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• 2023 General Session
• H.B. 24

H.B. 24 Prescription Discount Program Amendments

• Bill Text
• Status
• Hearings/Debate

Bill Sponsor: Rep. Ward, Raymond P.

Floor Sponsor: Sen. Kennedy, Michael S.

• Drafting Attorney: Christopher Williams
• Fiscal Analyst: Ivan D. Djambov

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• Bill Tracking

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• Bill Text
  • Introduced
  • Enrolled (Currently Displayed)

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• Related Documents
  • Fiscal Note
  • House Transmittal Letter 1
  • Senate Transmittal Letter 1

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• Information
  • Last Action: 15 Mar 2023, Governor Signed
  • Last Location: Lieutenant Governor's office for filing
  • Effective Date: 3 May 2023
  • Session Law Chapter: 267
  • Committee Note: The Health and Human Services Interim Committee recommended this bill. (12-0-6)

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• Similar Bills
  • Health Insurance
  • Health
  • Health Care
  • Public Employees' Health Program
  • Pharmaceuticals

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• Sections Affected
  • 49-20-421

Enrolled

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H.B. 24

1     PRESCRIPTION DISCOUNT PROGRAM AMENDMENTS
2     2023 GENERAL SESSION
3     STATE OF UTAH
4     Chief Sponsor: Raymond P. Ward
5     Senate Sponsor: Michael S. Kennedy
6     

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7     LONG TITLE
8     General Description:
9          This bill allows the Public Employees' Benefit and Insurance Program (program) to add
10     additional drugs to the prescription discount program.
11     Highlighted Provisions:
12          This bill:
13          ▸     modifies definitions;
14          ▸     allows the Public Employees' Benefit and Insurance Program to add additional
15     drugs to the prescription discount program;
16          ▸     requires the program to notify the Legislature when an additional drug is added to
17     the program; and
18          ▸     makes technical changes.
19     Money Appropriated in this Bill:
20          None
21     Other Special Clauses:
22          None
23     Utah Code Sections Affected:
24     AMENDS:
25          49-20-421, as last amended by Laws of Utah 2021, Chapter 255
26     

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27     Be it enacted by the Legislature of the state of Utah:
28          Section 1. Section 49-20-421 is amended to read:
29          49-20-421. Prescription discount program.

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30          (1) As used in this section:
31          [(a) "Diabetes" means:]
32          [(i) complete insulin deficiency or type 1 diabetes;]
33          [(ii) insulin resistant with partial insulin deficiency or type 2 diabetes; or]
34          [(iii) elevated blood glucose levels induced by pregnancy or gestational diabetes.]
35          [(b)] (a) "Discount program" means [a process developed by the program that allows
36     participants to purchase a qualified prescription at a discounted, post-rebate rate] the
37     prescription discount program created by this section.
38          [(c)] (b) "Epinephrine auto-injector" means the same as that term is defined in Section
39     26-41-102.
40          [(d) "Individual with diabetes" means an individual who has been diagnosed with
41     diabetes and who uses insulin to treat diabetes.]
42          [(e)] (c) "Insulin" means a prescription drug that contains insulin.
43          [(f)] (d) "Participant" means a resident of Utah who:
44          (i) [has a qualified condition] has a prescription or standing prescription for a qualified
45     prescription;
46          (ii) does not receive health coverage under the program; and
47          (iii) enrolls in the discount program.
48          [(g)] (e) "Prescription drug" means the same as that term is defined in Section
49     58-17b-102.
50          [(h) "Qualified condition" means the individual:]
51          [(i) uses insulin to treat diabetes; or]
52          [(ii) has a prescription or a standing prescription drug order for an epinephrine
53     auto-injector issued under Section 58-17b-1005.]
54          [(i) "Qualified prescription" means:]
55          [(i) insulin; or]
56          [(ii) epinephrine auto-injector.]
57          (f) "Qualified prescription" means a prescription drug, including insulin and

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58     epinephrine auto-injectors, that the program has determined:
59          (i) treats a serious, prevalent, and ongoing condition;
60          (ii) does not have a generic substitute;
61          (iii) qualifies for a substantial rebate; and
62          (iv) would not result in financial losses to the state risk pool if sold as part of the
63     discount program.
64          [(j)] (g) "Rebate" means the same as that term is defined in Section 31A-46-102.
65          (2) [Notwithstanding Subsection 49-20-201(1), and for the purpose of the discount
66     program only, the program shall offer a discount program that allows participants to purchase a
67     qualified prescription at a discounted, post-rebate price when a rebate is available.] The
68     program shall create a prescription discount program for a participant to purchase a qualified
69     prescription at a discounted, post-rebate price.
70          (3) The [discount] program [described in Subsection (2)] shall:
71          (a) provide a participant with a card or electronic document that identifies the
72     participant as eligible for the discount on a qualified prescription [related to the participant's
73     qualified condition];
74          (b) provide a participant with information about pharmacies that will honor the
75     discount; and
76          [(c) allow a participant to purchase a qualified prescription at a discounted, post-rebate
77     price; and]
78          [(d)] (c) provide a participant with instructions to pursue a reimbursement of the
79     purchase price from the participant's health insurer.
80          [(4) The discount program shall charge a price for a qualified prescription that allows
81     the program to retain only enough of any rebate for the qualified prescription to make the state
82     risk pool whole for providing a discounted qualified prescription to participants.]
83          (4) The program may not retain any amount of a rebate for a qualified prescription
84     except for an amount necessary to make the state risk pool whole for providing the qualified
85     prescription to participants.

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86          (5) For each drug added to the discount program, the program shall notify the Health
87     and Human Services Interim Committee, providing:
88          (a) the name of the drug; and
89          (b) the primary condition the drug treats.