A few new proposals by State Representative Dan Carter (R-2) could expand the breadth to which insurance policies cover certain medical services for residents of Connecticut.
Report by Paula Antolini
March 3, 2015 10:22AM EDT
HARTFORD – A few new proposals by State Representative Dan Carter (R-2) could expand the breadth to which insurance policies cover certain medical services for residents of Connecticut.
Carter’s bill, H.B. 5784, would prevent pharmacists from substituting a prescribed abuse-deterrent opioid for a generic supplement – unless the pharmacist receives written permission from the prescribing health care provider to do so.
“Generic medications are on the whole an equally effective, and affordable, option for patients,” said Rep. Carter. “However, in this instance, abuse-deterrent opioids are generally made with a specific formula that is vital to recovery. Generic substitutes for these prescriptions are often made without this formulation. For that reason, I want to make sure that patients are getting the exact remedies they are prescribed.”
This bill greatly correlates with S.B. 21, a proposal co-sponsored by Rep. Carter that would require health insurance policies that cover prescription drugs to also cover abuse-deterrent opioid analgesics to the same degree as nonabuse-deterrent opioid analgesics.
“Prescription opioid abuse is a growing problem that has become a critical public health issue,” said Rep. Carter. “By altering the prescribed formulation of an opioid, abusers are being enabled. The goal of S.B. 21 is to simply allow practitioners to choose which patients receive an abuse deterrent formulation of medication vs a regular opioid. Healthcare providers are keenly aware of the risks of opioid abuse and are the only people in direct contact with patients and, therefore, the only people in the position to make the determination whether or not a patient is, or might be, at an increased risk of opioid abuse.”
H.B. 5784 is currently with the General Law Committee, while S.B. 21 is with the Insurance and Real Estate Committee.
Another insurance bill Rep. Carter proposed, and has now been successfully adopted by the Insurance and Real Estate committee is H.B. 5836, which would require medical evaluations or appointments ordered by a court to be covered by health insurance.
“The stress of being caught up in the judicial process is something most of us try to avoid,” Rep. Carter said. “It can be debilitating in some instances, especially when defendants or plaintiffs are required to see a specific therapist or health care provider for evaluation and/or treatment by order of the court. Unfortunately, these visits can be costly, especially at a time when people are swamped with legal fees. Ensuring individuals forced to see a court appointed therapist do not experience any additional financial hardship when they already have insurance covering mental health services is the right thing to do. Hence, I am in full support of this bill.”
“I have also submitted a bill in Judiciary,” added Rep. Carter, “to allow individuals the ability to choose a therapist or provider in their insurance plan, as these folks need some protection for the instances where there is no provider available.”