SB 312: Pharmacy Practice Amendments - Utah

Amended 3/5/2025 15:03:264 → Substitute #1 · 5 edits

MODERATE

This bill amends Utah's pharmacy practice laws to recognize pharmacists as healthcare providers in specific situations, clarify when devices are needed for drug delivery, update pharmacy audit procedures, and modify the charitable drug recycling program eligibility.

Scope change

The bill expands the scope of pharmacist authority by explicitly recognizing them as healthcare providers for certain consultations and expands the definition of eligible pharmacies for the charitable drug recycling program.

ELIGIBILITY

Added new section recognizing pharmacists as healthcare providers for consultations regarding emergency refills, insulin refills, prescribing certain devices, and dispensing specific drugs.

Modified the definition of eligible pharmacy for the charitable drug recycling program to include Class A and Class B pharmacies more clearly.

REQUIREMENT

Modified the prescription device section to clarify when a pharmacist can prescribe devices like nebulizers and diabetic supplies when they are necessary for appropriate drug delivery.

Updated pharmacy audit requirements to clarify notice periods and restrictions on extrapolation methods for calculating recoupments.

DEFINITION

Updated various definitions throughout the pharmacy practice chapter for consistency and clarity.

Amended Excerpts 3/5/2025 15:03:264 → Amended 3/5/2025 15:03:264 · 4 edits

MODERATE

This bill amends Utah's pharmacy practice laws to clarify when pharmacists are considered health care providers for insurance purposes, update definitions related to pharmacy operations, and establish a future effective date for new provisions. The changes aim to ensure pharmacists receive appropriate recognition for their clinical services while maintaining consistency with existing pharmacy regulations.

Scope change

The bill expands the scope of when pharmacists are recognized as health care providers by insurers, specifically for consultations related to emergency refills, insulin refills, and prescribing certain medical devices and supplies.

ELIGIBILITY

Added provision recognizing pharmacists as health care providers for consultations regarding emergency prescription refills, insulin refills, and prescribing nebulizers, spacers, diabetic supplies, and certain prescription drugs or devices.

TIMELINE

Established that the new health care provider recognition provisions apply to health benefit plans renewed or entered into on or after January 1, 2026.

DEFINITION

Updated and reorganized definitions in the Pharmacy chapter, including clarifications for analytical laboratories, animal euthanasia agencies, automated pharmacy systems, beyond use dates, and pharmacy classifications.

REQUIREMENT

Added requirement that the new pharmacist health care provider provisions only apply when the health benefit plan covers the prescription drug or device in question.

Enrolled → Amended Excerpts 3/5/2025 15:03:264 · 4 edits

MODERATE

The bill was amended to expand the circumstances under which insurers must recognize pharmacists as healthcare providers for reimbursement purposes. The changes add emergency refill dispensing and insulin refill dispensing to the list of pharmacist services that count as healthcare provider consultations, while removing the ability to bill for dispensing drugs under Section 58-17b-1004.

Scope change

The scope of pharmacist reimbursement expanded to include emergency and insulin refills, but the scope was narrowed by removing the ability to bill for drugs dispensed under Section 58-17b-1004.

ELIGIBILITY

Added emergency refill dispensing for prescriptions as a qualifying pharmacist service for insurer reimbursement.

Added dispensing of exhausted insulin prescriptions as a qualifying pharmacist service for insurer reimbursement.

Removed the ability to bill insurers for dispensing drugs described in Section 58-17b-1004 as a qualifying pharmacist service.

REQUIREMENT

Reorganized the list of qualifying pharmacist consultations from a two-item list to a five-item list with new letter designations (a through e) to accommodate the added and removed services.

Introduced → Enrolled · 6 edits · Mar 27, 2025

MODERATE

This bill updates Utah pharmacy laws to recognize pharmacists as healthcare providers in specific situations, clarifies reimbursement rules for pharmacies, and modifies audit requirements for pharmacy records. It also updates definitions related to pharmacy classifications and charitable drug recycling programs.

Scope change

The bill expands pharmacist authority to prescribe certain devices and recognize pharmacists as healthcare providers for insurance reimbursement purposes in limited circumstances.

ELIGIBILITY

Pharmacists are now recognized as healthcare providers for insurance reimbursement when prescribing nebulizers, spacers, diabetic supplies, or other devices necessary for drug delivery.

REQUIREMENT

Reimbursement rules now require insurers to pay pharmacies the ingredient cost plus dispensing fee minus patient payment, with ingredient costs capped at maximum allowable cost or average wholesale price.

Pharmacy audit requirements were changed to require 10 days advanced written notice for on-site audits and limit audits to 200 selected claims annually.

DEFINITION

Updated definitions for pharmacy classifications (Class A through E) and charitable pharmacy eligibility for the prescription drug recycling program.

SCOPE

Added new section recognizing pharmacists as healthcare providers and establishing reimbursement standards for prescription drug dispensing.

TIMELINE

New reimbursement provisions apply to health benefit plans renewed or entered into on or after January 1, 2026.

Pharmacy Practice Amendments

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