CONNECTICUT SUMMARY OF EXISTING LAW

Prohibits a contract for pharmacy services entered into in the state between a health carrier or PBM and a pharmacy or pharmacist shall from containing a provision allowing the health carrier or PBM to recoup, directly or indirectly, from a pharmacy or pharmacist any portion of a claim that such health carrier or PBM has paid to the pharmacy or pharmacist, unless such recoupment is permitted under State auditing law or required by applicable law.

Link to Existing Law: CT ST § 38a-477cc

PRACTICAL NOTE

This is a standard clawback law and prohibits retrospective DIR fees. It must be noted that these requirements are limited to insurance plans regulated by the State, and may exclude Medicare Part D, TRICARE, and possibly ERISA-regulated plans. A private right of action exists under the CT Unfair Trade Practices Law.