SB 300 would establish Utah's state-run health financing program, replacing Medicaid and public employee health plans for all residents and government employees. It creates the Utah Health Services Commission to manage the program, requires healthcare facilities to stop billing directly (with the state billing on their behalf), and transitions existing health programs into the new system. The program would be funded by a new tax, while certain outdated health programs would be repealed. This bill directly affects all Utah residents, government employees, and healthcare providers through these structural changes to the state's health coverage system.
HB 468 requires health insurance plans in Utah to cover mobile mammography screenings when provided by an approved mobile unit (like a bus or vehicle with FDA-accredited equipment) in rural areas. It defines "rural area" as specific county classifications and mandates that coverage must reimburse mobile units at the same rate as in-network facility screenings. The bill also requires mobile units to accept the reimbursement amount plus any patient cost-sharing as full payment and to follow U.S. Preventive Services Task Force guidelines for screenings. This law takes effect January 1, 2027, directly affecting insurers, mobile mammography providers, and patients in rural Utah.
SB 319 requires Utah health insurance companies to increase transparency around preauthorization processes. It mandates insurers to post detailed preauthorization requirements and statistics on their websites, disclose if they use artificial intelligence in reviews, and make decisions within seven days. The bill also sets minimum validity periods for authorizations covering chronic or long-term care conditions and requires independent medical judgment for denials. These changes directly affect insurers, healthcare providers submitting requests, and patients seeking covered services.
HB 599 amends Utah's social services funding to redirect interest earned from the Medicaid ACA Fund into the General Fund, freeing up $759,700 annually for 2026-2027. It adds immunosuppressive drugs to Medicaid's preferred drug list and transitions the Children's Health Insurance Program (CHIP) into Medicaid, with dental services for CHIP beneficiaries to be provided through the University of Utah School of Dentistry. The bill also allocates funds from electronic cigarette taxes to support substance use treatment and prevention services. These changes directly affect Medicaid beneficiaries, CHIP enrollees (now covered under Medicaid), and individuals seeking substance use treatment.
SB 161 amends Utah's guardianship laws to clarify rights for individuals alleged to be incapacitated and update procedures for court-appointed health care assessments. The bill ensures that Health Insurance Portability and Accountability Act (HIPAA) rights are preserved and sets new standards for health care providers conducting assessments, including requiring their reports to be filed with the court. It also prohibits health care providers from interviewing the person seeking guardianship or including their opinions in assessment reports. These changes apply to guardianships granted on or after May 7, 2025.
HB 340 amends Utah's Medicare supplement insurance rules to allow individuals under 65 who are eligible for Medicare to enroll in Medicare supplement plans under specific circumstances. The bill prohibits insurers from denying coverage or charging more for preexisting conditions diagnosed within six months before coverage starts. It also requires insurers to let enrollees switch to comparable or lower-tier plans annually without medical underwriting and establishes loss ratio standards for premium refunds. These changes directly affect Utah residents under 65 who qualify for Medicare but previously faced enrollment barriers. The bill focuses on expanding access and standardizing coverage terms without appropriating state funds.
SB 175 updates Utah's health insurance requirements for autism spectrum disorder (ASD) coverage. It requires health benefit plans to cover ASD treatment - including applied behavior analysis - and expands the list of qualified providers (like psychologists and social workers) eligible for reimbursement for diagnosis and treatment. The bill also removes outdated language about preexisting conditions and clarifies definitions for ASD diagnosis and treatment under Utah law. These changes directly affect health insurance plans sold in Utah's individual and large group markets, ensuring coverage for children aged 2-10 years with ASD. The law amends specific Utah Code sections (26B-3-904 and 31A-22-642) without appropriating new funds.
HB 258 requires health insurance plans in Utah to cover reversal treatments for gender transition if the plan covers transition-related care. Specifically, plans covering hormonal transgender treatments must also cover reversal hormonal treatments, and plans covering surgical sex transition procedures must cover reversal surgeries. This applies to all health benefit plans renewed or entered into on or after January 1, 2027. The bill directly affects insurers and policyholders by mandating this coverage, without appropriating funds or adding new administrative requirements.
HB 417 allows patients to use non-medical transportation (like family rides or public transit) for moving between healthcare facilities when their condition doesn't require ambulance transport. It requires hospitals to provide written notices explaining why ambulance isn't needed, potential insurance coverage issues, and cost details, and to help arrange the transport. Receiving facilities cannot charge for admission or readmission if the patient arrives within two hours of discharge without a medical condition change, and must hold the offered bed. The bill also protects hospitals from liability when non-medical transport is permitted under the specified conditions.
HB 171 clarifies that insurance plans must allow patients to select physician assistants (PAs) as primary care providers without higher costs or barriers. It amends Utah law to explicitly include PAs in insurance coverage requirements for primary care, ensuring they are recognized alongside physicians, obstetricians, gynecologists, and pediatricians. The bill requires insurers to cover PA services as primary care under the same terms as other providers, preventing higher premiums or copays for choosing a PA. This affects patients seeking primary care and insurance companies operating in Utah, with the changes taking effect May 6, 2026.
