Bill > HB0257

This bill makes several amendments to Utah's insurance and pharmacy benefit regulations, focusing on improving transparency and consumer protections. The bill requires health benefit plans to implement prescription drug synchronization policies, allowing patients to align their medication refill dates without incurring additional fees. It mandates that pharmaceutical manufacturer rebates be used exclusively to benefit enrollees, either by reducing out-of-pocket costs at the point of sale, lowering premiums, or enhancing health benefits. The bill also prohibits health benefit plans from requiring pharmacies to participate in multiple networks and introduces new requirements for pharmacy benefit managers (PBMs), including offering self-funded health plans pharmacy benefit management services that do not use "spread pricing" (a practice where PBMs charge health plans more for pharmacist services than they reimburse pharmacies). Additionally, the bill expands definitions related to pharmacy benefits, such as administrative fees, rebates, and pharmacy services, and requires the insurance commissioner to assist pharmacy associations in developing a form that outlines pharmacies' rights under state and federal law. These changes aim to increase transparency, reduce costs for consumers, and provide more flexibility for pharmacies and health benefit plans. The bill is set to take effect on May 7, 2025.

Business and Industry, Health and Social Services

https://le.utah.gov/~2025/bills/static/HB0257.html