Spotlight on State

Spotlight on State: Utah

This is part of a series of summaries that highlight notable legislation and initiatives in health policy and reform of all 50 states. Check back on The Source as we roll out additional states each week.

See Utah page.

Utah was one of the first states to operate an APCD, and claims to be the first to begin tracking and analyzing episodes of care, an important feature of risk-sharing based payment systems for states looking to reduce private payer and Medicaid expenditures. The state also enacted a right to shop program in 2018, which requires the Public Employees’ Benefit and Insurance Program to implement a savings reward program and allows health insurers to reward plan enrollees for selecting high-quality and low-cost health care providers. Additionally, to promote prescription drug price transparency, the legislature passed laws to prohibit pharmacy benefits managers from preventing a pharmacist from disclosing cost information to a patient,

In 2020, Utah enacted laws to mandate telehealth parity, requiring certain health benefit plans to provide coverage parity and commercially reasonable reimbursement for telehealth services and telemedicine services.

Utah’s full Medicaid expansion became effective in January 2020. The expansion extends Medicaid eligibility to Utah adults whose annual income is up to 138% of the federal poverty level.

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