Connecticut Lawmakers Pass Health Insurance and Patient Protection Act

July 9, 2025

EGWP marketplace medicaid Medicare

SB 10 passed the legislature and now heads to the Gov. Ned Lamont (D) where he is expected to sign it into law. The bill would require changes regarding how insurers report mental health parity compliance to the Department of Insurance and expands drug step therapy prohibitions for patients being treated for multiple sclerosis or rheumatoid arthritis.

In addition, the measure allows the Insurance Commissioner to reduce filed premiums if the Commissioner finds the premiums exceed the state’s established growth benchmark over the last two plan years. Lastly, SB 10 prohibits certain limitations on reimbursement for general anesthesia and reinstates an unfair trade practice provision for a violation of facility fee limits.

In a separate PBM reform bill, HB 7192, most of the problematic issues failed to advance and legislation landed in a reasonable place. In lieu of a fiduciary requirement, the bill includes a PBM “good faith and fair dealing” provision along with a notification of any conflict of interest. The bill also requires PBMs to offer a pass-through option and includes additional rebate reporting requirements among other provisions.

The bill does not include provisions related to delinking, spread pricing, or stop loss changes. The governor is expected to sign the bill.

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