PA 15-165—sHB 6770

Human Services Committee

AN ACT CONCERNING MEDICAID COVERAGE FOR OVER-THE-COUNTER DRUGS AND PRODUCTS AND REQUIREMENTS FOR MEDICAID BENEFIT CARDS AND NOTICE OF REGULATIONS

SUMMARY: This act expands the types of over-the-counter drugs and products that the Department of Social Services (DSS) may pay for through its medical assistance programs to include those the DSS commissioner determines to be appropriate for coverage based on their clinical efficacy, safety, and cost effectiveness. The law generally bans DSS from paying for over-the-counter drugs and products, with certain exceptions (see BACKGROUND). By law, DSS may require prior authorization for any covered over-the-counter drug.

The law allows the DSS commissioner to implement policies and procedures to administer DSS programs while in the process of adopting them as regulations, as long as he gives notice of his intent to adopt the regulations. Prior law required him to print the notice in the Connecticut Law Journal within 20 days after the date of implementation. The act instead requires DSS, within the same time period, to print the notice on the department's website and the eRegulations system.

The act repeals a law that required DSS, by January 1, 2016, to require state-issued Medicaid benefit cards to include the name of and contact information for the beneficiary's primary care provider, if he or she had one.

The act also makes technical changes and removes an obsolete provision.

EFFECTIVE DATE: July 1, 2015, except for the repealer, which is effective upon passage.

BACKGROUND

Over-The-Counter Drugs and Products

The law permits DSS to pay for the following over-the-counter drugs and products:

1. over-the-counter drug coverage through the Connecticut AIDS Drug Assistance Program,

2. insulin or insulin syringes,

3. nutritional supplements for people who must be tube fed or who cannot safely get nutrition in any other form,

4. smoking cessation drugs, and

5. drugs that must be covered as essential health benefits under the federal Affordable Care Act (CGS 17b-280a).

OLR Tracking: KMD; RP; PF; BS