Bill > HB0409

This bill amends Utah's Medicaid pharmacy program provisions, primarily focusing on drug prescription and authorization processes. The bill maintains the existing preferred drug list system while introducing several key changes. For psychotropic drugs (including anti-psychotics, anti-depressants, mood stabilizers, anti-anxiety medications, and ADHD stimulants), the bill establishes a tracking system to monitor healthcare provider prescribing patterns and aims to encourage compliance with the preferred drug list. The bill specifically protects certain drug categories, such as preventing immunosuppressive drugs from being included on the preferred drug list and ensuring that organ transplant patients can receive their prescribed immunosuppressive medications without additional restrictions. The bill also mandates a quick prior authorization process, requiring the Medicaid department to approve or deny override requests within 24 hours during business hours and provide emergency medication supplies outside those hours. Notably, the bill changes the delivery model for the Medicaid drug program, transitioning to an exclusively fee-for-service model starting July 1, 2026, and takes effect on May 7, 2025. The overall goal appears to be improving medication access, controlling costs, and ensuring appropriate prescription practices within the Medicaid pharmacy program.

Business and Industry, Health and Social Services

https://le.utah.gov/~2025/bills/static/HB0409.html