Connecticut Health Law

The 2025 Regular Session of the Connecticut General Assembly led to the passage of significant legislation affecting both institutional and individual health care providers in the state. Below, we highlight some of the more noteworthy legislation effective or scheduled to take effect on January 1, 2026 along with a reminder of a 2024 legislative enactment with an upcoming January 1 compliance deadline.

Health Care Facilities

• Hospital Provider Tax

Substantial revisions to the hospital provider tax were enacted this year, including a change in the tax base for inpatient and outpatient hospital services. While the new tax rate will take effect on July 1, 2026, not later than January 1, 2026 each hospital must report to the Department of Revenue Services information necessary to calculate the hospital’s audited inpatient net revenue, audited outpatient net revenue and audited net revenue for the applicable federal fiscal year. The information must also be reported by January 1, 2029 and every four years thereafter. As under current law, a hospital that fails to provide the requested information timely is subject to a penalty of $1,000/day for each day it fails to provide the information. (PA 25-168, §§360-361, effective July 1, 2026, and applicable to calendar quarters beginning on or after that date). 

• Medical Diagnostic Equipment (passed in 2024)

Both federal and Connecticut law require health care providers to ensure accessibility of medical diagnostic equipment (MDE) by persons with disabilities, including compliance with the federal standards for accessibility promulgated by the Architectural and Transportation Barriers Compliance Board. MDE is generally defined under both laws to include an examination table, an examination chair, a weight scale, mammography equipment and x-ray, imaging and other radiological diagnostic equipment.

Federal law is already in effect governing new acquisitions of MDE and applies to recipients of federal financial assistance, which includes Medicare and Medicaid providers. A Connecticut statute passed in 2024 applies to health care facilities (hospitals, outpatient clinics, long-term care facilities and hospice facilities) and “practice locations” (defined as the office of nine or more physicians, advanced practice registered nurses (APRNs) or a combination of both). Under the Connecticut law, health care facilities and practice locations with at least three exam rooms must have available an accessible examination table or chair in at least one examination room and an accessible weight scale (if it uses a weight scale) by January 1, 2026. Facilities and practice locations with fewer than three exam rooms and/or fewer than nine physicians/APRNs (who are also recipients of federal financial assistance) are subject to federal law and have until July 8, 2026 to obtain an exam table and weight scale (if they use this equipment). Both laws have limited exemptions. (PA 24-113, effective July 1, 2024).

• Facility Fees

The law governing facility fees has been amended to provide that it is an unfair trade practice if a hospital, health system or hospital-based facility collects a facility fee in violation of the Connecticut statute governing facility fees (CGS §19a-508c(l)). Under the Connecticut Unfair Trade Practices Act, courts may issue restraining orders; award actual and punitive damages, costs and reasonable attorneys’ fees; and impose civil penalties. These penalties are in addition to the $1,000 civil penalty that the Office of Health Strategy may impose for a violation of the facility fee law. (PA 25-94, §10, effective January 1, 2026).

Health Care Practitioners

• Certification for Medical Marijuana

The law governing certification for the palliative use of marijuana has been amended. For example, the amended law permits the prescribing physician, APRN or physician assistant to determine the length of the validity of the certification. Instead of just one year as under current law, the prescriber may choose six months, one year, 18 months or two years. Pharmacists employed by licensed dispensary facilities may grant a temporary extension of the written certification for a period not to exceed 90 consecutive days following expiration. In addition, these pharmacists may themselves issue 90-day temporary certifications of palliative marijuana if they conduct an in-person examination of the patient and meet other requirements specified in the new law. (PA 25-101, §5, effective January 1, 2026).

• Continuing Education for Physical Therapists

On and after January 1, 2026, the continuing education requirements for physical therapists must include not fewer than two hours of training or education on ethics and jurisprudence: (1) during the first registration period in which continuing education is required; and (2) not less than once every two years thereafter. (PA 25-97, §3, effective July 1, 2025).

• Promotion of Careers in Health Care

Several laws have been enacted this year aimed at increasing the number of health care practitioners in Connecticut. For example, by January 1, 2026: (1) the Department of Public Health (DPH) must establish, within available appropriations, a virtual education pilot program for persons seeking certification as a nurse's aide or emergency medical technician and a grant program to recruit athletic trainers to work in Connecticut; and (2) the Department of Education must promote careers in radiologic technology, nuclear medicine technology and respiratory care as part of the 2022 plan developed by the Chief Workforce Officer to encourage Connecticut high school students to pursue high-demand careers in health care. (PA 25-162, §§2-4, various effective dates).

DPH is currently required to adopt regulations to, among other things, set forth procedures for retired physicians to return to active employment. On and after January 1, 2026, retired physicians may renew their licenses at a reduced rate. (PA 25-96, §11, effective October 1, 2025).

Health Insurance 

• Electronic Notices

Under a new law, certain health insurers that issue or renew a policy on or after January 1, 2026 may allow plan sponsors, on behalf of consumers, to consent to the delivery of all communications pertaining to a policy by electronic means, provided each covered individual: (1) is provided notification of electronic delivery and an opportunity to choose delivery by mail; and (2) may submit a request to opt out of electronic delivery at any time. (PA 25-87, §2, effective January 1, 2026). 

• Insurance Coverage for Specific Health Conditions

Beginning in 2026, certain individual and group health insurers will generally be required to cover biomarker testing to diagnose, treat, manage or monitor an insured’s disease or condition. New laws also prohibit certain insurers from: (1) requiring step therapy for multiple sclerosis, rheumatoid arthritis, schizophrenia, major depressive disorder or bipolar disorder; (2) imposing an arbitrary time limit on reimbursement for general anesthesia provided during a medically necessary procedure; or (3) refusing to reimburse for general anesthesia on the basis that a medical procedure has exceeded the insurer’s predetermined time limit. (PA 25-16, §§4-5 and PA 25-94, §§4-5 and 8-9, each effective January 1, 2026).

Prescription Drugs 

• Price Caps on Prescription Drugs 

On and after January 1, 2026, pharmaceutical manufacturers and wholesale distributors will be subject to a cap on the prices they may charge for: (1) brand-name drugs (or biological products) for which the exclusive marketing rights granted under federal law have expired for at least 24 months; and (2) generic drugs or interchangeable biological products. Violators who make at least $250,000 in total annual sales per year are subject to civil penalties. Under the new law, a drug that is determined by the federal Secretary of Health and Human Services to be in shortage will not be subject to the price cap. (PA 25-168, §§345-347, effective July 1, 2025).

• New Price Reporting Requirements

Under a new law, the Connecticut Insurance Department (CID) must require health carriers to report annually on pricing in effect for the prior year and profit generated between the health carrier and a pharmacy benefits manager (or mail-order pharmacy) doing business with the health carrier, if the information is reasonably available. Information noted as proprietary must be kept confidential by the CID in accordance with state law. (PA 25-167, §4, effective January 1, 2026). 

• Non-Resident Pharmacies

If a nonresident pharmacy intends to sell, deliver or offer sterile pharmaceuticals for sale or delivery in Connecticut, it must submit to the Department of Consumer Protection (DCP), as part of its initial application, an inspection report dated within the previous six months from a government agency with regulatory oversight of the pharmacy or third-party entity with expertise in sterile compounding evidencing that the pharmacy complies with the most recent United States Pharmacopeia standards. Not later than June 30 of even-numbered years thereafter, the nonresident pharmacy must submit to DCP a new inspection report. (PA 25-101, §§2-3, effective January 1, 2026).

• Pharmacy Benefits Managers

In an effort to ensure fair drug pricing, the law governing contracts for pharmacy services has been amended to require pharmacy benefits managers to offer a health plan the option of being charged the same price for a prescription drug that the pharmacy benefits manager pays a pharmacy for the drug. (PA 25-167, §2, effective January 1, 2026).

Finally…

• Not later than January 1, 2026, DPH must establish, within available appropriations, a pancreatic cancer screening and treatment referral program to: (1) promote screening and detection of pancreatic cancer among persons who may be susceptible due to higher risk factors; (2) educate the public, including unserved and underserved populations, regarding pancreatic cancer and the benefits of early detection; and (3) provide referrals to appropriate pancreatic screening and counseling services and treatment referral services. (PA 25-168, §180, effective October 1, 2025).

If you have any questions or would like more information about these new laws and how they may affect your practice, please contact a Pullman & Comley Health Care attorney.