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Utah · Through 2026 General Session

Utah Code § 31A-46-309: Reimbursement -- Prohibitions.

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Where this section sits in the code
  1. Title 31A Insurance Code
  2. Chapter 31A-46 Pharmacy Benefits Act
  3. Part 31A-46-3 Operating Requirements

(1) This section applies to a contract entered into or renewed on or after January 1, 2021, between a pharmacy benefit manager and a pharmacy.

(2) A pharmacy benefit manager may not vary the amount it reimburses a pharmacy for a drug on the basis of whether:

(a) the drug is a 340B drug; or

(b) the pharmacy is a 340B entity.

(3) Subsection (2) does not apply to a drug reimbursed, directly or indirectly, by the Medicaid program.

(4) A pharmacy benefit manager may not:

(a) on the basis that a 340B entity participates, directly or indirectly, in the 340B drug discount program:

(i) assess a fee, charge-back, or other adjustment on the 340B entity;

(ii) restrict access to the pharmacy benefit manager's pharmacy network;

(iii) require the 340B entity to enter into a contract with a specific pharmacy to participate in the pharmacy benefit manager's pharmacy network;

(iv) create a restriction or an additional charge on a patient who chooses to receive drugs from a 340B entity; or

(v) create any additional requirements or restrictions on the 340B entity; or

(b) require a claim for a drug to include a modifier to indicate that the drug is a 340B drug unless the claim is for payment, directly or indirectly, by the Medicaid program.

Collected 2026-09-03T11:34:33Z. Source file · JSON

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