On June 1, 2018, Connecticut Governor Dannel P. Malloy signed into law Public Act 18-77 “An Act Limiting Auto Refills of Prescription Drugs Covered Under the Medicaid Program and Requiring the Commissioner of Social Services to Provide CHIP Data to the Health Information Technology Officer” (PA 18-77). This legislation allows the Department of Social Services (DSS) to prohibit pharmacies from automatically refilling certain prescription drugs for Medicaid beneficiaries and prohibits DSS from paying for refills of such drugs unless it receives a request for payment from the beneficiary or his or her legal representative.
Under PA 18-77, the DSS commissioner is tasked with recommending to the Connecticut legislature’s Human Services Committee the prescription drugs that should be subject to the automatic refill prohibition. The Human Services Committee, after holding a public hearing, will approve, deny or modify the DSS commissioner’s recommendations.
Existing law allows DSS’s Pharmaceutical and Therapeutics Committee to, among other things, recommend to DSS which prescription drugs require Medicaid beneficiaries to receive prior authorization from DSS and to consult with DSS to create preferred drug lists for the Medicaid program. This legislation now adds that this committee may recommend which prescription drugs should be eligible for automatic refills.
PA 18-77 also makes changes to existing law concerning the all-payer claims database. The all-payer claims database is a database that stores medical, dental and pharmacy insurance claims data from various reporting entities, such as insurers and third-party administrators. The database is overseen by Connecticut’s health information technology officer. This legislation modifies existing law to require DSS to provide the health information technology officer with health claims data and certain other data related to the administration of Connecticut’s Children’s Health Insurance Program (CHIP); the CHIP data will then be included in the all-payer claims database.