Overview
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.
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.
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 0052 – Utah
Introduced: 2025 Status:
This bill introduces new regulations for health insurance plans and drug discount coupons in Utah, focusing on how cost-sharing requirements are calculated and applied. The bill defines key terms like “biosimilar” (a biological product highly […]
HB 0466 – Utah
Introduced: 2025 Status: In Process
This bill enacts the Uniform Antitrust Pre-Merger Notification Act in Utah, which establishes a comprehensive framework for pre-merger notifications based on the Hart-Scott-Rodino Antitrust Improvements Act. The bill requires businesses to file electronic copies of […]
HB 0495 – Utah
Introduced: 2025 Status: Enacted
This bill makes several amendments to health care practices and insurance regulations in Utah. The first section updates health care claims practices, requiring insurers to timely pay valid claims within specific timeframes, provide written explanations […]
HB 0519 – Utah
Introduced: 2025 Status:
This bill addresses the 340B drug discount program by establishing new regulations for pharmaceutical manufacturers. The 340B program allows certain healthcare providers, such as hospitals and community health centers, to purchase prescription drugs at discounted […]
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 […]
Utah Code § 26-1-3. Purpose of title–Consolidation of health functions into single state agency: Utah Health Code – Utah
Introduced: Status: Enacted
The purpose of this title is to consolidate into a single agency of state government certain health functions exercised by the Department of Human Services.
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Utah Code § 26-1-37. Duty to establish standards for the electronic exchange of clinical health information: Utah Health Code – Utah
Introduced: Status: Enacted
An electronic exchange of clinical health information by a health care provider, a third party payer, the department, or a local health department is a disclosure for treatment, payment, or health care operations if it […]
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Utah Code § 26-1-38. Local health emergency assistance program: Utah Health Code – Utah
Introduced: Status: Enacted
The department shall establish, to the extent of funds appropriated by the Legislature, a local health emergency assistance program.
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Utah Code § 26-1-6. Fee schedule adopted by department: Utah Health Code – Utah
Introduced: Status: Enacted
When the department submits a fee schedule to the Legislature, the Legislature may approve, modify, or reject the proposed fee schedule.
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Utah Code § 26-18-11. Rural hospitals: Medical Assistance Act – Utah
Introduced: Status: Enacted
For purposes of the Medicaid program, the Division of Medicaid and Health Financing may not discriminate among rural hospitals on the basis of size.
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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.
KEY RESOURCES
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