Overview
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 2024, the Utah legislature considered legislation addressing telemedicine services, health insurance benefits, standards for healthcare facilities, and health benefit plan cost sharing, all of which ultimately died.
See below for an overview of existing Utah state mandates. Click on citation tab for detailed information of specific statutes (click link to download statute text).
State Action
Latest Legislative Session: 1/17/2023 - 3/3/2023 (2023 term). *Current session bill updates are ongoing. Check back weekly for updates.
HB 110 – Utah
Introduced: 2021 Status: Enacted
Health Care Payment Amendments. This bill provides that a governmental entity within the state that is a health care provider may not collect an overdue payment for a medical material or service from the debtor’s …
HB 116 – Utah
Introduced: 2022 Status: Inactive / Dead
This bill limits when a health care provider may seek payment for a medical service or procedure from an individual or a health benefit plan. For an insured patient, a health care provider may not, …
HB 127 – Utah
Introduced: 2017 Status: Inactive / Dead
This bill requires a health insurer to develop and implement a savings reward program for enrollees; requires an insurer to obtain approval of the savings reward program from the insurance commission; and gives the commissioner …
HB 128 – Utah
Introduced: 2017 Status: Enacted
This bill defines terms; modifies the circumstances under which a health care provider may make a report to a credit bureau, use the services of a collection agency, or use a non-routine billing or notification …
HB 154 – Utah
Introduced: 2017 Status: Enacted
This bill defines terms; amends the Medical Assistance Act regarding reimbursement for telemedicine services; amends the Insurance Code to require insurer transparency regarding telehealth reimbursement; amends the Public Employees’ Benefit and Insurance Program Act (PEHP) …
Utah Code § 26-36b-205. Calculation of assessment: Inpatient Hospital Assessment Act – Utah
Introduced: Status: Enacted
Except as provided in Subsection (1)(b), an annual assessment is payable on a quarterly basis for each private hospital in an amount calculated by the division at a uniform assessment rate for each hospital discharge, …
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Utah Code § 26-36b-206. State teaching hospital and non-state government hospital mandatory intergovernmental transfer: Inpatient Hospital Assessment Act – Utah
Introduced: Status: Enacted
The state teaching hospital and a non-state government hospital shall make an intergovernmental transfer to the Medicaid Expansion Fund created in Section 26-36b-208, in accordance with this section.
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Utah Code § 26-36b-207. Penalties and interest: Inpatient Hospital Assessment Act – Utah
Introduced: Status: Enacted
If a hospital fails to timely pay the full amount of a quarterly assessment or the mandated intergovernmental transfer, the department shall add to the assessment or intergovernmental transfer a penalty equal to 5% of …
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Utah Code § 26-36b-208. Medicaid Expansion Fund: Inpatient Hospital Assessment Act – Utah
Introduced: Status: Enacted
A state agency administering the provisions of this chapter may use money from the fund to pay the costs, not otherwise paid for with federal funds or other revenue sources, of the health coverage improvement …
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Utah Code § 26-36b-209. Hospital reimbursement: Inpatient Hospital Assessment Act – Utah
Introduced: Status: Enacted
Hospital reimbursement regulations under the state health coverage improvement program, the enhancement waiver program, and Medicaid waiver expansion.
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FTC v. HCA Healthcare & Steward Health Care – Utah
District Court: District of Utah Status: Pending
HCA Healthcare, the second largest health system with six hospitals in the Wasatch Front region of Utah, proposed to acquire five hospitals from Steward Health …
In re: Suboxone Antitrust Litigation (State of Wisconsin, et al. v. Indivior Inc, et al.) – Alabama, Alaska, Arkansas, California, Colorado, Connecticut, Delaware, District of Columbia, Florida, Georgia, Hawaii, Idaho, Illinois, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Nebraska, New Hampshire, New Mexico, New York, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, South Dakota, Tennessee, Utah, Virginia, Washington, West Virginia, Wisconsin
District Court: E.D. Pennsylvania Status: Pending
In September 2016, 35 state attorneys general and the District of Columbia brought a multi-district case against pharmaceutical manufacturer Indivior, MonoSol RX et al., alleging …
In Re: Generic Pharmaceuticals Pricing Antitrust Litigation – Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, District of Columbia, Florida, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, South Carolina, Tennessee, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin
District Court: Eastern District of Pennsylvania Status: Pending
Plaintiffs are attorney generals from 48 states, Puerto Rico, and the District of Columbia, as well as classes of private plaintiffs that filed an antitrust …
Additional Resources
STATE BUDGET
Utah’s fiscal year begins on July 1 and ends on June 30 of the following year. Agencies submit their budget requests to the governor in October. The governor submits his or her proposed budget to the state legislature in December. The legislature typically passes a budget in March. A simple majority is required to pass a budget. Utah is one of 44 states in which the governor has line item veto authority.
STATE LEGISLATURE
The Utah State Legislature meets annually for a 45-day session, starting on the first Tuesday after the third Monday in January. There are 29 state senators serving four-year staggered terms. The 75 members of the House of Representatives serve two-year terms. Bills do not carry over from year to year.