HB 6588 — AN ACT CONCERNING PSYCHOTROPIC DRUGS AND MENTAL HEALTH SERVICES.

The task force shall terminate on the date that it submits such report or December 31, 2021, whichever is later.

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

Section 1 January 1, 2022 New section Sec.

2 January 1, 2022 New section Sec.

3 January 1, 2022 38a-476b Sec.

4 from passage New section Sec.

5 from passage New section HB6588 / File No.

691 6 HB6588 File No.

691 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:

Municipalities Effect FY 22 $ FY 23 $ Various Municipalities Potential Minimal Minimal Savings Explanation There is no fiscal impact to the State resulting from the bill as amended, which prohibits health insurance policies that provide pharmaceutical benefits from prescribing a supply of psychotropic drugs that is larger than the prescribing provider deems clinically necessary.

The provisions of the bill as amended are consistent with the current contract between the state and its pharmacy benefit manager.

To the extent that the provisions of the bill as amended change the volume of psychotropic drugs utilized and the rate paid for such drugs as determined by a plan's formulary, there is a potential minimal savings to fully-insured municipal plans that will be reflected in premiums for contracts effective after January 1, 2022.

Pursuant to federal law, self-insured plans are exempt from state health insurance mandates.

1 1The state employee and retiree health plan is currently a self-insured plan and therefore not required to comply with state health mandates;

however, the plan has historically adopted all mandated health plan requirements.

HB6588 / File No.

691 HB6588 File No.

691 Sections 4 and 5 of the bill as amended, which establish task forces related to peer supportandmental healthservices,have no fiscalimpact as PA 17-236 prohibits transportation allowances for members of task forces.

House "A" changes the membership of the task forces established in the underlying bill and does not result in a fiscal impact.

The Out Years The annualized ongoing fiscal impact identified above would continue into the future subject to future premiums for fully insured municipal plans.

HB6588 / File No.

691 8 HB6588 File No.

691 OLR Bill Analysis HB 6588 (as amended by House "A")* AN ACT CONCERNING MENTAL HEALTH CARE AND SUBSTANCE ABUSE SERVICES.

SUMMARY This bill prohibits certain health insurance policies that cover outpatient prescription drugs from:

1.

requiring a health care provider to prescribe a supply of outpatient psychotropic drugs greater than that which he or she deems clinically appropriate or 2.

imposing a cost-sharing amount (i.e., coinsurance, copayment, deductible, or out-of-pocket expense) for a less than 90-day supply of these drugs that exceeds the 90-day, reduced pro-rata, cost-sharing amount.

These provisions apply to individual or group health insurance policies delivered, issued, renewed, amended, or continued in Connecticut that cover (1) basic hospital expenses;

(2) basic medical- surgical expenses;

(3) major medical expenses;

(4) hospital or medical services, including those provided under an HMO plan;

or (5) single service ancillary health coverage, including vision, dental, or prescription drug coverage.

Because of the federal Employee Retirement Income Security Act (ERISA), state insurance benefit mandates do not apply to self-insured benefit plans.

The bill also prohibits mental health care benefits provided under statelaw,withstatefunds,ortostateemployees,fromrequiringahealth care provider to prescribe an outpatient psychotropic drug in a quantity greater than that which the provider deems clinically appropriate.

HB6588 / File No.

691 9 HB6588 File No.

691 Lastly, the bill establishes two task forces:

one to study mental health service provider networks and the other to study peer support services.

*House Amendment “A” reduces the size of both task forces from 11 to 10 members, modifies the qualification requirements for certain task force appointees, and makes other conforming changes.

EFFECTIVE DATE:

January 1, 2022, except the task force provisions are effective upon passage.

§ 4 — MENTAL HEALTH SERVICE PROVIDER NETWORK TASK FORCE The bill establishes a 10-member task force to study ways to encourage mental health service providers to participate in provider networks.

The task force must report its findings and recommendations to the Insurance and Real Estate Committee by January 1, 2022.

It terminates on the date when it submits the report or on January 1, 2022, whichever is later.

The task force consists of the insurance commissioner, or his designee, and the following members:

1.

one appointed by the House speaker, who represents the Connecticut Health Insurance Exchange (i.e., “the exchange”);

2.

one appointed by the Senate president pro tempore;

3.

one appointed by the House majority leader;

4.

one appointed by the House minority leader;

5.

one appointed by the Senate majority leader, who represents a carrier offering or selling a qualified health plan through the exchange;

6.

one appointed by the Senate minority leader, who has experience working for a carrier offering or selling health insurance in the large group market;

HB6588 / File No.

691 10 HB6588 File No.

691 7.

the Office of Health Strategy’s executive director or her designee;

and 8.

two appointed by the governor, both of whom must be licensed healthcare providers, one of whom must also have experience working within a provider network.

Under the bill, the legislatively appointed members may be members of the General Assembly.

Appointing authorities must (1) make their initial appointments within 30 days after the bill’s passage and (2) fill any vacancies.

The House speaker and the Senate president pro tempore pick the task force’s chairpersons.

The chairpersons must schedule the first meeting, which must be held within 60 days after the bill passes.

The bill requires the Insurance and Real Estate Committee’s administrative staff to serve as the task force’s staff.

§ 5 — PEER SUPPORT SERVICES TASK FORCE The bill establishes a 10-member task force to study health insurance coverage for peer support services, including how to increase its coverage to people in Connecticut.

The task force must report its findings and recommendations to the Insurance and Real Estate Committee by December 31, 2021.

It terminates on that date or on the date when it submits its report, whichever is later.

The bill provides the task force’s appointments, qualifications, and appointing authorities, as shown in Table 1.

Table 1:

Peer Support Services Task Force Members Appointing Number of Appointee Qualifications Authority Appointments House speaker 2 One must be a recovery support specialist and the other must be a Connecticut Certification Board member House majority 1 Must represent a program overseen by the Department of Mental Health and Addiction HB6588 / File No.

691 11 HB6588 File No.

691 leader Services Senate president One must be a recovery coach and the other pro tempore must represent the Connecticut Hospital Association Senate majority 1 Must represent an organization that trains leader recovery coaches or recovery support specialists House minority 1 Must be a peer supervisor from an leader organization that employs peers (presumably, peer support specialists) Senate minority 1 Must represent an organization that provides leader Medicaid services Governor 2 One must be a young adult with various peer support experience and the other must have community reentry perspective Under thebill,thelegislatively-appointedmembersmay be members of the General Assembly.

Appointing authorities must (1) make their initial appointments within 30 days after the bill’s passage and (2) fill any vacancies.

The House speaker and the Senate president pro tempore pick the chairpersons from among the task force members.

The chairs must schedule the first meeting, which must be held within 60 days after the bill passes.

The bill requires the Insurance and Real Estate Committee’s administrative staff to serve as the task force’s staff.

COMMITTEE ACTION Insurance and Real Estate Committee Joint Favorable Yea 18 Nay 0 (03/22/2021) HB6588 / File No.

691 12