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Utah House passes pharmacy benefit manager transparency bill
Summary
The House approved the first substitute to HB 16, the Pharmacy Benefits Manager Act, requiring PBMs to report aggregate prescription payment data to health plans while protecting proprietary information; the bill passed 66–2 and will go to the Senate.
The Utah House on Feb. 7 passed the first substitute to House Bill 16, the Pharmacy Benefits Manager (PBM) Act, aimed at giving health benefit plans more visibility into how prescription dollars flow through PBMs and pharmacies. Representative Vickers, sponsor of the substitute, said the change narrows the reporting requirement to aggregate totals and adds provisions to protect proprietary data; he told colleagues the measure does not create a new agency or require a fee.
Supporters said the measure is intended to increase transparency so health benefit plans can assess whether PBMs are delivering cost-effective services. Representative Vickers said the substitute addresses industry concerns by requiring an aggregate total report rather than line-by-line prescriptions, carving out plans that own PBMs from an awkward self-reporting requirement and including limited protections for proprietary material.
Members pressed the sponsor in floor questioning about the bill's enforcement language and whether the statutory penalty language could create a strict-liability unfair-trade-practice exposure under Title 13. Representative Vickers said legislative analysts and the sponsor believed the provided remedy language aligned with approaches used in other states and with oversight by the Department of Insurance.
The sponsor cited examples from other jurisdictions, including a Texas state employee program that reported large first-year savings after comparable transparency measures were adopted. Opponents and skeptics asked whether market-based solutions had been exhausted before resorting to statute; the sponsor replied that health plans repeatedly request information but do not consistently obtain it, and statutory clarity ensures consistent access.
After discussion and summation, the House recorded a final passage vote of 66 yes and 2 no. The bill will be transmitted to the Utah Senate for consideration.
Provenance: Topic introduced on the floor at SEG 453; discussion and final passage recorded through SEG 730.
Next steps: Transmittal to the Senate; no implementation dates were specified on the floor.
