In Review: Utah Bill 0042 (Draft-Bollinger)—The bill raises significant PBM concerns by overriding negotiated policies implemented in 2023-2024 and replacing them with new statutory mandates. It prohibits spread pricing, expands MAC requirements, and authorizes contract holders—including self-funded ERISA plans—to audit PBM performance and access related GPO data, while explicitly bringing self-funded plans within scope. The bill mandates detailed MAC disclosures and reimbursement adjustments tied to pharmacy acquisition costs and applies to new or renewed contracts beginning January 1, 2027, with an effective date of May 6, 2026.

If you have any questions, please contact Tonia Sorrell-Neal at tsorrell-neal@pcmanet.org.