{"data":{"id":"us-ut/utah-code-26b-3-305","jurisdiction":"us-ut","citation":"Utah Code § 26B-3-305","heading":"Drug prior approval program.","body":"(1) A drug prior approval program approved or implemented by the board shall meet the following conditions:\n(a) except as provided in Subsection (2), a drug may not be placed on prior approval for other than medical reasons;\n(b) the board shall hold a public hearing at least 30 days prior to placing a drug on prior approval;\n(c) notwithstanding the provisions of Section 52-4-202, the board shall provide not less than 14 days' notice to the public before holding a public hearing under Subsection (1)(b);\n(d) the board shall consider written and oral comments submitted by interested parties prior to or during the hearing held in accordance with Subsection (1)(b);\n(e) the board shall provide evidence that placing a drug class on prior approval:\n(i) will not impede quality of recipient care; and\n(ii) that the drug class is subject to clinical abuse or misuse;\n(f) the board shall reconsider its decision to place a drug on prior approval:\n(i) no later than nine months after any drug class is placed on prior approval; and\n(ii) at a public hearing with notice as provided in Subsection (1)(b);\n(g) the program shall provide an approval or denial of a request for prior approval:\n(i) by either:\n(A) fax;\n(B) telephone; or\n(C) electronic transmission;\n(ii) at least Monday through Friday, except for state holidays; and\n(iii) within 24 hours after receipt of the prior approval request;\n(h) the program shall provide for the dispensing of at least a 72-hour supply of the drug on the prior approval program:\n(i) in an emergency situation; or\n(ii) on weekends or state holidays;\n(i) the program may be applied to allow acceptable medical use of a drug on prior approval for appropriate off-label indications; and\n(j) before placing a drug class on the prior approval program, the board shall:\n(i) determine that the requirements of Subsections (1)(a) through (i) have been met; and\n(ii) by majority vote, place the drug class on prior approval.\n(2) The board may, only after complying with Subsections (1)(b) through (j), consider the cost:\n(a) of a drug when placing a drug on the prior approval program; and\n(b) associated with including, or excluding a drug from the prior approval process, including:\n(i) potential side effects associated with a drug; or\n(ii) potential hospitalizations or other complications that may occur as a result of a drug's inclusion on the prior approval process.","path":["Title 26B Utah Health and Human Services Code","Chapter 26B-3 Health Care - Administration and Assistance","Part 26B-3-3 Administration of Medicaid Programs: Drug Utilization Review and Long Term Care Facility Certification"],"source_url":"https://le.utah.gov/xcode/Title26B/Chapter3/26B-3-S305.html","current_through":"2026 General Session","vintage":"","retrieved_at":"2026-09-03T11:34:33Z","sha256":"b280f1fd9dba1f6c3e464fbf039f82c7e39249d8f0e5c17a7c87cba723363bcb","source_id":"us-ut","stale":false,"prev":"us-ut/utah-code-26b-3-304","next":"us-ut/utah-code-26b-3-306"},"notice":"GroundRules: Original legal text. Not legal advice."}