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SB 331

AN ACT CONCERNING STEP THERAPY REQUIREMENTS FOR PRESCRIPTION DRUGS COVERED UNDER THE MEDICAID PROGRAM AND REQUIRED NOTICE TO ENROLLEES OF PRESCRIPTION DRUG PAYMENT SUSPENSIONS, DENIALS OR IMPOSITION OF NEW REQUIREMENTS.

2026 Regular Session Introduced by Saud Anwar and 2 co-sponsors

SB 331 modifies Medicaid step therapy requirements to expand patient access to physician-prescribed medications, potentially increasing drug costs but improving treatment outcomes for low-income beneficiaries.

FAV. RPT., TAB. FOR CAL., SEN.
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Bill Summary · SB 331

Legislative bill overview

SB 331 addresses step therapy requirements—a practice where insurers require patients to try cheaper drugs first before covering more expensive medications—for prescription drugs covered under Connecticut's Medicaid program. The bill aims to modify or restrict how step therapy protocols are applied to Medicaid beneficiaries, potentially streamlining access to prescribed medications.

Why is this important

Step therapy can delay patient access to medications their doctors have specifically prescribed, potentially worsening health outcomes for vulnerable populations. Medicaid beneficiaries—who are often lower-income individuals with complex health conditions—may face particular hardship when forced to try ineffective or incompatible drugs before accessing their physician's recommended treatment.

Potential points of contention

  • Cost implications: Restricting step therapy requirements could increase Medicaid pharmaceutical spending, raising questions about program sustainability and budget impact
  • Clinical judgment vs. cost control: Tension between allowing doctors full prescribing discretion and insurers' legitimate need to manage costs and prevent unnecessary expensive treatments
  • Definition and scope: Unclear whether the bill allows any exceptions to step therapy or creates broad exemptions that could undermine the practice entirely for cost-conscious prescribing

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

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