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HB 5591

AN ACT CONCERNING PRESCRIPTION DRUG REIMBURSEMENT RATES TO PHARMACIES.

2025 Regular Session Introduced by Steven Winter

Connecticut bill adjusts insurance reimbursement rates to pharmacies for prescription drug dispensing to address pharmacy profitability and access concerns.

REF. TO JOINT COMM. ON Insurance and Real Estate
#drugs #healthinsurancerates #pharmacies
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Bill Summary · HB 5591

Legislative bill overview

HB 5591 addresses how much pharmacies are reimbursed by insurance companies for dispensing prescription drugs. The bill was introduced in Connecticut and referred to the Joint Committee on Insurance and Real Estate in January 2025. The specific mechanisms and rate adjustments are not detailed in the available information.

Why is this important

Reimbursement rates directly affect pharmacy profitability and, consequently, drug accessibility and pharmacy closures in underserved areas. Many independent and rural pharmacies have closed in recent years due to reimbursement rates not covering their operating costs, even as drug prices remain high for consumers.

Potential points of contention

  • Pharmacy margins vs. insurer costs: Pharmacies argue reimbursement rates are unsustainably low, while insurers and pharmacy benefit managers contend that higher reimbursement rates increase premiums for consumers and employers
  • Independent vs. chain pharmacies: Different pharmacy types operate on different cost structures, making a one-size-fits-all reimbursement rate potentially unfair to some segments
  • Transparency concerns: The bill may need to address how reimbursement formulas are calculated and whether pharmacy benefit managers' role in setting rates requires greater disclosure

Compiled from official sources — confirm details with the bill’s official record.

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