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Utah Code Title 26B. Utah Health and Human Services Codes § 26B-3-305. Drug prior approval program

Current as of January 01, 2025 | Updated by Findlaw Staff

(1) A drug prior approval program approved or implemented by the board shall meet the following conditions:

(a) except as provided in Subsection (2), a drug may not be placed on prior approval for other than medical reasons;

(b) the board shall hold a public hearing at least 30 days prior to placing a drug on prior approval;

(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);

(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);

(e) the board shall provide evidence that placing a drug class on prior approval:

(i) will not impede quality of recipient care; and

(ii) that the drug class is subject to clinical abuse or misuse;

(f) the board shall reconsider its decision to place a drug on prior approval:

(i) no later than nine months after any drug class is placed on prior approval; and

(ii) at a public hearing with notice as provided in Subsection (1)(b);

(g) the program shall provide an approval or denial of a request for prior approval:

(i) by either:

(A) fax;

(B) telephone; or

(C) electronic transmission;

(ii) at least Monday through Friday, except for state holidays; and

(iii) within 24 hours after receipt of the prior approval request;

(h) the program shall provide for the dispensing of at least a 72-hour supply of the drug on the prior approval program:

(i) in an emergency situation; or

(ii) on weekends or state holidays;

(i) the program may be applied to allow acceptable medical use of a drug on prior approval for appropriate off-label indications; and

(j) before placing a drug class on the prior approval program, the board shall:

(i) determine that the requirements of Subsections (1)(a) through (i) have been met; and

(ii) by majority vote, place the drug class on prior approval.

(2) The board may, only after complying with Subsections (1)(b) through (j), consider the cost:

(a) of a drug when placing a drug on the prior approval program; and

(b) associated with including, or excluding a drug from the prior approval process, including:

(i) potential side effects associated with a drug; or

(ii) potential hospitalizations or other complications that may occur as a result of a drug's inclusion on the prior approval process.

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Cite this article: FindLaw.com - Utah Code Title 26B. Utah Health and Human Services Codes § 26B-3-305. Drug prior approval program - last updated January 01, 2025 | https://codes.findlaw.com/ut/title-26b-utah-health-and-human-services-codes/ut-code-sect-26b-3-305/

FindLaw Codes may not reflect the most recent version of the law in your jurisdiction. Please verify the status of the code you are researching with the state legislature before relying on it for your legal needs.

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