UT
Utah Senate Bill SB0069

Utah 2025 Regular Session

Utah Senate Bill SB0069 Compare Versions

OldNewDifferences
1-Enrolled Copy S.B. 69
1+03-03 22:38 4th Sub. (Pumpkin) S.B. 69
2+Evan J. Vickers proposes the following substitute bill:
23 1
34 Medication Amendments
45 2025 GENERAL SESSION
56 STATE OF UTAH
67 Chief Sponsor: Evan J. Vickers
7-House Sponsor: Steve Eliason
8+House Sponsor:
89 2
910
1011 3
1112 LONG TITLE
1213 4
1314 General Description:
1415 5
15-This bill addresses the 340B drug discount program.
16+This bill addresses participation in a federal drug discount program.
1617 6
1718 Highlighted Provisions:
1819 7
1920 This bill:
2021 8
21-▸ defines a term;
22+▸ defines terms;
2223 9
23-▸ prohibits certain conduct by a pharmaceutical manufacturer with respect to the 340B drug
24+▸ prohibits a pharmaceutical manufacturer from restricting, prohibiting, or otherwise
2425 10
25-discount program; and
26+interfering with a 340B entity's ability to:
2627 11
28+● acquire a 340B drug; or
29+12
30+● participate in the 340B drug discount program;
31+13
2732 ▸ permits the Public Employees' Benefit and Insurance Program to adjust its business
28-12
29-practices to mitigate any resulting financial impacts.
30-13
33+14
34+practices to mitigate any resulting financial impacts;
35+15
36+▸ permits a manufacturer to request certain claim information from 340B entities; and
37+16
38+▸ requires 340B entities to submit information to the Insurance Department.
39+17
3140 Money Appropriated in this Bill:
32-14
41+18
3342 None
34-15
43+19
3544 Other Special Clauses:
36-16
45+20
3746 None
38-17
47+21
3948 Utah Code Sections Affected:
40-18
49+22
4150 ENACTS:
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51+23
4352 31A-46-311, Utah Code Annotated 1953
44-20
53+24
54+31A-46-312, Utah Code Annotated 1953
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4556
46-21
57+26
4758 Be it enacted by the Legislature of the state of Utah:
48-22
59+27
4960 Section 1. Section 31A-46-311 is enacted to read:
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61+28
5162 31A-46-311 . Prohibited actions with respect to the 340B drug discount program.
52-24
63+4th Sub. S.B. 69 4th Sub. (Pumpkin) S.B. 69 03-03 22:38
64+29
5365 (1) As used in this section, "manufacturer" means a pharmaceutical manufacturer, including
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66+30
5567 an agent or affiliate of a pharmaceutical manufacturer.
56-26
68+31
5769 (2) A manufacturer may not:
58-27
70+32
5971 (a) directly or indirectly restrict or prohibit:
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61-(i) a pharmacy from contracting with a 340B entity, including by denying the S.B. 69 Enrolled Copy
62-29
72+33
73+(i) a pharmacy from contracting with a 340B entity, including by denying the
74+34
6375 pharmacy access to a drug that is manufactured by the manufacturer;
64-30
76+35
6577 (ii) a 340B entity from contracting with a pharmacy, including by denying the 340B
66-31
78+36
6779 entity access to a drug that is manufactured by the manufacturer;
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80+37
6981 (iii) the acquisition, dispensing, or delivery of a 340B drug to any location authorized
70-33
82+38
7183 by a 340B entity to receive the drug, unless prohibited by federal law; or
72-34
84+39
7385 (iv) a 340B entity from receiving 340B drug discount program pricing for a 340B
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86+40
7587 drug, including by imposing a time limitation on a 340B entity to replenish or
76-36
77-submit a claim for a 340B drug;
78-37
79-(b) directly or indirectly:
80-38
81-(i) require a 340B entity to purchase a 340B drug from a supplier if the manufacturer
82-39
83-would otherwise permit the 340B entity to purchase a drug that is not a 340B drug
84-40
85-from the supplier; or
8688 41
87-(ii) require a 340B entity to submit any claim data, utilization data, or information
89+submit a claim for a 340B drug; or
8890 42
89-about a 340B entity's contracts with a third-party as a condition for allowing the
91+(b) interfere with:
9092 43
91-acquisition of a 340B drug by, or delivery of a 340B drug to, a 340B entity, unless
93+(i) a contract between a pharmacy and a 340B entity; or
9294 44
93-the data or information sharing is required by federal law; or
95+(ii) the ability of a pharmacy and a 340B entity to enter into a contract.
9496 45
95-(c) interfere with:
97+(3) The Public Employees' Benefit and Insurance Program created in Section 49-20-103
9698 46
97-(i) a contract between a pharmacy and a 340B entity; or
99+may adjust the program's business practices to mitigate any financial impacts resulting
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99-(ii) the ability of a pharmacy and a 340B entity to enter into a contract.
101+from this section.
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101-(3) The Public Employees' Benefit and Insurance Program created in Section 49-20-103
103+(4) Nothing in this section shall be construed to conflict with federal law.
102104 49
103-may adjust the program's business practices to mitigate any financial impacts resulting
105+Section 2. Section 31A-46-312 is enacted to read:
104106 50
105-from this section.
107+31A-46-312 . Claim information sharing and use -- 340B entity public reporting.
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107-(4) Nothing in this section is to be construed to conflict with federal law.
109+(1) As used in this section:
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109-Section 2. Effective Date.
111+(a) "Bad debt" means the amount of money charged by a 340B entity for providing
110112 53
113+health care services to a patient for which the 340B entity does not receive payment.
114+54
115+(b) "Claim information" means information that is:
116+55
117+(i) described in Subsection (2); and
118+56
119+(ii) related to a claim for a 340B drug that is:
120+57
121+(A) dispensed by a contract pharmacy; and
122+58
123+(B) manufactured by a single pharmaceutical manufacturer.
124+59
125+(c) "Contract pharmacy" means a pharmacy contracting with an entity participating in
126+60
127+the 340B drug discount program to dispense drugs purchased through the 340B drug
128+61
129+discount program.
130+62
131+(d) "Financial assistance" means the cost incurred by a 340B entity for providing health
132+- 2 - 03-03 22:38 4th Sub. (Pumpkin) S.B. 69
133+63
134+care services to a patient at a reduced cost or no cost.
135+64
136+(e) "Uncompensated care" means the sum of a 340B entity's bad debt and financial
137+65
138+assistance.
139+66
140+(2) A pharmaceutical manufacturer may request from a 340B entity the following claim
141+67
142+information:
143+68
144+(a) prescription number;
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146+(b) prescribed date;
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148+(c) fill date;
149+71
150+(d) national drug code;
151+72
152+(e) quantity;
153+73
154+(f) pharmacy identification;
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156+(g) prescriber identification number; and
157+75
158+(h) 340B covered entity identification.
159+76
160+(3) A 340B entity that receives a request from a pharmaceutical manufacturer as described
161+77
162+in Subsection (2) shall provide to the pharmaceutical manufacturer the requested claim
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164+information.
165+79
166+(4) A pharmaceutical manufacturer may only use claim information received under this
167+80
168+section to identify a rebate for an insurer or a third party administrator that is ineligible
169+81
170+for payment under the pharmaceutical manufacturer's policy.
171+82
172+(5)(a) Beginning on July 1, 2026, a 340B entity shall annually provide, on or before the
173+83
174+first day of the month after the 340B entity files the 340B entity's Medicare cost
175+84
176+report, the following to the department in a form and manner determined by the
177+85
178+department:
179+86
180+(i) the name of the 340B entity;
181+87
182+(ii) a copy of the 340B entity's annual 340B program recertification;
183+88
184+(iii) if the 340B entity is required to conduct a community health needs assessment
185+89
186+under Section 501(r)(3)(A), Internal Revenue Code, a copy of the 340B entity's
187+90
188+most recent community health needs assessment;
189+91
190+(iv) a statement that the 340B entity is in compliance with the 340B drug discount
191+92
192+program;
193+93
194+(v) the total number of contract pharmacies with which the 340B entity contracts;
195+94
196+(vi) the total number of contract pharmacies located out-of-state and the states in
197+95
198+which out-of-state contract pharmacies are located; and
199+96
200+(vii) for the prior year:
201+- 3 - 4th Sub. (Pumpkin) S.B. 69 03-03 22:38
202+97
203+(A) a description of the impact of the 340B drug discount program on the patients
204+98
205+and community served by the 340B entity;
206+99
207+(B) the total operating costs of the 340B entity;
208+100
209+(C) the total uncompensated care provided by the 340B entity; and
210+101
211+(D) the total number of prescriptions and the percentage of the 340B entity's
212+102
213+prescriptions filled at contract pharmacies.
214+103
215+(b) An officer of the 340B entity shall certify the completeness and accuracy of the
216+104
217+information submitted in accordance with Subsection (5)(a).
218+105
219+(c)(i) The department shall use the information described in Subsection (5)(a) to
220+106
221+prepare a report detailing aggregate information received from a 340B entity.
222+107
223+(ii) The department shall submit the report described in Subsection (5)(c)(i) to the
224+108
225+Health and Human Services Interim Committee on or before July 1, 2027.
226+109
227+(iii) The department shall post the report described in Subsection (5)(c)(ii) on a
228+110
229+publicly accessible website.
230+111
231+(6) Nothing in this section shall be construed to conflict with federal law.
232+112
233+Section 3. Effective Date.
234+113
111235 This bill takes effect on May 7, 2025.
112-- 2 -
236+- 4 -