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Press Releases - May 31, 2016

 Contact: Donna Tommelleo, 860-297-3958
Insurance Commissioner Reminds Health Insurers
Of Coverage Guidelines for Opioid Abuse Deterrent Drugs

To help address the opioid epidemic sweeping the nation and now confronting Connecticut, Insurance Commissioner Katharine L. Wade is reminding health insurers that FDA-approved opioid abuse deterrent drugs prescribed for pain management purposes must be covered if medically necessary.

“The epidemic tears apart families and ruins lives and must be addressed on several fronts,” Commissioner Wade said. “That is the intent behind Public Act 16-43. The law Governor Malloy recently signed the law will go a long way in helping Connecticut communities combat this scourge.”

The Department’s bulletin HC-112 issued May 31, 2016 cites state law and federal guidance governing insurance companies’ drug lists, also known as formularies. Under the Affordable Care Act, drug lists are required to cover “at least the greater of one drug in every category and class or the same number of drugs in each category and class as the benchmark plan.”

“We are making certain that consumers have access to these drugs and that their providers have the tools and flexibility to prescribe the drug that best meets their needs,” Commissioner Wade said.

About the Connecticut Insurance Department: The mission of the Connecticut Insurance Department is to protect consumers through regulation of the industry, outreach, education and advocacy. The Department recovers an average of $4 million yearly on behalf of consumers and regulates the industry by ensuring carriers adhere to state insurance laws and regulations and are financially solvent to pay claims. The Department’s annual budget is funded through assessments from the insurance industry. Each year, the Department returns an average of $100 million a year to the state General Fund in license fees, premium taxes, fines and other revenue sources to support various state programs, including childhood immunization.
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