Section 17b-491a - Prior authorization requirements for prescription drugs. Schedule for dispensing of maximum quantities of oral dosage units. Submission of schedule and revisions thereto to General Assembly(a) The Commissioner of Social Services may require prior authorization of any prescription for a drug covered under a medical assistance program administered by the Department of Social Services, including an over-the-counter drug. The authorization for a brand name drug product shall be valid for one year from the date the prescription is first filled. The Commissioner of Social Services shall establish a procedure by which prior authorization under this subsection shall be obtained from an independent pharmacy consultant acting on behalf of the Department of Social Services, under an administrative services only contract.(b) When prior authorization is required for coverage of a prescription drug under a medical assistance program administered by the Department of Social Services and a pharmacist is unable to obtain the prescribing physician's authorization at the time the prescription is presented to be filled, the pharmacist shall dispense a one-time fourteen-day supply. The commissioner shall process a prior authorization request from a physician or pharmacist not later than twenty-four hours after the commissioner's receipt of the request. If prior authorization is not granted or denied within twenty-four hours of receipt by the commissioner of the request for prior authorization, it shall be deemed granted.(c) The Commissioner of Social Services, not later than October 1, 2012, shall issue a flier to pharmacies for distribution to Medicaid recipients who receive such one-time prescription supplies in the absence of prior prescription authorization. The flier shall notify recipients that (1) prior authorization is required for the prescription to be fully filled, (2) the fourteen-day supply is a one-time supply, and (3) recipients must contact the prescriber to arrange for prior authorization of a full prescription. The commissioner shall require pharmacists who receive Medicaid reimbursements for prescriptions to provide said flier to such Medicaid recipients.(d) Notwithstanding the provisions of section 17b-262 and any regulation adopted thereunder, on or after July 1, 2000, the Commissioner of Social Services may establish a schedule of maximum quantities of oral dosage units permitted to be dispensed at one time for prescriptions covered under a medical assistance program administered by the Department of Social Services, including prescriptions for over-the-counter drugs, based on a review of utilization patterns.(e) A schedule established pursuant to subsection (d) of this section and on and after July 1, 2005, any revisions thereto shall be submitted to the joint standing committees of the General Assembly having cognizance of matters relating to public health, human services and appropriations and the budgets of state agencies.Within sixty days of receipt of such a schedule or revisions thereto, said joint standing committees of the General Assembly shall approve or deny the schedule or any revisions thereto and advise the commissioner of their approval or denial of the schedule or any revisions thereto. The schedule or any revisions thereto shall be deemed approved unless all committees vote to reject such schedule or revisions thereto within sixty days of receipt of such schedule or revisions thereto.Conn. Gen. Stat. § 17b-491a
( June Sp. Sess. P.A. 00-2, S. 36, 53; P.A. 04-76 , S. 21 ; P.A. 05-280 , S. 17 ; Sept. Sp. Sess. P.A. 09-5, S. 34; P.A. 10-26 , S. 3 ; June 12 Sp. Sess. P.A. 12-1 , S. 27 .)
Amended by P.A. 24-0081,S. 94 of the Connecticut Acts of the 2024 Regular Session, eff. 7/1/2024.Amended by P.A. 12-0001, S. 27 of the Connecticut Acts of the 2012 Special Session, eff. 7/1/2012.Amended by P.A. 10-0026, S. 3 of the February 2010 Regular Session, eff. 5/10/2010.Amended by P.A. 09-0005, S. 34 of the Sept. 2009 Sp. Sess., eff. 10/5/2009.