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Evan J. Vickers proposes the following substitute bill:
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Medication Amendments
2025 GENERAL SESSION
STATE OF UTAH
Chief Sponsor: Evan J. Vickers
House Sponsor:
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LONG TITLE
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General Description:
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This bill addresses participation in a federal drug discount program.
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Highlighted Provisions:
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This bill:
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▸ defines terms;
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▸ prohibits a pharmaceutical manufacturer from restricting, prohibiting, or otherwise
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interfering with a 340B entity's ability to:
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● acquire a 340B drug; or
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● participate in the 340B drug discount program;
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▸ permits the Public Employees' Benefit and Insurance Program (program) to adjust the
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program's business practices to mitigate any resulting financial impacts;
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▸ permits a manufacturer to request certain claim information from 340B entities; and
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▸ requires 340B entities to submit information to the Insurance Department.
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Money Appropriated in this Bill:
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None
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Other Special Clauses:
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None
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Utah Code Sections Affected:
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ENACTS:
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31A-46-311, Utah Code Annotated 1953
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31A-46-312, Utah Code Annotated 1953
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Be it enacted by the Legislature of the state of Utah:
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Section 1. Section 31A-46-311 is enacted to read:
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31A-46-311 . Protection of pharmacy discount drug market.
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(1) As used in this section, "manufacturer" means a pharmaceutical manufacturer, including
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an agent or affiliate of a pharmaceutical manufacturer.
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(2) A manufacturer may not:
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(a) directly or indirectly, restrict or prohibit:
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(i) a pharmacy from contracting with a 340B entity, including by denying the
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pharmacy access to a drug that is manufactured by the manufacturer;
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(ii) a 340B entity from contracting with a pharmacy, including by denying the 340B
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entity access to a drug that is manufactured by the manufacturer;
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(iii) the acquisition, dispensing, or delivery of a 340B drug to any location authorized
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by a 340B entity to receive the drug, unless prohibited by federal law; or
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(iv) a 340B entity from receiving 340B drug discount program pricing for a 340B
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drug, including by imposing a time limitation on a 340B entity to replenish or
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submit a claim for a 340B drug;
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(b) directly or indirectly:
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(i) require a 340B entity to purchase a 340B drug from a supplier if the manufacturer
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would otherwise permit the 340B entity to purchase a drug that is not a 340B drug
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from the supplier; or
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(ii) require a 340B entity to submit any claim data, utilization data, or information
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about a 340B entity's contracts with a third party as a condition for allowing the
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acquisition of a 340B drug by, or delivery of a 340B drug to, a 340B entity, unless
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the data or information sharing is required by federal law; or
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(c) interfere with:
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(i) a contract between a pharmacy and a 340B entity; or
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(ii) the ability of a pharmacy and a 340B entity to enter into a contract.
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(3) The Public Employees' Benefit and Insurance Program created in Section 49-20-103
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may adjust the program's business practices to mitigate any financial impacts resulting
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from this section.
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(4) Nothing in this section is to be construed to conflict with federal law.
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Section 2. Section 31A-46-312 is enacted to read:
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31A-46-312 . Claim information sharing and use -- 340B entity public reporting.
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(1) As used in this section:
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(a) "Bad debt" means the cost incurred by a participating 340B entity for providing
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health care services to a patient for which the participating 340B entity does not
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receive payment.
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(b) "Claim information" means information that is:
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(i) described in Subsection (2); and
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(ii) related to a claim for a 340B drug that is:
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(A) dispensed by a contract pharmacy; and
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(B) manufactured by a single pharmaceutical manufacturer.
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(c) "Contract pharmacy" means a pharmacy contracting with an entity participating in
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the 340B drug discount program to dispense drugs purchased through the 340B drug
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discount program.
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(d) Financial assistance" means the cost incurred by a participating 340B entity for
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providing health care services to a patient at a reduced cost or no cost.
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(e) "Participating 340B entity" means a 340B entity that is a hospital described in 42
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U.S.C. Sec. 256b(a)(4)(L).
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(f) Uncompensated care means the sum of a participating 340B entity's bad debt and
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financial assistance.
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(2) pharmaceutical manufacturer may request from a participating 340B entity the
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following claim information:
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(a) prescription number;
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(b) prescribed date;
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(c) fill date;
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(d) national drug code;
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(e) quantity;
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(f) pharmacy identification; and
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(g) 340B covered entity identification.
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(3) A participating 340B entity that receives a request from a pharmaceutical manufacturer
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as described in Subsection (2) shall provide to the pharmaceutical manufacturer the
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requested claim information.
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(4)(a) A pharmaceutical manufacturer may only use claim information received under
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this section to identify a rebate for an insurer or a third party administrator that is
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ineligible for payment under the pharmaceutical manufacturers policy.
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(b) A pharmaceutical manufacturer may not use claim information received under this
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section to:
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(i) establish restrictions or limitations on a participating 340B entity's ability to
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purchase a 340B drug, including by establishing:
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(A) allocations on purchasing based on the number of claims for which the
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participating 340B entity provides claim information; or
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(B) time limits for a participating 340B entity to replenish or replace inventory of
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a 340B drug;
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(ii) recoup from a participating 340B entity a discount for a 340B drug;
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(iii) discriminate against, lower the reimbursement for, or impose any separate
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condition on a participating 340B entity; or
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(iv) take any other action that is not expressly authorized under this part.
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(5)(a) Beginning on July 1, 2026, on or before July 1 each year, a participating 340B
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entity shall provide the following to the department in a form and manner determined
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by the department:
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(i) the name of the participating 340B entity;
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(ii) a copy of the participating 340B entity's annual 340B program recertification;
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(iii) if the participating 340B entity is required to conduct a community health needs
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assessment under Section 501(r)(3)(A), Internal Revenue Code, a copy of the
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participating 340B entity's most recent community health needs assessment;
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(iv) a statement that the participating 340B entity is in compliance with the 340B
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drug discount program;
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(v) the total number of contract pharmacies with which the participating 340B entity
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contracts;
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(vi) the total number of contract pharmacies located out-of-state and the states in
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which out-of-state contract pharmacies; and
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(vii) for the prior year:
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(A) a description of the impact of the 340B drug discount program on the patients
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and community served by the participating 340B entity;
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(B) the total operating costs of the participating 340B entity;
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(C) the total uncompensated care provided by the participating 340B entity; and
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(D) the total number of prescriptions and the percentage of the participating 340B
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entity's prescriptions filled at contract pharmacies.
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(b) An officer of the participating 340B entity shall certify the completeness and
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accuracy of the information submitted in accordance with Subsection (5)(a).
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(c)(i) The department shall use the information described in Subsection (5)(a) to
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prepare a report detailing aggregate information received from a participating
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340B entity.
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(ii) The department shall submit the report described in Subsection (5)(c)(i) to the
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Health and Human Services Interim Committee on or before October 1, 2026.
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(iii) The department shall post the report described in Subsection (5)(c)(ii) on a
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publicly accessible website.
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(6) Nothing in this section shall be construed to conflict with federal law.
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Section 3. Effective Date.
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This bill takes effect on May 7, 2025.
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