Section 310 – Prohibited actions with respect to a federally qualified health center.
Effective 5/5/2021 31A-46-310. Prohibited actions with respect to a federally qualified health center. (1) As used in this section, “federally qualified health center”: (a) means the same as that term is defined in 42 U.S.C. Sec. 1395x(aa)(4); and (b) includes the pharmacy or pharmacies that are operated by or contract with a federally qualified health […]
Section 401 – Penalties.
Effective 7/1/2019 31A-46-401. Penalties. A person that violates a provision of this chapter is subject to the penalties described in Section 31A-2-308. Enacted by Chapter 241, 2019 General Session
Section 402 – Severability.
Effective 7/1/2019 31A-46-402. Severability. If any provision of this chapter or the application of any provision of this chapter is found invalid, the remainder of this chapter shall be given effect without the invalid provision or application. Enacted by Chapter 241, 2019 General Session
Section 103 – Manufacturer reports — Insurer report — Publication by department.
Effective 5/4/2022 31A-48-103. Manufacturer reports — Insurer report — Publication by department. (1) (a) A manufacturer of a drug shall, beginning January 1, 2022, report to the department the information described in Subsection (1)(b) no more than 30 days after the day on which an increase to the wholesale acquisition cost of the drug results […]
Section 307 – Pharmacy benefit manager reporting.
Effective 5/12/2020 31A-46-307. Pharmacy benefit manager reporting. (1) A pharmacy benefit manager may not enter into or renew a contract with an insurer on or after January 1, 2021, to administer or manage rebate contracting or rebate administration unless the pharmacy benefit manager agrees to regularly report to the insurer information regarding pharmaceutical manufacturer rebates […]
Section 308 – Out-of-state mail service pharmacies — Drugs not readily available in all pharmacies.
Effective 5/12/2020 31A-46-308. Out-of-state mail service pharmacies — Drugs not readily available in all pharmacies. (1) As used in this section, “out-of-state mail service pharmacy” means the same as that term is defined in Section 58-17b-102. (2) Except as provided in Subsection (3), a third party payor of pharmaceutical services within the state, or its […]
Section 309 – Reimbursement — Prohibitions.
Effective 5/12/2020 31A-46-309. Reimbursement — Prohibitions. (1) This section applies to a contract entered into or renewed on or after January 1, 2021, between a pharmacy benefit manager and a pharmacy. (2) A pharmacy benefit manager may not vary the amount it reimburses a pharmacy for a drug on the basis of whether: (a) the […]
Section 202 – Application for licensure.
Effective 7/1/2019 31A-46-202. Application for licensure. (1) To obtain or renew a license as a pharmacy benefit manager, a person shall: (a) submit an application to the commissioner on forms and in a manner established by the commissioner by rule made in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act; and (b) pay […]
Section 302 – Direct or indirect remuneration by pharmacy benefit managers — Disclosure of customer costs — Limit on customer payment for prescription drugs.
Effective 5/12/2020 31A-46-302. Direct or indirect remuneration by pharmacy benefit managers — Disclosure of customer costs — Limit on customer payment for prescription drugs. (1) If a pharmacy service entity engages in direct or indirect remuneration with a pharmacy, the pharmacy service entity shall make a reimbursement report available to the pharmacy upon the pharmacy’s […]
Section 303 – Insurer and pharmacy benefit management services — Registration — Maximum allowable cost — Audit restrictions.
Effective 5/12/2020 31A-46-303. Insurer and pharmacy benefit management services — Registration — Maximum allowable cost — Audit restrictions. (1) An insurer and an insurer’s pharmacy benefit manager is subject to the pharmacy audit provisions of Section 58-17b-622. (2) A pharmacy benefit manager shall not use maximum allowable cost as a basis for reimbursement to a […]