SB 182, An Act Prohibiting Certain Health Carriers From Requiring Step Therapy For Prescription Drugs Used To Treat A Mental Or Behavioral Health Condition Or A Chronic, Disabling Or Life-Threatening Condition

TESTIMONY OF CONNECTICUT HOSPITAL ASSOCIATION SUBMITTED TO THE PUBLIC HEALTH COMMITTEE
Monday, February 26, 2024

SB 182, An Act Prohibiting Certain Health Carriers From Requiring Step Therapy For Prescription Drugs Used To Treat A Mental Or Behavioral Health Condition Or A Chronic, Disabling Or Life-Threatening Condition

The Connecticut Hospital Association (CHA) appreciates this opportunity to submit testimony concerning SB 182, An Act Prohibiting Certain Health Carriers From Requiring Step Therapy For Prescription Drugs Used To Treat A Mental Or Behavioral Health Condition Or A Chronic, Disabling Or Life-Threatening Condition. CHA supports the bill.

Connecticut hospitals are critical to their communities. They are confronting the challenges posed by a post-pandemic healthcare system with an exemplary healthcare workforce that continues to provide outstanding care. But challenges remain. Hospitals are treating sicker patients, it continues to be challenging to hire and retain staff, and the financial headwinds are grave. Through it all, hospitals are steadfast, providing high-quality 24-hour care for everyone who walks through their doors, focusing on making Connecticut’s healthcare system more equitable, and driving world-class innovation right here in Connecticut.

SB 182 makes an important change to existing state statute regulating the use of step therapy by prohibiting the required use of step therapy for a prescribed drug for the treatment of a behavioral health condition or a chronic, disabling, or life-threatening condition or disease, provided the prescribed drug is in compliance with approved U.S. Food and Drug Administration (FDA) indications. Connecticut law already includes provisions that prohibit a step therapy requirement for prescribed drugs for cancer treatment for an individual with stage IV metastatic cancer and for the treatment of schizophrenia, major depressive disorder, or bipolar disorder. The limited behavioral health conditions were adopted and included as part of last year’s budget bill.

CHA appreciates the focus on the treatment of a broader set of behavioral health conditions. The pandemic exposed and aggravated deficiencies in Connecticut’s behavioral health system. Rising numbers of people experiencing mental health and substance use issues due to isolation, delays in care, and fear caused by COVID-19, coupled with chronic staffing shortages, have stressed the state’s healthcare system even further. The crisis is evident in hospital emergency departments (EDs), which are often the only option for people who cannot access care in more appropriate settings.

In order to meet the challenges we are facing, it is important that we take a whole-system approach, supporting additional resources and taking down barriers to care. SB 182 addresses one such barrier.

The practice of medicine and the provision of healthcare evolve rapidly with new technologies and scientific discoveries. It should be left to trained and licensed healthcare providers to review, consider, and incorporate new information, emerging technologies, healthcare approaches, and available medications in treatment and care conversations with their patients.

This is especially true for individuals seeking care for behavioral and mental health conditions. Providers require the flexibility to prescribe in a manner that, in their professional judgement, best meets the clinical needs of their patients, and they should retain the flexibility to alter that course of care if required. These prescribing decisions should be made by the provider and patient, not by an insurance company.

Thank you for your consideration of our position. For additional information, contact CHA Government Relations at (203) 294-7310.