Utah 2023 Regular Session

Utah House Bill HB0024 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1		-	Enrolled Copy H.B. 24
	1	+	H.B. 24
	2	+	LEGISLATIVE GENERAL COUNSEL
	3	+	6 Approved for Filing: C. Williams 6
	4	+	6 12-19-22 5:49 PM 6
	5	+	H.B. 24
2	6		1 PRESCRIPTION DISCOUNT PROGRAM AMENDMENTS
3	7		2 2023 GENERAL SESSION
4	8		3 STATE OF UTAH
5	9		4 Chief Sponsor: Raymond P. Ward
6	10		5 Senate Sponsor: Michael S. Kennedy
7	11		6
8	12		7LONG TITLE
9		-	8General Description:
10		-	9 This bill allows the Public Employees' Benefit and Insurance Program (program) to add
11		-	10additional drugs to the prescription discount program.
12		-	11Highlighted Provisions:
13		-	12 This bill:
14		-	13 <modifies definitions;
15		-	14 <allows the Public Employees' Benefit and Insurance Program to add additional
16		-	15drugs to the prescription discount program;
17		-	16 <requires the program to notify the Legislature when an additional drug is added to
18		-	17the program; and
19		-	18 <makes technical changes.
20		-	19Money Appropriated in this Bill:
21		-	20 None
22		-	21Other Special Clauses:
23		-	22 None
24		-	23Utah Code Sections Affected:
25		-	24AMENDS:
26		-	25 49-20-421, as last amended by Laws of Utah 2021, Chapter 255
27		-	26
28		-	27Be it enacted by the Legislature of the state of Utah:
29		-	28 Section 1. Section 49-20-421 is amended to read:
30		-	29 49-20-421. Prescription discount program. H.B. 24 Enrolled Copy
	13	+	8Committee Note:
	14	+	9 The Health and Human Services Interim Committee recommended this bill.
	15	+	10 Legislative Vote:12 voting for0 voting against 6 absent
	16	+	11General Description:
	17	+	12 This bill allows the Public Employees' Benefit and Insurance Program (program) to add
	18	+	13additional drugs to the prescription discount program.
	19	+	14Highlighted Provisions:
	20	+	15 This bill:
	21	+	16 <modifies definitions;
	22	+	17 <allows the Public Employees' Benefit and Insurance Program to add additional
	23	+	18drugs to the prescription discount program;
	24	+	19 <requires the program to notify the Legislature when an additional drug is added to
	25	+	20the program; and
	26	+	21 <makes technical changes.
	27	+	22Money Appropriated in this Bill:
	28	+	23 None
	29	+	24Other Special Clauses:
	30	+	25 None
	31	+	26Utah Code Sections Affected:
	32	+	27AMENDS:
	33	+	HB0024 H.B. 24 12-19-22 5:49 PM
31	34		- 2 -
32		-	30 (1) As used in this section:
33		-	31 [(a) "Diabetes" means:]
34		-	32 [(i) complete insulin deficiency or type 1 diabetes;]
35		-	33 [(ii) insulin resistant with partial insulin deficiency or type 2 diabetes; or]
36		-	34 [(iii) elevated blood glucose levels induced by pregnancy or gestational diabetes.]
37		-	35 [(b)] (a) "Discount program" means [a process developed by the program that allows
38		-	36participants to purchase a qualified prescription at a discounted, post-rebate rate] the
39		-	37prescription discount program created by this section.
40		-	38 [(c)] (b) "Epinephrine auto-injector" means the same as that term is defined in Section
41		-	3926-41-102.
42		-	40 [(d) "Individual with diabetes" means an individual who has been diagnosed with
43		-	41diabetes and who uses insulin to treat diabetes.]
44		-	42 [(e)] (c) "Insulin" means a prescription drug that contains insulin.
45		-	43 [(f)] (d) "Participant" means a resident of Utah who:
46		-	44 (i) [has a qualified condition] has a prescription or standing prescription for a qualified
47		-	45prescription;
48		-	46 (ii) does not receive health coverage under the program; and
49		-	47 (iii) enrolls in the discount program.
50		-	48 [(g)] (e) "Prescription drug" means the same as that term is defined in Section
51		-	4958-17b-102.
52		-	50 [(h) "Qualified condition" means the individual:]
53		-	51 [(i) uses insulin to treat diabetes; or]
54		-	52 [(ii) has a prescription or a standing prescription drug order for an epinephrine
55		-	53auto-injector issued under Section 58-17b-1005.]
56		-	54 [(i) "Qualified prescription" means:]
57		-	55 [(i) insulin; or]
58		-	56 [(ii) epinephrine auto-injector.]
59		-	57 (f) "Qualified prescription" means a prescription drug, including insulin and Enrolled Copy H.B. 24
	35	+	28 49-20-421, as last amended by Laws of Utah 2021, Chapter 255
	36	+	29
	37	+	30Be it enacted by the Legislature of the state of Utah:
	38	+	31 Section 1. Section 49-20-421 is amended to read:
	39	+	32 49-20-421. Prescription discount program.
	40	+	33 (1) As used in this section:
	41	+	34 [(a) "Diabetes" means:]
	42	+	35 [(i) complete insulin deficiency or type 1 diabetes;]
	43	+	36 [(ii) insulin resistant with partial insulin deficiency or type 2 diabetes; or]
	44	+	37 [(iii) elevated blood glucose levels induced by pregnancy or gestational diabetes.]
	45	+	38 [(b)] (a) "Discount program" means [a process developed by the program that allows
	46	+	39participants to purchase a qualified prescription at a discounted, post-rebate rate] the
	47	+	40prescription discount program created by this section.
	48	+	41 [(c)] (b) "Epinephrine auto-injector" means the same as that term is defined in Section
	49	+	4226-41-102.
	50	+	43 [(d) "Individual with diabetes" means an individual who has been diagnosed with
	51	+	44diabetes and who uses insulin to treat diabetes.]
	52	+	45 [(e)] (c) "Insulin" means a prescription drug that contains insulin.
	53	+	46 [(f)] (d) "Participant" means a resident of Utah who:
	54	+	47 (i) [has a qualified condition] has a prescription or standing prescription for a qualified
	55	+	48prescription;
	56	+	49 (ii) does not receive health coverage under the program; and
	57	+	50 (iii) enrolls in the discount program.
	58	+	51 [(g)] (e) "Prescription drug" means the same as that term is defined in Section
	59	+	5258-17b-102.
	60	+	53 [(h) "Qualified condition" means the individual:]
	61	+	54 [(i) uses insulin to treat diabetes; or]
	62	+	55 [(ii) has a prescription or a standing prescription drug order for an epinephrine
	63	+	56auto-injector issued under Section 58-17b-1005.]
	64	+	57 [(i) "Qualified prescription" means:]
	65	+	58 [(i) insulin; or] 12-19-22 5:49 PM H.B. 24
60	66		- 3 -
61		-	58epinephrine auto-injectors, that the program has determined:
62		-	59 (i) treats a serious, prevalent, and ongoing condition;
63		-	60 (ii) does not have a generic substitute;
64		-	61 (iii) qualifies for a substantial rebate; and
65		-	62 (iv) would not result in financial losses to the state risk pool if sold as part of the
66		-	63discount program.
67		-	64 [(j)] (g) "Rebate" means the same as that term is defined in Section 31A-46-102.
68		-	65 (2) [Notwithstanding Subsection 49-20-201(1), and for the purpose of the discount
69		-	66program only, the program shall offer a discount program that allows participants to purchase a
70		-	67qualified prescription at a discounted, post-rebate price when a rebate is available.] The
71		-	68program shall create a prescription discount program for a participant to purchase a qualified
72		-	69prescription at a discounted, post-rebate price.
73		-	70 (3) The [discount] program [described in Subsection (2)] shall:
74		-	71 (a) provide a participant with a card or electronic document that identifies the
75		-	72participant as eligible for the discount on a qualified prescription [related to the participant's
76		-	73qualified condition];
77		-	74 (b) provide a participant with information about pharmacies that will honor the
78		-	75discount; and
79		-	76 [(c) allow a participant to purchase a qualified prescription at a discounted, post-rebate
80		-	77price; and]
81		-	78 [(d)] (c) provide a participant with instructions to pursue a reimbursement of the
82		-	79purchase price from the participant's health insurer.
83		-	80 [(4) The discount program shall charge a price for a qualified prescription that allows
84		-	81the program to retain only enough of any rebate for the qualified prescription to make the state
85		-	82risk pool whole for providing a discounted qualified prescription to participants.]
86		-	83 (4) The program may not retain any amount of a rebate for a qualified prescription
87		-	84except for an amount necessary to make the state risk pool whole for providing the qualified
88		-	85prescription to participants. H.B. 24 Enrolled Copy
	67	+	59 [(ii) epinephrine auto-injector.]
	68	+	60 (f) "Qualified prescription" means a prescription drug, including insulin and
	69	+	61epinephrine auto-injectors, that the program has determined:
	70	+	62 (i) treats a serious, prevalent, and ongoing condition;
	71	+	63 (ii) does not have a generic substitute;
	72	+	64 (iii) qualifies for a substantial rebate; and
	73	+	65 (iv) would not result in financial losses to the state risk pool if sold as part of the
	74	+	66discount program.
	75	+	67 [(j)] (g) "Rebate" means the same as that term is defined in Section 31A-46-102.
	76	+	68 (2) [Notwithstanding Subsection 49-20-201(1), and for the purpose of the discount
	77	+	69program only, the program shall offer a discount program that allows participants to purchase a
	78	+	70qualified prescription at a discounted, post-rebate price when a rebate is available.] The
	79	+	71program shall create a prescription discount program for a participant to purchase a qualified
	80	+	72prescription at a discounted, post-rebate price.
	81	+	73 (3) The [discount] program [described in Subsection (2)] shall:
	82	+	74 (a) provide a participant with a card or electronic document that identifies the
	83	+	75participant as eligible for the discount on a qualified prescription [related to the participant's
	84	+	76qualified condition];
	85	+	77 (b) provide a participant with information about pharmacies that will honor the
	86	+	78discount; and
	87	+	79 [(c) allow a participant to purchase a qualified prescription at a discounted, post-rebate
	88	+	80price; and]
	89	+	81 [(d)] (c) provide a participant with instructions to pursue a reimbursement of the
	90	+	82purchase price from the participant's health insurer.
	91	+	83 [(4) The discount program shall charge a price for a qualified prescription that allows
	92	+	84the program to retain only enough of any rebate for the qualified prescription to make the state
	93	+	85risk pool whole for providing a discounted qualified prescription to participants.]
	94	+	86 (4) The program may not retain any amount of a rebate for a qualified prescription
	95	+	87except for an amount necessary to make the state risk pool whole for providing the qualified
	96	+	88prescription to participants.
	97	+	89 (5) For each drug added to the discount program, the program shall notify the Health H.B. 24 12-19-22 5:49 PM
89	98		- 4 -
90		-	86 (5) For each drug added to the discount program, the program shall notify the Health
91		-	87and Human Services Interim Committee, providing:
92		-	88 (a) the name of the drug; and
93		-	89 (b) the primary condition the drug treats.
	99	+	90and Human Services Interim Committee, providing:
	100	+	91 (a) the name of the drug; and
	101	+	92 (b) the primary condition the drug treats.