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2021 Utah Code
Title 49 - Utah State Retirement and Insurance Benefit Act
Chapter 20 - Public Employees' Benefit and Insurance Program Act
Part 4 - Insurance Program
Section 421 - Prescription discount program.
Universal Citation:
UT Code § 49-20-421 (2021)
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Effective 7/1/2021
49-20-421. Prescription discount program.
Amended by Chapter 255, 2021 General Session
49-20-421. Prescription discount program.
- (1) As used in this section:
- (a) "Diabetes" means:
- (i) complete insulin deficiency or type 1 diabetes;
- (ii) insulin resistant with partial insulin deficiency or type 2 diabetes; or
- (iii) elevated blood glucose levels induced by pregnancy or gestational diabetes.
- (b) "Discount program" means a process developed by the program that allows participants to purchase a qualified prescription at a discounted, post-rebate rate.
- (c) "Epinephrine auto-injector" means the same as that term is defined in Section 26-41-102.
- (d) "Individual with diabetes" means an individual who has been diagnosed with diabetes and who uses insulin to treat diabetes.
- (e) "Insulin" means a prescription drug that contains insulin.
- (f) "Participant" means a resident of Utah who:
- (i) has a qualified condition;
- (ii) does not receive health coverage under the program; and
- (iii) enrolls in the discount program.
- (g) "Prescription drug" means the same as that term is defined in Section 58-17b-102.
- (h) "Qualified condition" means the individual:
- (i) uses insulin to treat diabetes; or
- (ii) has a prescription or a standing prescription drug order for an epinephrine auto-injector issued under Section 58-17b-1005.
- (i) "Qualified prescription" means:
- (i) insulin; or
- (ii) epinephrine auto-injector.
- (j) "Rebate" means the same as that term is defined in Section 31A-46-102.
- (a) "Diabetes" means:
- (2) Notwithstanding Subsection 49-20-201(1), and for the purpose of the discount program only, the program shall offer a discount program that allows participants to purchase a qualified prescription at a discounted, post-rebate price when a rebate is available.
- (3) The discount program described in Subsection (2) shall:
- (a) provide a participant with a card or electronic document that identifies the participant as eligible for the discount on a qualified prescription related to the participant's qualified condition;
- (b) provide a participant with information about pharmacies that will honor the discount;
- (c) allow a participant to purchase a qualified prescription at a discounted, post-rebate price; and
- (d) provide a participant with instructions to pursue a reimbursement of the purchase price from the participant's health insurer.
- (4) The discount program shall charge a price for a qualified prescription that allows the program to retain only enough of any rebate for the qualified prescription to make the state risk pool whole for providing a discounted qualified prescription to participants.
Amended by Chapter 255, 2021 General Session
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