{"data":{"id":"us-ut/utah-code-31a-22-661","jurisdiction":"us-ut","citation":"Utah Code § 31A-22-661","heading":"Health benefit plan procedures related to prescription drugs.","body":"(1) As used in this section, \"long-term drug\" means an enrollee's prescription drug where the prescription has been active for at least 180 days with the health benefit plan.\n(2)\n(a) Except as provided in Subsection (2)(b), before a health benefit plan requires an enrollee to change from a prescribed long-term drug to another drug, the health benefit plan shall:\n(i) at least 30 days before the day on which the health benefit plan will require the enrollee to change from the long-term drug to another drug, provide notice that the health benefit plan will require the individual to change to another drug; and\n(ii) provide a justification for the change upon request.\n(b) Subsection (2)(a) does not apply if:\n(i) the change requires the individual to try a generic or a biosimilar of the long-term drug; or\n(ii) the long-term drug is not on the health benefit plan's formulary.\n(3) A health benefit plan shall provide an enrollee a justification as to why an enrollee must try a certain drug before a health benefit plan will cover a different prescribed drug.\n(4) This section does not apply to a drug that is provided under the health benefit plan's medical benefit.","path":["Title 31A Insurance Code","Chapter 31A-22 Contracts in Specific Lines","Part 31A-22-6 Accident and Health Insurance"],"source_url":"https://le.utah.gov/xcode/Title31A/Chapter22/31A-22-S661.html","current_through":"2026 General Session","vintage":"","retrieved_at":"2026-09-03T11:34:33Z","sha256":"0e65473c139a30365f471a9d38b7ee994045b616be1089e472cc06f1c5ff6829","source_id":"us-ut","stale":false,"prev":"us-ut/utah-code-31a-22-660","next":"us-ut/utah-code-31a-22-662"},"notice":"GroundRules: Original legal text. Not legal advice."}