1
2
3
4
5
6
7 LONG TITLE
8 General Description:
9 This bill addresses certain prescription drugs.
10 Highlighted Provisions:
11 This bill:
12 ▸ defines terms;
13 ▸ prohibits a health insurer from taking certain actions with respect to a
14 clinician-administered drug; and
15 ▸ authorizes a physician to issue orders regarding methadone under certain
16 circumstances.
17 Money Appropriated in this Bill:
18 None
19 Other Special Clauses:
20 None
21 Utah Code Sections Affected:
22 ENACTS:
23 31A-22-658, Utah Code Annotated 1953
24 58-37-23, Utah Code Annotated 1953
25
26 Be it enacted by the Legislature of the state of Utah:
27 Section 1. Section 31A-22-658 is enacted to read:
28 31A-22-658. Provider administered drugs.
29 (1) As used in this section:
30 (a) "Clinician-administered drug" means an outpatient prescription drug as defined in
31 Section 58-17b-102 that:
32 (i) cannot reasonably be self-administered by the patient to whom the drug is
33 prescribed or by an individual assisting the patient with self-administration;
34 (ii) is typically administered:
35 (A) by a health care provider; and
36 (B) in a physician's office or a health care facility as defined in Section 26-21-2; and
37 (iii) is not a vaccine.
38 (b) "Health insurer" means a person who offers health care insurance, including a
39 health maintenance organization as defined in Section 31A-8-101.
40 (2) A health insurer may not require:
41 (a) a clinician-administered drug dispensed by a third-party pharmacy selected by the
42 health insurer to be delivered to a health care entity that is a network provider that is able to
43 provide the clinician-administered drug; or
44 (b) a pharmacy to dispense a clinician-administered drug directly to an enrollee with
45 the intention that the enrollee will transport the drug to a health care provider for administering.
46 (3) Subsection (2)(a) does not apply if the health insurer has offered a network provider
47 that is administering a clinician-administered prescription drug the ability to participate on the
48 same terms and conditions that the health insurer offers to other similarly situated network
49 providers.
50 Section 2. Section 58-37-23 is enacted to read:
51 58-37-23. Methadone orders authorized.
52 (1) As used in this section:
53 (a) "Emergency medical order" means a medical order as defined in Section
54 58-17b-102 for up to a 72-hour supply of methadone.
55 (b) "General acute hospital" means the same as that term is defined in Section 26-21-2.
56 (c) "Qualified pharmacy" means a pharmacy that is located on the premises of a general
57 acute hospital that is licensed as a:
58 (i) class A pharmacy as defined in Section 58-17b-102; or
59 (ii) class B pharmacy as defined in Section 58-17b-102.
60 (d) "Qualified practitioner" means a practitioner who:
61 (i) is registered with the United States Drug Enforcement Administration to issue an
62 emergency medical order; and
63 (ii) is working at a general acute hospital.
64 (2) A qualified practitioner may issue an emergency medical order to a qualified
65 pharmacy to dispense up to a 72-hour supply of methadone on behalf of the qualified
66 practitioner:
67 (a) to relieve acute withdrawal symptoms while the qualified practitioner makes
68 arrangements to refer the patient for substance use disorder treatment; and
69 (b) in accordance with 21 C.F.R. Sec. 1306.07 and applicable regulation or guidance
70 issued by the United States Drug Enforcement Administration regarding an emergency medical
71 order.