UtahH.C.R. 22025 General SessionHouseWALLET

Concurrent Resolution Directing PEHP Regarding Pharmaceutical Rebates

Sponsored By: Norman K Thurston (Republican)

Signed by Governor

Health InsuranceResolutionsHealth and Human ServicesHealth CareHealth Care FacilitiesPharmaciesPublic Employees' Health ProgramPharmaceuticals

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Bill Overview

Analyzed Economic Effects

3 provisions identified: 2 benefits, 1 costs, 0 mixed.

Drug rebates for Utah state plan members

Utah’s state health plan administrator, PEHP, must provide members with estimated drug rebate values at the pharmacy counter. This applies when a member buys a drug with an estimated rebate. The amount reflects the member’s share of the drug cost, minus confirmed payment assistance that lowers out-of-pocket costs. The resolution sets no start or end date.

Utah health plan reviews drug manager contracts

PEHP must seek the best total value from its pharmacy benefit manager contract. It must keep monitoring and updating the contract and seek new bids. This requirement does not specify direct changes to members’ drug costs, benefits, or eligibility.

Utah state members share drug rebate costs

PEHP must spread the cost of providing rebate values across all covered state members, keeping the change cost-neutral for Utah. It must increase members’ premium share or reduce the state’s health savings account contribution. The resolution cites about $2 million in drug costs borne by a small group of members. It estimates spreading that burden across the state plan at about $2.84 per member monthly. It does not set the actual premium increase or account contribution cut.

Sponsors & Cosponsors

Sponsor

Norman K Thurston
Republican • House

Cosponsors

Wayne A. Harper
Republican • Senate

Roll Call Votes

All Roll Calls

Yes: 127 • No: 0

Senate vote • 2/12/2025

Senate/ passed 3rd reading

Yes: 24 • No: 0

Senate vote • 2/6/2025

Senate Comm - Favorable Recommendation

Yes: 4 • No: 0

Senate vote • 2/6/2025

Senate Comm - Consent Calendar Recommendation

Yes: 4 • No: 0

House vote • 1/31/2025

House/ passed 3rd reading

Yes: 71 • No: 0

House vote • 1/23/2025

House Comm - Amendment Recommendation

Yes: 12 • No: 0