26B-3-305. Drug prior approval program.

427 words·~2 min read·/ut/title-26b/chapter-3/26b-3-305

A research copy — for the controlling text, always check the official state or federal source. Not legal advice.

Effective 5/3/2023

(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.

Renumbered and Amended by Chapter 306 , 2023 General Session