SB 331 Connecticut Senate · 2026 Regular Session

AN ACT CONCERNING STEP THERAPY REQUIREMENTS FOR PRESCRIPTION DRUGS COVERED UNDER THE MEDICAID PROGRAM AND REQUIRED NOTICE TO ENROLLEES OF PRESCRIPTION DRUG PAYMENT SUSPENSIONS, DENIALS OR IMPOSITION OF NEW REQUIREMENTS.

This bill modifies Medicaid prescription drug coverage rules by changing step therapy requirements. It mandates that step therapy (requiring patients to try lower-cost drugs first) follow manufacturer and FDA guidelines when available. If no such guidelines exist, step therapy cannot exceed 30 days, after which prescribing doctors may bypass the requirement if they determine the initial treatment is ineffective for the patient. The bill directly affects Medicaid patients and their healthcare providers, streamlining access to prescribed medications under the Medicaid program.

Issues: ✓ Healthcare

Bill status in committee 1 of 4 stages cleared

Introduction

Feb 2026

Committee Review

Floor Vote

Governor

Introduced Feb 26, 2026 Last action Apr 27, 2026

Maddy AI version diff · 1 comparison

What changed between versions

Raised Bill → HS Joint Favorable Substitute · 6 edits

MODERATE

The bill was renumbered from a 'Raised Bill' to a 'Substitute Bill' after committee review. The primary substantive change is the expansion of the bill's title and scope to require the Medicaid department to send specific written notices to patients when their drug coverage is denied, suspended, or when new step therapy rules are introduced. This ensures patients receive clear, plain-language explanations of why coverage was affected and how to appeal the decision.

Scope change

The scope expanded from solely aligning step therapy requirements with manufacturer guidelines to also mandating a notification process for payment denials, suspensions, and new coverage requirements.

REQUIREMENT

Added a new section requiring the Department of Social Services to send written notices to enrollees regarding payment denials, suspensions, or new step therapy requirements.

Mandated that notices for electronic denials be provided immediately at the pharmacy or within 24 business hours.

Required written notice at least 10 days before any planned suspension or termination of payment for prescription drugs.

Established a requirement to notify enrollees 60 days before new prior authorization or step therapy requirements take effect, or immediately when prescribers are notified, whichever is earlier.

Required notices to include plain language explanations of the new requirements, compliance steps, and advice to discuss alternative drugs with prescribers.

Mandated that all notices inform patients of their due process and appeal rights under federal and state laws.

Floor votes

How they voted

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Full legislative history

Actions timeline

Total actions

Key actions

Committee

Apr 24, 2026

Upper · Passed

Joint Favorable

upper

Apr 21, 2026

Upper · Passed

IMMEDIATE TRANSMITTAL TO COMMITTEE

upper

Mar 19, 2026

Upper · Passed

Joint Favorable Substitute

upper

Feb 26, 2026

Committee

REF. TO JOINT COMM. ON Human Services

upper

2 primary · 0 co-sponsors