All Roll Calls
Yes: 176 • No: 3
UtahH.B. 5272026 General SessionHouseWALLET
Pharmacy Pricing Amendments
Sponsored By: Katy Hall (Republican)
Signed by Governor
Health InsuranceHealth and Human ServicesHealth CareHealth Care ProfessionalsCommercial Health Insurance\Managed Care ContractsPharmacistsPharmacy Benefit ManagersPharmaceuticals
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Bill Overview
Analyzed Economic Effects
4 provisions identified: 1 benefits, 1 costs, 2 mixed.
Stronger pharmacy pay rules and quick appeals
Beginning May 6, 2026, a pharmacy benefit manager (PBM) can use MAC pricing only when the drug is A- or B-rated (or similar), is generally sold in Utah, and is not obsolete. PBMs must share a searchable list showing each drug and its MAC and update prices at least weekly. Pharmacies have 21 days to appeal; PBMs must decide in 14 business days. If the appeal is upheld, the PBM must adjust pay and let the pharmacy reverse and resubmit the claim at no charge.
Medicaid drug pricing rules carved out
Beginning May 6, 2026, when a pharmacy benefit manager (PBM) works for Utah Medicaid, the law’s MAC pricing and appeal rules do not apply to that work. Medicaid PBM services follow separate program rules.
State rules and fines for pharmacy pricing
Beginning May 6, 2026, the Department of Insurance can set rules to carry out these pharmacy pricing laws. The commissioner can order up to $2,500 per violation, per day, when a pharmacy benefit manager (PBM) breaks the law.
Stricter pharmacy pricing definitions and audits
Beginning May 6, 2026, the law updates key terms for pharmacy pricing, like MAC, rebates, and the federal 340B program. Insurers and their PBMs must also follow Utah’s pharmacy audit rules. This clarifies pricing rules and increases oversight of claims and payments.
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Sponsors & Cosponsors
Sponsor
Katy Hall
Republican • House
Cosponsors
Evan J. Vickers
Republican • Senate
Roll Call Votes
House vote • 3/6/2026
House/ concurs with Senate amendment
Yes: 66 • No: 1
Senate vote • 3/6/2026
Senate/ substituted
Yes: 0 • No: 0
Senate vote • 3/6/2026
Senate/ passed 2nd & 3rd readings/ suspension
Yes: 24 • No: 0
House vote • 3/2/2026
Senate Comm - Favorable Recommendation
Yes: 2 • No: 1
House vote • 2/27/2026
House/ substituted
Yes: 0 • No: 0
House vote • 2/27/2026
House/ passed 3rd reading
Yes: 62 • No: 1
House vote • 2/24/2026
House Comm - Substitute Recommendation
Yes: 11 • No: 0
House vote • 2/24/2026
House Comm - Favorable Recommendation
Yes: 11 • No: 0
Actions Timeline
Governor Signed
3/19/2026House/ to Governor
3/17/2026HouseHouse/ received enrolled bill from Printing
3/17/2026HouseHouse/ enrolled bill to Printing
3/12/2026HouseEnrolled Bill Returned to House or Senate
3/12/2026Draft of Enrolled Bill Prepared
3/11/2026Bill Received from House for Enrolling
3/11/2026House/ signed by Speaker/ sent for enrolling
3/11/2026HouseHouse/ received from Senate
3/11/2026HouseSenate/ to House
3/10/2026SenateSenate/ signed by President/ returned to House
3/10/2026SenateSenate/ received from House
3/10/2026SenateHouse/ to Senate
3/6/2026HouseHouse/ concurs with Senate amendment
3/6/2026HouseHouse/ placed on Concurrence Calendar
3/6/2026HouseHouse/ received from Senate
3/6/2026HouseSenate/ to House with amendments
3/6/2026SenateSenate/ passed 2nd & 3rd readings/ suspension
3/6/2026SenateSenate/ substituted
3/6/2026SenateSenate/ 2nd & 3rd readings/ suspension
3/6/2026SenateSenate/ Rules to 2nd Reading Calendar
3/6/2026SenateSenate/ 2nd Reading Calendar to Rules
3/4/2026SenateSenate/ placed on 2nd Reading Calendar
3/2/2026SenateSenate/ committee report favorable
3/2/2026SenateSenate Comm - Favorable Recommendation
3/2/2026
Bill Text
Enrolled
3/12/2026
Substitute #4
3/5/2026
Substitute #3
2/27/2026
Substitute #2
2/26/2026
Substitute #1
2/23/2026
Introduced
2/9/2026
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