HB 52 Utah House · 2025 General Session

Health Insurance Modifications

HB 52 requires health insurers to count drug or device discount coupons toward an enrollee's deductible and copay costs, unless specific exceptions apply (like when a generic or biosimilar alternative exists). It also mandates that pharmaceutical companies and coupon providers allow the full coupon value to reduce out-of-pocket costs at the pharmacy and disclose coupon terms to insurers 12 months in advance. The bill directly affects health insurance enrollees using coupons, insurers, and drug manufacturers. It takes effect May 7, 2025, and does not apply to "qualifying health benefit plans" meeting specific cost-sharing criteria.

Issues: ✓ Healthcare

Bill status introduced 1 of 4 stages cleared

Introduction

Jan 2025

Committee Review

Floor Vote

Governor

Introduced Jan 21, 2025 Last action Mar 8, 2025

Maddy AI version diff · 2 comparisons

What changed between versions

Substitute #1 → Substitute #2 · 5 edits

MODERATE

The bill was resubstituted with minor formatting changes and one substantive addition: a new definition for 'biosimilar' and a new enforcement provision requiring the department to enforce the bill within existing appropriations. The core policy regarding drug discount coupons and cost sharing requirements remains largely unchanged.

DEFINITION

Added a new definition for 'biosimilar' in Section 31A-22-662(1)(a) to clarify the term used in the exceptions for drug discount coupons.

ENFORCEMENT

Added a new subsection (6) to Section 31A-22-662 requiring the department to enforce the section within existing appropriations.

Added a new subsection (3) to Section 31A-48-104 requiring the department to enforce that section within existing appropriations.

REQUIREMENT

Modified Section 31A-48-104(2)(b) to require disclosure of drug discount coupon terms at least 12 months before the coupon is issued, rather than just before issuance.

TECHNICAL

Removed Senate Sponsor name from the header and other minor formatting changes including page numbering and timestamp information.

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Full legislative history

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Committee

Jan 21, 2025

Introduced

House/ 1st reading (Introduced)

lower

1 primary · 0 co-sponsors