtection, request,in auditconsultation pharmacywith servicesthe contractsSecretary of the Office of Policy and Management, determines a Canadian prescription drug importation program is feasible, the Commissioner of Consumer Protection may submit a request to the federal Food and Drug Administration seeking approval for compliance.the program under Section 804 of the federal Food, Drug and Cosmetic Act, 21 USC 384(b) to 21 USC 384(h), inclusive, as amended from time to time.

EFFECTIVEIf DATE:submitted, such request shall, at a minimum:

January(1) 1,Describe 2026the §state's 3plans —for HEALTHoperating CARRIERthe REBATEprogram ANNUALand REPORTINGdescribe Existingany lawopportunities requires the insurance commissioner to annuallycoordinate reportor onoperate health carrier rebate practices for the priorprogram yearin andcoordination publishwith theother reportstates; on the department’s website.

The(2) billDemonstrate expandsthat theany requiredprescription contentsdrug ofthat thisis reportimported toand includePublic theAct (1) percentage of rebate dollars sHB7192 / File No.

91625-167 1314 sHB7192of File24 Substitute House Bill No.

9167192 healthdistributed carriersin usedthis tostate reduceunder cost-sharingthe requirementsprogram andwould: (2) an evaluation of rebate practices to reduce cost-sharing for health care plans delivered, issued, renewed, amended, or continued.

Under(A) existinglaw,Meet thereportmustall include(1)applicable anexplanationofhowfederal carriers accounted for rebates when calculating premiums, (2) a statement disclosing whether and howstate carriersstandards madefor rebatessafety available to insureds at the point of purchase, (3) any other way carriers applied rebates, and (4)effectiveness; any other information the commissioner deems relevant.

EFFECTIVEand DATE:(B) Comply with all federal tracing procedures;

Octoberand 1,(3) 2025State § 4 — HEALTH CARRIER PRICING AND PROFIT REPORTING REQUIREMENTS Under the bill,estimated thecosts insuranceof commissionerimplementing must require health carriers to annually report on pricing offered to, and profit generated between, the carrierprogram. and any PBM or mail-order pharmacy doing business in Connecticut.

The(b) commissionerIf mustthe postfederal aFood linkand toDrug theseAdministration reportsapproves onthe request, the department’sCommissioner website.of Consumer Protection shall:

EFFECTIVE(1) DATE:Submit to the Secretary of the Office of Policy and Management, and the Commissioners of Social Services and Health Strategy, a notice disclosing that the federal Food and Drug Administration approved such request;

Julyand 1,(2) 2025Submit §to 5the —joint PRESCRIPTIONstanding DRUGcommittees SHORTAGESof TASKthe FORCEGeneral TheAssembly billhaving createscognizance anofmattersrelatingtoappropriationsandthebudgets ongoingof taskstate forceagencies, togeneral studylaw, emergencyhuman preparednessservices and mitigationpublic strategieshealth fora prescriptionnotice drugdisclosing shortages.that the federal Food and Drug Administration approved such request.

(c) The taskCommissioner force must identify drugs at risk of shortageConsumer inProtection thisshall statenot andoperate recommendthe waysprogramunlessthefederalFoodandDrugAdministrationapprovesthe torequest. address that (see below).

EFFECTIVENotwithstanding DATE:the foregoing, the department may expend resources in advance of such approval to ensure efficient implementation.

UponSec. passage Task Force Members, Administration, and Reporting Requirement The task force includes eight members appointed by the legislative leaders, as shown in the following table.

Appointees12. may be legislators.

Table:(Effective October 1, 2027) If the Canadian prescription drug importation program is established, each participating wholesaler may import and distribute a prescription drug in this state from a participating Canadian supplier under the program if:

Task(1) ForceSuch Appointeddrug Membersmeets Appointingthe Authorityfederal AppointeeFood Qualificationsand HouseDrug speakerAdministration's •standards Expertconcerning in prescription drug supplysafety, chainseffectiveness, sHB7192misbranding /and FilePublic Act No.

91625-167 1415 sHB7192of File24 Substitute House Bill No.

9167192 Appointingadulteration; Authority Appointee Qualifications • Expert in federal law on prescription drug shortages Senate president pro • Representative of hospitals tempore • Representative of providers who treat patients with rare diseases House majority leader • Representative of the Mohegan or Mashantucket Pequot tribes Senate majority leader • Representative of the Mohegan or Mashantucket Pequot tribes House minority leader • Unspecified qualifications Senate minority leader • Unspecified qualifications The task force also includes the following seven officials or their designees:

the(2) DepartmentImporting ofsuch Consumerdrug Protectionwould (DCP),not DECD,violate healthfederal strategy,patent insurance,laws; public health, and social services commissioners and UConn Health Center’s chief executive officer.

Appointingand authorities(3) mustSuch makedrug theiris initialnot: appointments within days after the bill’s passage and fill any vacancy.

The(A) HouseA speakercontrolled andsubstance, Senateas presidentdefined proin tempore21 mustUSC select802, theas taskamended force chairpersons from amongtime itsto members.time;

The(B) chairpersonsA mustbiological scheduleproduct, andas holddefined thein first42 meetingUSC within262, 60as daysamended afterfrom thetime bill’sto passage.time;

The(C) GeneralAn Lawinfused Committee’sdrug; administrative staff serves in that capacity for the task force.

The(D) billAn requiresintravenously theinjected taskdrug; force, starting by January 1, 2026, to annually report its findings and recommendations to the General Law, Human Services, Insurance and Real Estate, and Public Health committees.

The(E) reportsA mustdrug identify (1) those drugs the task force determines are at risk of shortage and (2) strategies to mitigate these shortages, including ways to increase in-state production of drugs that areis atinhaled riskduring ofsurgery; shortage and critically necessary for health care in the state.

§or 6(F) —A STRATEGICdrug SUPPLYthat CHAINis INITIATIVEa ThebillrequirestheDECDcommissionertoexpandthedepartment’sparenteral StrategicSupplyChainInitiativetoincludeeffortstopreventormitigatedrug, prescriptionthe drugimportation shortages.of which is determined by the federal Secretary of Health and Human Services to pose a threat to the public health.

ThisSec. must include incorporating the task sHB7192 / File No.

91613. 15 sHB7192 File No.

916(Effective force’sOctober recommendations1, (see2027) §If 5).a Canadian prescription drug importation program is established, participating wholesalers may, subject to the provisions of sections 9 to 12, inclusive, and sections 14 to 18, inclusive, of this act, import and distribute drugs in this state from a participating Canadian supplier under the program to:

Under(1) theA bill,pharmacy theor initiativeinstitutional ispharmacy, aas DECD-administereddefined programtoin helpsection state-based20- companiesof increasethe theirgeneral productionstatutes; capacity to win new business and attract out-of-state and international supply chain operations.

EFFECTIVEand DATE:(2) A qualifying laboratory.

JulySec. 1, 2025 BACKGROUND Connecticut Unfair Insurance Practices Act The law prohibits engaging in unfair or deceptive acts or practices in the business of insurance.

It14. authorizes the insurance commissioner to conduct investigations and hearings, issue cease and desist orders, impose fines, revoke or suspend licenses, and order restitution for per se violations (i.e.

violations(Effective specificallyOctober listed1, in2027) statute).If a Canadian prescription drug importation program is established, the Commissioner of Consumer Protection shall require that each participating Canadian supplier and participating wholesaler (1) comply with all applicable track-and-trace Public Act No.

The25-167 law16 alsoof allows24 theSubstitute commissionerHouse toBill askNo. the attorney general to seek injunctive relief in Superior Court if he believes someone is engaging in other unfair or deceptive acts not specifically defined in statute.

Fines7192 mayrequirements, beand upshall tonot (1)distribute, $5,000dispense peror violationsell outside of this state any prescription drug that is imported into this state under the program, and (2) make available to athe $50,000commissioner maximumall ortrack-and-trace (2)$25,000perviolationtoa$250,000maximuminanysix-monthperiodrecords ifnot later than forty-eight hours after the violationcommissioner wasrequests knowinglysuch committed.records.

TheSec. law also imposes a fine of up to $50,000, in addition to or in place of a license suspension or revocation, for violating a cease and desist order (CGS §§ 38a-815 to - 819).

Connecticut15. Unfair Trade Practices Act By law, CUTPA prohibits businesses from engaging in unfair and deceptive acts or practices.

It(Effective allowsOctober the1, DCP2027) commissioner,(a) underA specifiedparticipating procedures,wholesaler toin issueany regulationsapproved definingCanadian anprescription unfairdrug tradeimportation practice,program investigateshall complaints,ensure issuethe ceasesafety and desistquality orders,of orderall restitutiondrugs inthat casesmay involvingbe lessimported thanand $10,000,distributed imposein civilthis penaltiesstate ofunder up to $5,000, enter into consent agreements, ask the attorneyprogram. general to seek injunctive relief, and accept voluntary statements of compliance.

ItThe alsoparticipating allowswholesaler individualsshall, toif sue.such program is established:

Courts(1) mayFor issueeach restraininginitial orders;shipment of a drug that is imported into this state by a participating wholesaler, ensure that a qualifying laboratory engaged by theparticipating wholesaler testsastatistically validsample size for each batch of each drug in such shipment for authenticity and degradation in a manner that is consistent with the Food, Drug and Cosmetic Act;

award(2) actualFor each shipment of a drug that is imported into this state by a participating wholesaler and punitivehas damages,been costs,sampled and reasonabletested attorney’spursuant sHB7192to /subdivision File(1) No.of this subsection, ensure that a qualifying laboratory engaged by theparticipating wholesaler tests astatistically validsample of such shipment for authenticity and degradation in a manner that is consistent with the Food, Drug and Cosmetic Act;

916(3) 16Only sHB7192import Filedrugs No.into this state that are (A) approved for marketing in the United States, (B) not adulterated or misbranded, and (C) meet all of the labeling requirements under 21 USC 352, as amended from time to time;

916(4) fees;Maintain qualifying laboratory records, including, but not limited to, complete data derived from all tests necessary to ensure that each drug imported into this state under any approved Canadian Public Act No.

and25-167 impose17 civil penalties of up24 toSubstitute $5,000House forBill willfulNo. violations and up to $25,000 for a restraining order violation.

Legislative7192 Historyprescription Thedrug Houseimportation referredprogram theis billin (Filecompliance 414)with to the Appropriationsrequirements Committee,of whichthis reportedsection; a substitute that eliminated provisions on a Canadian prescription drug importation program.

Relatedand Bill(5) sSBMaintain 11documentation (Filedemonstrating 420),that §§the 16,testing 23-25,required &by 36-37,this favorablysection reportedwas byconducted at a qualifying laboratory in accordance with the HumanServicesandJudiciarycommittees,hasprovisionssimilartothisFood, bill.Drug and Cosmetic Act and all other applicable federal and state laws and regulations concerning qualifying laboratory qualifications.

COMMITTEE(b) ACTIONThe Humanparticipating Serviceswholesaler Committeeshall Jointmaintain Favorableall Yeainformation 19 Nay 3 (03/13/2025) Insurance and Realdocumentationpursuanttothissectionforaperiodofnotlessthanthree Estateyears Committeefrom Jointthe Favorabledate Yeaof 8submission Nayof 5such (04/15/2025)information Appropriationsand Committeedocumentation Jointto Favorablethe Substituteparticipating Yeawholesaler 44by Naya 6qualifying (05/05/2025)laboratory. sHB7192 / File No.

916(c) 17Each participating wholesaler shall maintain all of the following information for each drug that such participating wholesaler imports and distributes in this state under the program, and submit such information to the Commissioner of Consumer Protection upon request by the commissioner:

(1) The name and quantity of the active ingredient of such drug;

(2) A description of the dosage form of such drug;

(3) The date on which such participating wholesaler received such drug;

(4) The quantity of such drug that such participating wholesaler received;

(5) The point of origin and destination of such drug;

(6) The price paid by such participating wholesaler for such drug;

(7) A report regarding any drug that fails qualifying laboratory Public Act No.

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7192 testing;

and (8) Such additional information and documentation that the commissioner deems necessary to ensure the protection of the public health.

(d) The Commissioner of Consumer Protection shall require each participating Canadiansupplier inany approvedCanadianprescription drug importation program to maintain the following information and documentation and, upon request by the commissioner, submit such information and documentation to the commissioner for each drug that such participating Canadian supplier exports into this state under the program:

(1) The original source of such drug, including, but not limited to:

(A) The name of the manufacturer of such drug;

(B) The date on which such drug was manufactured;

and (C) The location where such drug was manufactured;

(2) The date on which such drug was shipped;

(3) The quantity of such drug that was shipped;

(4) The quantity of each lot of such drug originally received and the source of such lot;

(5) The lot or control number and the batch number assigned to such drug by the manufacturer;

and (6) Such additional information and documentation that the Commissioner of Consumer Protection deems necessary to ensure the protection of the public health.

Sec.16.(EffectiveOctober1,2027)(a)IftheCommissionerofConsumer Public Act No.

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7192 Protection determines that public health, safety or welfare requires emergency action, the commissioner may order a participating Canadian supplier, participating wholesaler, relabeler, repacker and qualifying laboratory to cease and desist from actions specified in the order that create the need for such emergency action pending administrative proceedings.

Such cease and desist order shall be (1) in writing;

(2) signed by the Commissioner of Consumer Protection;

and (3) effective upon delivery to the respondent.

An administrative proceeding conducted in accordance with chapter 54 of the general statutes shall be promptly instituted following a cease and desist order.

The commissioner may impose a civil penalty, in an amount not to exceed five thousand dollars, after a hearing conducted pursuant to chapter 54 of the general statutes.

(b) The commissioner may require the recall, embargo or destruction, pursuant to section 21a-96 of the general statutes, of any drug that was imported and distributed under the program and has been identified as adulterated, within the meaning of section 21a-105 of the general statutes, or misbranded.

(c) In the event of a cease and desist, recall, embargo or destruction order, the person adversely impacted by such order shall provide written notice to all other businesses participating in the program, informing them of the order.

Sec.

17.

(Effective October 1, 2027) If a Canadian prescription drug importation program is established, the Commissioner of Consumer Protection may adopt regulations in accordance with the provisions of chapter54ofthegeneralstatutestoimplementtheprovisionsofsections to 16, inclusive, and section 18 of this act.

Sec.

18.

(Effective October 1, 2027) Not later than one hundred eighty daysafterthefirstimportationofanyCanadianprescriptiondrugunder the importation program begins, and biannually thereafter, the Public Act No.

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7192 Commissioner of Consumer Protection shall submit a report, in accordance with the provisions of section 11-4a of the general statutes, to the joint standing committees of the General Assembly having cognizanceofmattersrelatingtoappropriationsandthe budgetsofstate agencies, general law, human services and public health.

Such report shall describe (1) the operation of the program, if established, and (2) any violation of sections 9 to 17, inclusive, of this act that resulted in any action taken by the commissioner pursuant to section 16 of this act and the status of the investigation into such violation.

Sec.

19.

(NEW) (Effective July 1, 2025) (a) As used in this section and sections 20 and 21 of this act, "drug purchasing agency" means the Judicial Branch and the Department of Mental Health and Addiction Services, Children and Families, Developmental Services or Public Health.

Except as provided in subsection (c) of this section, the Department of Administrative Services shall negotiate bulk prices for prescription drugs on behalf of drug purchasing agencies with the goal of purchasing such drugs at lower prices than the prices of such drugs purchased by a single drug purchasing agency.

(b) In purchasing drugs at bulk prices pursuant to this section, a drug purchasing agency may enter into a compact with officials in other states to increase the state's purchasing power in negotiations with pharmaceutical companies.

(c) A drug purchasing agency may negotiate its own drug prices upon demonstrating to the Commissioner of Administrative Services that it is able to purchase such drugs at a cheaper price than the state's bulk pricing agreements, or if operational conditions require.

Such demonstration shall be made in writing.

(d) Not later than February 1, 2026, the Commissioner of Administrative Services, or the commissioner's designee, shall file a report, in accordance with the provisions of section 11-4a of the general Public Act No.

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7192 statutes, with the joint standing committees of the General Assembly having cognizance ofmattersrelatingtoappropriationsandthebudgets of state agencies, general law, human services and public health on any savings realized from bulk purchases of prescription drugs pursuant to subsection (a) of this section.

Sec.

20.

(NEW) (Effective July 1, 2025) (a) As used in this section, (1) "maximum fair prices" means the prices negotiated by the Centers for Medicare and Medicaid Services for certain prescription drugs under the Inflation Reduction Act, P.L.

117-69, and (2) "drug purchasing agency" has the same meaning as provided in section 19 of this act.

A drug purchasing agency may incorporate as a guiding price in the negotiations with a pharmaceutical drug manufacturer, the maximum fair prices in any negotiation with a pharmaceutical drug manufacturer to supply prescription drugs for health care programs subsidized by the state.

(b) In purchasing drugs at bulk prices pursuant to section 19 of this act or maximum fair prices pursuant to this section, a drug purchasing agency may enter into a compact with officials in other states to increase the state's purchasing power in negotiations with pharmaceutical companies.

A drug purchasing agency shall consider recommendations of the council established pursuant to section 21 of this act in any negotiations for prescription drugs pursuant to this section or section 19 of this act.

Sec.

21.

(NEW) (Effective October 1, 2025) (a) There is established an Advisory Council on Pharmaceutical Procurement to advise the Commissioner of Administrative Services and drug purchasing agencies on prescription drug negotiations pursuant to sections 19 and of this act.

(b) The council shall consist of five members appointed by the Governor, one of which shall be designated by the Governor to serve as Public Act No.

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7192 chairperson of the council.

The council shall include members who have expertise in health policy, health care economics or clinical medicine.

(c) All initial appointments to the council shall be made not later than thirty days after the effective date of this section.

Any vacancy shall be filled by the appointing authority.

(d) The chairperson shall schedule the first meeting of the council, which shall be held not later than sixty days after the effective date of this section.

(e) No member of the council may (1) have a direct ownership or investment interest in a pharmaceutical company, (2) be employed by such company or participate in the management of such company, or (3) receive or have the right to receive, directly or indirectly, remuneration under a compensation arrangement with such company.

(f) Not later than January 1, 2026, and annually thereafter, the council shall submit a report on its findings and recommendations to the Commissioner of Administrative Services and the joint standing committees of the General Assembly having cognizance of matters relating to general law, human services and public health, in accordance with the provisions of section 11-4a of the general statutes.

Sec.

22.

(NEW) (Effective from passage) (a) Not later than thirty days after the effective date of this section, the Commissioner of Social Services shall petition the Secretary of the Department of Health and Human Services pursuant to 28 USC 1498, as amended from time to time, to authorize generic, lower cost forms of glucagon-like peptide (GLP-1) prescription drugs approved by the federal Food and Drug Administration to treat obesity or diabetes.

(b) Upon approval of such petition, the commissioner may enter into a contract with any manufacturer of generic forms of such drugs approved by the federal Food and Drug Administration to supply such Public Act No.

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7192 drugs to the state for use by HUSKY Health program members.

The commissioner may enter into a consortium with officials in other states in contracting with such manufacturer for such drugs.

Governor's Action:

Approved July 8, 2025 Public Act No.

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