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2025 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 (2025)
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Effective 5/7/2025
49-20-421. Prescription discount program.
Amended by Chapter 122, 2025 General Session
49-20-421. Prescription discount program.
- (1)As used in this section:
- (a)"Discount program" means the prescription discount program created by this section.
- (b)"Epinephrine auto-injector" means a portable, disposable drug delivery device that contains a measured, single dose of epinephrine that is used to treat a person suffering a potentially fatal anaphylactic reaction.
- (c)"Insulin" means a prescription drug that contains insulin.
- (d)"Participant" means a resident of Utah who:
- (i)has a prescription or standing prescription for a qualified prescription;
- (ii)does not receive health coverage under the program; and
- (iii)enrolls in the discount program.
- (e)"Prescription drug" means the same as that term is defined in Section 58-17b-102.
- (f)"Qualified prescription" means a prescription drug, including insulin and epinephrine auto-injectors, that the program has determined:
- (i)treats a serious, prevalent, and ongoing condition;
- (ii)does not have a generic substitute;
- (iii)qualifies for a substantial rebate; and
- (iv)would not result in financial losses to the state risk pool if sold as part of the discount program.
- (g)"Rebate" means the same as that term is defined in Section 31A-46-102.
- (2)The program shall create a prescription discount program for a participant to purchase a qualified prescription at a discounted, post-rebate price.
- (3)The program shall:
- (a)provide a participant with a card or electronic document that identifies the participant as eligible for the discount on a qualified prescription;
- (b)provide a participant with information about pharmacies that will honor the discount; and
- (c)provide a participant with instructions to pursue a reimbursement of the purchase price from the participant's health insurer.
- (4)The program may not retain any amount of a rebate for a qualified prescription except for an amount necessary to make the state risk pool whole for providing the qualified prescription to participants.
- (5)For each drug added to the discount program, the program shall notify the Health and Human Services Interim Committee, providing:
- (a)the name of the drug; and
- (b)the primary condition the drug treats.
Amended by Chapter 122, 2025 General Session
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