SB 300 — Single Payer Health Insurance Amendments

{Section 2.

Section 26B-1-423 is amended to read:

} 26B-1-423.

Rural Physician Loan Repayment Program Advisory Committee -- Membership -- Compensation -- Duties.

(1) There is created the Rural Physician Loan Repayment Program Advisory Committee consisting of the following eight members appointed by the executive director:

(a) two legislators whose districts include a rural county as defined in Section [26B-4-701] 26C-1-101;

(b) five administrators of a hospital located in a rural county as defined in Section [26B-4-701] 26C-1-101, nominated by an association representing Utah hospitals, no more than two of whom are employed by hospitals affiliated by ownership;

and (c) a physician currently practicing in a rural county as defined in Section [26B-4-701] 26C-1-101.

(2) (a) An appointment to the committee shall be for a four-year term unless the member is appointed to complete an unexpired term.

(b) The executive director shall adjust the length of term at the time of appointment or reappointment so that approximately one-half of the committee is appointed every two years.

(c) The executive director shall annually appoint a committee chair from among the members of the committee.

(3) (a) The committee shall meet at the call of:

(i) the chair;

(ii) at least three members of the committee;

or (iii) the executive director.

(b) The committee shall meet at least once each calendar year.

(4) (a) A majority of the members of the committee constitutes a quorum.

(b) The action of a majority of a quorum constitutes the action of the committee.

(5) A member may not receive compensation or benefits for the member's service, but may receive per diem and travel expenses in accordance with:

- 9 - SB0300 compared with SB0300S01 (a) Section 63A-3-106;

(b) Section 63A-3-107;

and (c) rules made by the Division of Finance pursuant to Sections 63A-3-106 and 63A-3-107.

(6) The committee shall make recommendations to the department for the development and modification of rules to administer the Rural Physician Loan Repayment Program created in Section 26B-4-703.

(7) As funding permits, the department shall provide staff and other administrative support to the committee.

26B-2-10126B-2-101. (Effective 01/01/28).

(5)(a)(5) (a) "Associated with the licensee" means that an individual is:

(i) service on the following bodies, unless that service includes direct access to a -child 8or -a 03-04vulnerable 16:57adult: 1st Sub.

(Green) S.B.

300 child or a vulnerable adult:

- 10 - SB0300 compared with SB0300S01 (6) "Behavioral health receiving center" means a 23-hour non-secure program or facility that is responsible for, and provides mental health crisis services to, an individual experiencing a mental health crisis.

(7)(a)(7) (a) "Boarding school" means a private school that:

and (iv)(A)(iv) (A) does not provide the treatment or services described in Subsection (49)(a);

(b)(i)(b) (i) For purposes of Subsection (7)(a)(iii), "education" means a course of study for one or more grades from kindergarten through grade 12.

-(c) 9"Boarding -school" 1stdoes Sub.not include a therapeutic school.

(Green) S.B.

300 03-04 16:57 (c) "Boarding school" does not include a therapeutic school.

- 11 - SB0300 compared with SB0300S01 (a) finding a person to adopt the child;

(13)(a)(13) (a) "Congregate care program" means any of the following that provide services to a child:

- 1012 - 03-04SB0300 16:57compared 1stwith Sub.SB0300S01 (17) "Directly supervised" means that an individual is being supervised under the uninterrupted visual and auditory surveillance of another individual who has a current background check approval issued by the office.

(Green) S.B.

300 (17) "Directly supervised" means that an individual is being supervised under the uninterrupted visual and auditory surveillance of another individual who has a current background check approval issued by the office.

(29)(a)(29) (a) "Human services program" means:

- 13 - SB0300 compared with SB0300S01 (iv) an outdoor youth program;

-(vi) 11a -residential 1stsupport Sub.program;

(Green) S.B.

300 03-04 16:57 (vi) a residential support program;

and - 14 - SB0300 compared with SB0300S01 (b) is used to improve mental health, prevent mental disorders, and treat mental health conditions.

-(38) 12"Minor" -means 03-04child. 16:57 1st Sub.

(Green) S.B.

300 (38) "Minor" means child.

and (c)(i)(c) (i) regular therapy, including group, individual, or supportive family therapy;

- 15 - SB0300 compared with SB0300S01 (45) "Qualifying residential treatment program" means a residential treatment program that is licensed under this part and:

(46) "Qualifying recovery residence" means a recovery residence that is licensed under this -part 13and: - 1st Sub.

(Green) S.B.

300 03-04 16:57 part and:

(47)(a)(47) (a) "Recovery residence" means a home, residence, or facility that meets at least two of the following requirements:

or (v)(A)(v) (A) receives public funding;

or - 16 - SB0300 compared with SB0300S01 (iv) a home, residence, or facility, in which:

-(49) 14(a) -"Residential 03-04support 16:57program" 1stmeans Sub.a program that arranges for or provides the necessities of life as a protective service to individuals or families who have a disability or who are experiencing a dislocation or emergency that prevents them from providing these services for themselves or their families.

(Green) S.B.

300 (49)(a) "Residential support program" means a program that arranges for or provides the necessities of life as a protective service to individuals or families who have a disability or who are experiencing a dislocation or emergency that prevents them from providing these services for themselves or their families.

(50)(a)(50) (a) "Residential treatment" means a 24-hour group living environment for four or more individuals unrelated to the owner or provider that offers room or board and specialized treatment, behavior - 17 - SB0300 compared with SB0300S01 modification, rehabilitation, discipline, emotional growth, or habilitation services for persons with emotional, psychological, developmental, or behavioral dysfunctions, impairments, or chemical dependencies.

-(i) 15for -less 1stthan Sub.six consecutive nights;

(Green) S.B.

300 03-04 16:57 (i) for less than six consecutive nights;

- 18 - SB0300 compared with SB0300S01 (55) "Substance abuse disorder" or "substance use disorder" mean the same as "substance use disorder" is defined in Section 26B-5-501.

-(ii) 16in -a 03-04public 16:57school; 1st Sub.

(Green) S.B.

300 (ii) in a public school;

- 19 - SB0300 compared with SB0300S01 (59) "Vulnerable adult" means an elder adult or an adult who has a temporary or permanent mental or physical impairment that substantially affects the person's ability to:

(60)(a)(60) (a) "Youth program" means a program designed to provide behavioral, substance use, or mental health services to minors that:

(b) "Youth program" does not include recreational programs such as Boy Scouts, Girl -Scouts, 174-H, -and 1stother Sub.such organizations.

(Green)(61) S.B.(a) "Youth transportation company" means any person that transports a child for payment to or from a congregate care program in Utah.

300 03-04 16:57 Scouts, 4-H, and other such organizations.

(61)(a) "Youth transportation company" means any person that transports a child for payment to or from a congregate care program in Utah.

26B-2-20126B-2-201. (Effective 01/01/27).

- 20 - SB0300 compared with SB0300S01 As used in this part:

(5)(a)(5) (a) "Assisted living facility" means:

and (ii) a type II assisted living facility, which is a residential facility with a home-like -setting 18that -provides 03-04an 16:57array 1stof Sub.coordinated supportive personal and health care services available 24 hours per day to residents who have been assessed under department rule to need any of these services.

(Green) S.B.

300 setting that provides an array of coordinated supportive personal and health care services available 24 hours per day to residents who have been assessed under department rule to need any of these services.

- 21 - SB0300 compared with SB0300S01 (6) "Birthing center" means a facility that:

and (b)(i)(b) (i) is freestanding;

(13)(a)(13) (a) "Health care facility" means general acute hospitals, specialty hospitals, home health agencies, hospices, nursing care facilities, residential-assisted living facilities, -birthing 19centers, -ambulatory 1stsurgical Sub.facilities, small health care facilities, abortion clinics, facilities owned or operated by health maintenance organizations, end stage renal disease facilities, and any other health care facility which the committee designates by rule.

(Green) S.B.

300 03-04 16:57 birthing centers, ambulatory surgical facilities, small health care facilities, abortion clinics, facilities owned or operated by health maintenance organizations, end stage renal disease facilities, and any other health care facility which the committee designates by rule.

- 22 - SB0300 compared with SB0300S01 (14) "Health maintenance organization" means an organization, organized under the laws of any state which:

or (b)(i)(b) (i) provides or otherwise makes available to enrolled participants at least the following basic health care services:

(15)(a)(15) (a) "Home health agency" means an agency, organization, or facility or a subdivision of an agency, organization, or facility which employs two or more direct care staff persons who provide licensed nursing services, therapeutic services of physical therapy, speech therapy, occupational therapy, medical social services, or home health aide services on a visiting basis.

(17) "Nursing care facility" means a health care facility, other than a general acute or specialty hospital, constructed, licensed, and operated to provide patient living -accommodations, 2024-hour -staff 03-04availability, 16:57and 1stat Sub.least two of the following patient services:

(Green) S.B.

300 accommodations, 24-hour staff availability, and at least two of the following patient services:

- 23 - SB0300 compared with SB0300S01 (b) a structured, supportive social living environment based on a professionally designed and supervised treatment plan, oriented to the individual's habilitation or rehabilitation needs;

-(a) 21performs -abortions, 1stas Sub.defined in Section 76-7-301, after the first trimester of pregnancy;

(Green) S.B.

300 03-04 16:57 (a) performs abortions, as defined in Section 76-7-301, after the first trimester of pregnancy;

26B-2-206- (Effective24 01/01/27).- SB0300 compared with SB0300S01 26B-2-206.

(1)(a)(1) (a) A person or governmental unit acting severally or jointly with any other person or governmental unit, may not establish, conduct, or maintain a health care facility in this state without receiving a license from the department as provided by this part and the rules[ ] adopted pursuant to this part .

(4)(a)(4) (a) The department may issue a license for a period of time not to exceed 12 months from the date of issuance for an abortion clinic and not to exceed 24 months from the date of issuance for other health care facilities that meet the provisions of this part and department rules adopted pursuant to this part.

(7)(a)(7) (a) Beginning November 1, 2030, the department may not issue or renew a health -care 22facility -license 03-04unless 16:57the 1stlicensee Sub.has:

(Green) S.B.

300 care facility license unless the licensee has:

- 25 - SB0300 compared with SB0300S01 Section 5.

Section 26B-3-104.15 is enacted to read:

26B-3-104.126B-3-104.1. (Effective 01/01/27).

26B-3-90826B-3-908. (Effective 01/01/27).

-(v) 23provider -contracting 1stand Sub.discounts;

(Green) S.B.

300 03-04 16:57 (v) provider contracting and discounts;

- 26 - SB0300 compared with SB0300S01 (3) The department may enter into separate managed care organization contracts to provide dental benefits required by Section 26B-3-904.

[(5)(a)[(5) (a) The department may contract with the Group Insurance Division within the Utah State Retirement Office to provide services under Subsection (1) if no managed care organization is willing to contract with the department or the department determines no managed care organization meets the criteria established under Subsection (2).] [(b) In accordance with Section 49-20-201, a contract awarded under Subsection (5)(a) is not subject to the risk sharing required by Subsection (4).] Section 7.

Section 26C-1-1017 is enacted to read:

TITLE26C-1-101. 26C.

Utah Cares Act CHAPTER 1.

General Provisions 26C-1-101 (Effective 07/01/27).

This26C. title is known as the "Utah Cares Act." Section 8.

SectionUtah 26C-1-102Cares isAct enacted1. to read:

26C-1-102General (EffectiveProvisions 07/01/27).This title is known as the "Utah Cares Act." Section 8.

Section 8 is enacted to read:

26C-1-102.

(1) "Accredited clinical education program" means a clinical education program for a health -care 24profession -that 03-04is 16:57accredited 1stby Sub.the Accreditation Council on Graduate Medical Education.

(Green) S.B.

300 care profession that is accredited by the Accreditation Council on Graduate Medical Education.

- 27 - SB0300 compared with SB0300S01 (4) "Commission" means the Utah Health Services Commission created in Section 26C-2-101.

(11)(a)(11) (a) "Health workforce" means the individuals, collectively and by profession, who deliver health care services or assist in the delivery of health care services.

-(a) 25licensed -as 1sta Sub.physician under Title 58, Chapter 67, Utah Medical Practice Act;

(Green) S.B.

300 03-04 16:57 (a) licensed as a physician under Title 58, Chapter 67, Utah Medical Practice Act;

- 28 - SB0300 compared with SB0300S01 (23) "UMEC" means the Utah Medical Education Council created in Section 26C-2-107.

Section 26C-1-1039 is enacted to read:

26C-1-10326C-1-103. (Effective 07/01/27).

Section 26C-1-10410 is enacted to read:

-26C-1-104. 26 - 03-04 16:57 1st Sub.

(Green) S.B.

300 26C-1-104 (Effective 07/01/27).

Section 26C-2-10111 is enacted to read:

CHAPTER26C-2-101. 2.

Utah Health Service Commission 26C-2-101 (Effective 07/01/27).

(1)- Notwithstanding29 Section- 63E-1-302,SB0300 therecompared iswith createdSB0300S01 an2. independent state agency known as the Utah Health Services Commission.

Utah Health Service Commission (1) {There } Notwithstanding Section 63E-1-302, there is created an independent state agency known as the Utah Health Services Commission.

(3)(a)(3) (a) Subject to Subsection (3)(e), the term of office of each appointed commission member is six years.

(4)(a)(4) (a) A majority of the commission members constitutes a quorum.

(7) Except as provided by law, no commissioner may hold any other office either under the government of the United States or of this state or of any municipal corporation within -this 27state. - 1st Sub.

(Green) S.B.

300 03-04 16:57 this state.

Section 26C-2-10212 is enacted to read:

26C-2-10226C-2-102. (Effective 07/01/27).

- 30 - SB0300 compared with SB0300S01 (3) ensure the delivery of quality health care services to all enrollees;

Section 26C-2-10313 is enacted to read:

26C-2-10326C-2-103. (Effective 07/01/27).

-(iii) 28evaluating -all 03-04capital 16:57expenses 1stin Sub.excess of a threshold amount to be determined annually by the commission;

(Green) S.B.

300 (iii) evaluating all capital expenses in excess of a threshold amount to be determined annually by the commission;

- 31 - SB0300 compared with SB0300S01 (a) consult with:

Section 26C-2-10414 is enacted to read:

26C-2-10426C-2-104. (Effective 07/01/27).

Section 26C-2-105,26C-2-105 which is renumbered from Section 26B-1-425 is renumbered and amended to read:

[26B-1-425] 26C-2-10526C-2-105. (Effective 07/01/27) (Repealed 07/01/27).

-(3) 29The -following 1stare Sub.members of the council:

(Green) S.B.

300 03-04 16:57 (3) The following are members of the council:

- 32 - SB0300 compared with SB0300S01 (e) the executive director of the Department of Commerce or that individual's designee;

(h) the chair of the Utah Indian Health Advisory Board;[ {[} and] (i) the chair of the Utah Medical Education Council created in Section [26B-4-706.] 26C-2-107;

(5)(a)(5) (a) A member appointed by the executive director under Subsection (4) shall serve a four-year term.

[(7)(a)[(7) (a) As used in this Subsection (7), "health workforce" means the same as that term is defined in Section 26B-4-705.] [(b)] (7) The council shall:

-[(C)] 30(iii) -options 03-04for 16:57training 1stand Sub.educating the health workforce;

(Green) S.B.

300 [(C)] (iii) options for training and educating the health workforce;

- 33 - SB0300 compared with SB0300S01 [(iv)] (d) review and comment on legislation relevant to Utah's health workforce;

(8) The council shall provide information described in Subsections [(7)(b)(ii)] (7)(b) and [[(iii)] (iii)] (c) to:

(9)(a)(9) (a) The Utah Medical Education Council created in Section [26B-4-706] 26C-2-107 is a subcommittee of the council.

-(i) 31that -information 1stis Sub.necessary for the council to fulfill a duty described in Subsection (7);

(Green) S.B.

300 03-04 16:57 (i) that information is necessary for the council to fulfill a duty described in Subsection (7);

- 34 - SB0300 compared with SB0300S01 (a) Section 63A-3-106;

Section 26C-2-106,26C-2-106 which is renumbered from Section 26B-4-705 is renumbered and amended to read:

[26B-4-705] 26C-2-10626C-2-106. (Effective 07/01/27).

(a) "Council" means the Utah Health Workforce Advisory Council created in Section [[26B-1-425] 26B-1-425] 26C-2-105.

[(c)(i)[(c) (i) "Health workforce" means the individuals, collectively and by profession, who deliver health care services or assist in the delivery of health care services.] [(ii) "Health workforce" includes any health care professional who does not work in the health sector and any non-health care professional who works in the health sector.] (2) There is created within the department the Utah Health Workforce Information Center.

(e) notwithstanding the provisions of Subsection 35A-4-312(3), receive information obtained by the Department of Workforce Services under the provisions of Section -35A-4-312 32for -purposes 03-04consistent 16:57with 1stthe Sub.information center's duties, including identifying changes in Utah's health workforce numbers, types, and geographic distribution;

(Green) S.B.

300 35A-4-312 for purposes consistent with the information center's duties, including identifying changes in Utah's health workforce numbers, types, and geographic distribution;

and - 35 - SB0300 compared with SB0300S01 (g) conduct research and provide analysis for any state agency as approved by the [[executive executive director or the executive director's designee] commission.

Section 26C-2-107,26C-2-107 which is renumbered from Section 26B-4-706 is renumbered and amended to read:

[26B-4-706] 26C-2-10726C-2-107. (Effective 07/01/27).

(1)(a)(1) (a) There is created the Utah Medical Education Council, which is a subcommittee of the Utah Health Workforce Advisory Council.

and] [(v)] (iv)(A)(iv) (A) three members of the general public who are not employed by or affiliated with any institution that offers, sponsors, or finances health care or medical education;

and (B) if the number of individuals appointed under Subsection (1)(b)(iii) is more than two, the governor may appoint an additional member of the public under -this 33Subsection -[(1)(b)(v)] 1st(1)(b)(iv) Sub.for each individual the governor appoints under Subsection (1)(b)(iii) beyond two.

(Green) S.B.

300 03-04 16:57 this Subsection [(1)(b)(v)] (1)(b)(iv) for each individual the governor appoints under Subsection (1)(b)(iii) beyond two.

- 36 - SB0300 compared with SB0300S01 (b) state agency outside of higher education;

(5)(a)(5) (a) [Consistent with Subsection (6)(b), a ] A majority of the members constitute a quorum.

(6)(a)(6) (a) Except as provided in Subsection (6)(b), members are appointed to four-year terms of office.

Section 26C-2-108,26C-2-108 which is renumbered from Section 26B-4-707 is renumbered and amended to read:

-[26B-4-707] 3426C-2-108. - 03-04 16:57 1st Sub.

(Green) S.B.

300 [26B-4-707] 26C-2-108 (Effective 07/01/27).

- 37 - SB0300 compared with SB0300S01 (b) state appropriations;

Section 26C-2-109,26C-2-109 which is renumbered from Section 26B-4-708 is renumbered and amended to read:

[26B-4-708] 26C-2-10926C-2-109. (Effective 07/01/27).

Section 26C-2-110,26C-2-110 which is renumbered fromand Sectionamended 26B-4-709to isread: renumbered - 35 - 1st Sub.

(Green)[26B-4-709] S.B.26C-2-110.

300 03-04 16:57 and amended to read:

[26B-4-709] 26C-2-110 (Effective 07/01/27).

and - 38 - SB0300 compared with SB0300S01 (4) as is necessary to carry out UMEC's duties under Section [26B-4-708] 26C-2-109, adopt rules in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act.

Section 26C-2-111,26C-2-111 which is renumbered from Section 26B-4-711 is renumbered and amended to read:

[26B-4-711] 26C-2-11126C-2-111. (Effective 07/01/27).

(c)(i)(c) (i) provide proof that the residency program is accredited by the Accreditation Council for Graduate Medical Education;

(d) identify how a grant funded residency position will be funded once the residency -program 36exhausts -the 03-04grant 16:57money; 1st Sub.

(Green) S.B.

300 program exhausts the grant money;

(5)(a)- 39 - SB0300 compared with SB0300S01 (5) (a) An applicant that receives a grant under this section may apply, every two years, to renew the grant for two years.

Section 26C-2-112,26C-2-112 which is renumbered from Section 26B-4-712 is renumbered and amended to read:

[26B-4-712] 26C-2-11226C-2-112. (Effective 07/01/27).

(1) As used in this section, "forensic psychiatry" means the provision of services by an -individual 37who: - 1st Sub.

(Green) S.B.

300 03-04 16:57 individual who:

and - 40 - SB0300 compared with SB0300S01 (ii) any resources or staff that need to be acquired for the program;

Section 26C-3-10123 is enacted to read:

CHAPTER26C-3-101. 3.

Utah Cares Health Financing Program 26C-3-101 (Effective 07/01/27).

(1)3. The commission shall appoint an executive director who shall be the executive and administrative head of the program.

-Utah 38Cares -Health 03-04Financing 16:57Program 1st(1) Sub.The commission shall appoint an executive director who shall be the executive and administrative head of the program.

(Green)(2) S.B.The executive director:

300 (2) The executive director:

- 41 - SB0300 compared with SB0300S01 (b) indemnify benefit plans or purchase commercial reinsurance as considered appropriate by the program;

(j)(i)(j) (i) require enrollees to participate in the electronic exchange of clinical health records in accordance with Section 26B-8-411 unless the enrollee opts out of participation;

and (ii) before enrollment, each time the enrollee logs onto the program's website, and each time the enrollee receives written enrollment information from the program, provide notice to the enrollee of the enrollee's participation in the electronic exchange of clinical health records and the option to opt out of participation at any -time; 39 - 1st Sub.

(Green) S.B.

300 03-04 16:57 time;

and - 42 - SB0300 compared with SB0300S01 (p) take additional actions necessary or appropriate to carry out the purposes of this chapter.

Section 26C-3-10224 is enacted to read:

26C-3-10226C-3-102. (Effective 01/01/28).

-(a) 40employees -of: 03-04 16:57 1st Sub.

(Green) S.B.

300 (a) employees of:

- 43 - SB0300 compared with SB0300S01 (3) Beginning January 1, 2028, and ending on January 1, 2030, entities described in Subsection (2)(a)(2) (a) shall transfer money to the fund equal to the annual amount the entity expended to provide employee health {care } insurance as of January 1, {2025} 2026.

Section 26C-4-10125 is enacted to read:

CHAPTER26C-4-101. 4.

Rates and Payments 26C-4-101 (Effective 01/01/28).

(1)4. Beginning November 1, 2029, for health care services provided to a non-enrollee, the program will bill the individual and reimburse the health care provider at a reasonable rate.

(2)(a)Rates Paymentand Payments (1) Beginning November 1, 2029, for emergencyhealth care ofservices anprovided enrolleeto obtaineda out-of-statenon-enrollee, shallthe beprogram paidwill atbill prevailingthe localindividual ratesand ofreimburse where the health care wasprovider obtained.at a reasonable rate.

(2) (a) Payment for emergency care of an enrollee obtained out-of-state shall be paid at prevailing local rates of where the care was obtained.

(c)(i)(c) (i) The commission may require that an enrollee be transported back to Utah when prolonged treatment of an emergency condition is necessary if transportation is safe for the patient in light of the patient's medical condition.

(3) If an enrollee has other health insurance coverage for a service that is covered by the -program, 41the -program 1stshall Sub.act as the secondary insurer for insurance coverage purposes.

(Green) S.B.

300 03-04 16:57 program, the program shall act as the secondary insurer for insurance coverage purposes.

Section 26C-4-10226 is enacted to read:

26C-4-10226C-4-102. (Effective 01/01/28).

- 44 - SB0300 compared with SB0300S01 (2) Except for operating and capital budget facilities, the program shall negotiate and set rates for health care providers and health care facilities participating in the program in an amount equal to or exceeding the Medicare fee amount plus 10% of the Medicare fee.

(3)(a)(3) (a) The program shall negotiate with each operating and capital budget facility independently to set a specific operating and capital budget for each facility.

Section 26C-5-10127 is enacted to read:

CHAPTER26C-5-101. 5.

Covered Health Benefits 26C-5-101 (Effective 01/01/28).

(1)5. The program shall provide a health plan that:

Covered Health Benefits (1) The program shall provide a health plan that:

Section 26C-5-102,26C-5-102 which is renumbered from Section 49-20-416 is renumbered and amended to read:

[49-20-416] 26C-5-10226C-5-102. (Effective 01/01/28).

and -(ii) 42is -a 03-04program 16:57enrolled 1stcontrolled Sub.substance prescriber.

(Green) S.B.

300 (ii) is a program enrolled controlled substance prescriber.

(2) The [health[health{]} ]program [offered to the state employee risk pool under Section 49-20-202 ]]shall shall reimburse a controlled substance prescriber who provides SBIRT services to [a covered individual] an enrollee who is 13 years [of age] old or older for the SBIRT services.

- 45 - SB0300 compared with SB0300S01 Section 29.

Section 26C-5-103,26C-5-103 which is renumbered from Section 49-20-418 is renumbered and amended to read:

[49-20-418] 26C-5-10326C-5-103. (Effective 01/01/28).

(2)(a)(2) (a) The program shall provide coverage for qualified assisted reproductive technology cycles.

(b)(i)(b) (i) the patient's physician verifies that the patient or the patient's spouse has a demonstrated condition recognized by a physician as a cause of infertility;

(c) the patient attests that the patient has been unable to attain a successful pregnancy through any less-costly,less- costly, potentially effective infertility treatments for which coverage is available under the health benefit plan;

and -(d) 43the -use 1stof Sub.the assisted reproductive technology procedure complies with the program's clinical policies and is performed by a health care provider who contracts with or is otherwise approved by the program.

(Green)(4) S.B.(a) The provision of a benefit in accordance with this section shall satisfy, in accordance with Subsection 31A-22-610.1(1)(c)(ii), the requirement to provide an adoption indemnity benefit to a qualified individual under Section 31A-22-610.1.

300- 03-0446 16:57- (d)SB0300 thecompared usewith ofSB0300S01 the(b) assistedIf reproductivea technologyqualified procedureindividual complieshas withreceived the program'sadoption clinicalindemnity policiesbenefit andrequired isunder performedSection by31A-22-610.1, athe healthqualified careindividual providermay whonot contractsreceive witha orbenefit isin otherwiseaccordance approvedwith bythis thesection. program.

(4)(a) The provision of a benefit in accordance with this section shall satisfy, in accordance with Subsection 31A-22-610.1(1)(c)(ii), the requirement to provide an adoption indemnity benefit to a qualified individual under Section 31A-22-610.1.

(b) If a qualified individual has received the adoption indemnity benefit required under Section 31A-22-610.1, the qualified individual may not receive a benefit in accordance with this section.

Section 26C-5-104,26C-5-104 which is renumbered from Section 49-20-419 is renumbered and amended to read:

[49-20-419] 26C-5-10426C-5-104. (Effective 01/01/28).

Section 26C-5-105,26C-5-105 which is renumbered from Section 49-20-420 is renumbered and amended to read:

[49-20-420] 26C-5-10526C-5-105. (Effective 01/01/28) (Partially Repealed 01/01/30).

or -(v) 44sickle -cell 03-04anemia. 16:57 1st Sub.

(Green) S.B.

300 (v) sickle cell anemia.

and - 47 - SB0300 compared with SB0300S01 (b) genetic testing of a qualified individual who receives in vitro fertilization services under Subsection (2)(a).

Section 26C-5-106,26C-5-106 which is renumbered from Section 49-20-422 is renumbered and amended to read:

[49-20-422] 26C-5-10626C-5-106. (Effective 01/01/28) (Repealed 07/01/27).

(A) is licensed under Title 26B, Chapter 2, Licensing and Certifications, or -accredited 45by -the 1stCommission Sub.for the Accreditation of Birth Centers;

(Green) S.B.

300 03-04 16:57 accredited by the Commission for the Accreditation of Birth Centers;

and] [(ii)(A)][(ii) (A)] (i) is pregnant;

- 48 - SB0300 compared with SB0300S01 (3) The program may establish limits for coverage under Subsection (2), including limits based on:

Section 26C-6-10133 is enacted to read:

CHAPTER26C-6-101. 6.

Medicaid Division 26C-6-101 (Effective 01/01/28).

Reserved.6.

Medicaid Division Reserved.

Section 26C-6-10234 is enacted to read:

26C-6-10226C-6-102. (Effective 01/01/28).

-(2) 46The -state 03-04Medicaid 16:57director 1stshall Sub.be the head of the division and report to the executive director of the program.

(Green) S.B.

300 (2) The state Medicaid director shall be the head of the division and report to the executive director of the program.

Section 26C-7-101,26C-7-101 which is renumbered from Section 49-20-406 is renumbered and amended to read:

Employee Benefits [49-20-406] 26C-7-10126C-7-101. (Effective 01/01/28).

- 49 - SB0300 compared with SB0300S01 (a) "Children" includes stepchildren and legally adopted children.

[(b)] (c)(i)(c) (i) "Line-of-duty death" means a death resulting from:

[(c)] (d)(i)(d) (i) "Strenuous activity" means engagement involving a difficult, stressful, or vigorous fire suppression, rescue, hazardous material response, emergency medical service, physical law enforcement, prison security, disaster relief, or other emergency response activity.

-(2) 47The -beneficiary 1stof Sub.a covered individual [who is employed by the state ]and who has a line-of-duty death shall receive[:] [(a)] the proceeds of a $50,000 group term life insurance policy paid for by the state and administered and provided as part of the group life insurance program under this chapter[;

(Green) S.B.

300 03-04 16:57 (2) The beneficiary of a covered individual [who is employed by the state ]and who has a line-of-duty death shall receive[:] [(a)] the proceeds of a $50,000 group term life insurance policy paid for by the state and administered and provided as part of the group life insurance program under this chapter[;

- 50 - SB0300 compared with SB0300S01 (4) The benefit provided under Subsection [(2)(a)] (2) is subject to the same terms and conditions as the group life insurance program provided under this chapter.

31A-22-605.531A-22-605.5. (Effective 01/01/28).

(2)(a)(2) (a) Notwithstanding the provisions of Subsection 31A-1-103(3)(f), the following shall apply to health coverage offered [to the state employees' risk pool under Subsection 49-20-202(1)(a)] through the program described in Section 26C-3-101:

and -(ii) 48in -accordance 03-04with 16:57Section 1st31A-22-613.5, Sub.disclosure requirements for coverage limitations.

(Green) S.B.

300 (ii) in accordance with Section 31A-22-613.5, disclosure requirements for coverage limitations.

and] [(ii) health coverage offered to public school districts, charter schools, and institutions of higher education under Subsection 49-20-201(1)(b).] [(c)] (3) [If health coverage offered to the state employees' risk pool under Subsections 49-20-201(1)(b)49-20-201(1) (b) and 49-20-202(1)(a) offers coverage in the same manner and to the same extent as the coverage required by an insurance mandate enacted under this title or coverage that is greater than the insurance mandate enacted under this title, the coverage offered to state employees under Subsections 49-20-201(1)(b) and 49-20-202(1)(a) will be considered in compliance with the - 51 - SB0300 compared with SB0300S01 insurance mandate.] Beginning January 1, 2028, a political subdivision, a public school district, a charter school, and a state funded institution of higher education may provide a health benefit plan exclusively through the program described in Section 26C-3-101.

The report shall include the costs and benefits of the particular mandatory obligation.] [(3)(a)[(3) (a) An insurance mandate for policies of accident and health insurance enacted under this title after January 1, 2012, shall apply to a health plan offered by a public school district, a charter school, or a state funded institution of higher education that is not insured through the Public Employees' Benefit and Insurance Program.] [(b) If an insurance mandate for policies of accident and health insurance is enacted under this title after January 1, 2012, the state shall determine whether each entity described in Subsections (2) and (3)(a) offers coverage in the same manner and to the same extent, or greater than the insurance coverage required in the mandate enacted after January 1, 2012.] [(c) Before enacting an insurance mandate, the state shall, for each entity that does not offer coverage in accordance with Subsection (3)(b):] -[(i) 49determine -the 1stcost Sub.to the entity of implementing the insurance mandate;

(Green) S.B.

300 03-04 16:57 [(i) determine the cost to the entity of implementing the insurance mandate;

31A-22-613.531A-22-613.5. (Effective 01/01/28).

(1)(a)(1) (a) This section applies to all health benefit plans.

- 52 - SB0300 compared with SB0300S01 (a) restrictions or limitations on prescription drugs and biologics, including:

(d)(i)(A)(d) (i) (A) each drug, device, and covered service that is subject to a preauthorization requirement as defined in Section 31A-22-650;

and (iii) sufficient information to allow a network provider or enrollee to submit all of the -information 50to -the 03-04insurer 16:57necessary 1stto Sub.meet each requirement for authorization described in Subsection (2)(d)(ii);

(Green) S.B.

300 information to the insurer necessary to meet each requirement for authorization described in Subsection (2)(d)(ii);

- 53 - SB0300 compared with SB0300S01 (ii) practice standards;

(4)(a)(4) (a) An insurer shall provide the enrollee with notice of an increase in costs for prescription drug coverage due to a change in benefit design under Subsection (2)(a):

-(5) 51Examples -of 1sta Sub.limitation or exclusion of coverage provided under this section or otherwise are for illustrative purposes only, and the failure of a particular fact situation to fall within the description of an example does not, by itself, support a finding of coverage.

(Green) S.B.

300 03-04 16:57 (5) Examples of a limitation or exclusion of coverage provided under this section or otherwise are for illustrative purposes only, and the failure of a particular fact situation to fall within the description of an example does not, by itself, support a finding of coverage.

and - 54 - SB0300 compared with SB0300S01 (c) if requested by a network provider for a specific drug, device, or covered service, provide the network provider with the information described in Subsection (2)(d) for the drug, device, or covered service by mail or email.

31A-22-63531A-22-635. (Effective 01/01/28).

[(b) includes the state employee's risk pool under Section 49-20-202.] (2)(a)(2) (a) Insurers offering a health benefit plan to an individual or small employer shall use a uniform application form.

(3) Notwithstanding the requirements of Subsection (2)(a), the uniform application and uniform waiver of coverage forms may, if the combination or modification is approved by the commissioner, be combined or modified to facilitate a more efficient and -consumer 52friendly -experience 03-04for 16:57insurers 1stusing Sub.electronic applications.

(Green)(4) S.B.(a) The uniform application form, and uniform waiver form, shall be adopted and approved by the commissioner in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act.

300 consumer friendly experience for insurers using electronic applications.

(4)(a) The uniform application form, and uniform waiver form, shall be adopted and approved by the commissioner in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act.

31A-22-64731A-22-647. (Effective 01/01/28).

- 55 - SB0300 compared with SB0300S01 (a) "Insurer" means a person who offers health care insurance, including a health maintenance organization as that term is defined in Section 31A-8-101.

-31A-22-654. 53 - 1st Sub.

(Green) S.B.

300 03-04 16:57 31A-22-654 (Effective 01/01/28).

- 56 - SB0300 compared with SB0300S01 (c) "Qualified enrollee" means an enrollee of a qualified insurer who:

(2)(a)(2) (a) A qualified insurer shall submit the information described in this Subsection (2) to the department for a plan year beginning:

(c)(i)(c) (i) If a qualified insurer determines that providing the coverage described in Subsection (3) for qualified enrollees will result in cost savings for the qualified insurer, the qualified insurer shall submit a summary of the results of the study described in Subsection (2)(b), and:

-(i) 54January -1, 03-042022, 16:57for 1sta Sub.plan year beginning on or after January 1, 2022, but before December 31, 2022;

(Green) S.B.

300 (i) January 1, 2022, for a plan year beginning on or after January 1, 2022, but before December 31, 2022;

and - 57 - SB0300 compared with SB0300S01 (b) genetic testing of a qualified enrollee who received in vitro fertilization services under Subsection (3)(a).

Section 31A-22-66341 is enacted to read:

31A-22-66331A-22-663. (Effective 01/01/28).

31A-46-31131A-46-311. (Effective 01/01/28).

(ii) a 340B entity from contracting with a pharmacy, including by denying the 340B -entity 55access -to 1sta Sub.drug that is manufactured by the manufacturer;

(Green) S.B.

300 03-04 16:57 entity access to a drug that is manufactured by the manufacturer;

or - 58 - SB0300 compared with SB0300S01 (iv) a 340B entity from receiving 340B drug discount program pricing for a 340B drug, including by imposing a time limitation on a 340B entity to replenish or submit a claim for a 340B drug;

49-21-10549-21-105. (Effective 01/01/28).

53-2d-70353-2d-703. (Effective 01/01/28).

Volunteer Emergency Medical Service Personnel -Insurance 56Program --- 03-04Creation 16:57-- 1stAdministration Sub.-- Eligibility -- Benefits -- Rulemaking -- Advisory board.

(Green) S.B.

300 Insurance Program -- Creation -- Administration -- Eligibility -- Benefits -- Rulemaking -- Advisory board.

- 59 - SB0300 compared with SB0300S01 (b) "Basic long-term disability benefit" means a $1,000 monthly benefit arising from a disability determined in accordance with Title 49, Chapter 21, Public Employees' Long-Term Disability Act, and excluding any coverage offered on a pilot basis.

-(3) 57(a) -The 1stbureau Sub.shall contract with a qualifying association to create, implement, and administer the Volunteer Emergency Medical Service Personnel Insurance Program described in this section.

(Green) S.B.

300 03-04 16:57 (3)(a) The bureau shall contract with a qualifying association to create, implement, and administer the Volunteer Emergency Medical Service Personnel Insurance Program described in this section.

- 60 - SB0300 compared with SB0300S01 (a) is licensed under Section 53-2d-402 as an emergency medical technician, an advanced emergency medical technician, or a paramedic;

and (iii)(A)(iii) (A) as a volunteer under the Fair Labor Standards Act, in accordance with 29 C.F.R.

(i)(A)(i) (A) is not eligible for a health benefit plan through an employer or a spouse's employer;

(i)(A)(i) (A) is not eligible for a dental plan through an employer or a spouse's employer;

or -(ii) 58the -individual's 03-04premium 16:57cost 1stfor Sub.individual, double, or family coverage exceeds 20% or greater of the premium cost of the program created by this section;

(Green) S.B.

300 (ii) the individual's premium cost for individual, double, or family coverage exceeds 20% or greater of the premium cost of the program created by this section;

(5)(a)(5) (a) A participant in the program is eligible to participate in PEHP in accordance with Subsection (5)(b) and Subsection 49-20-201(3).

- 61 - SB0300 compared with SB0300S01 (ii) accepts enrollment during an open enrollment period or for a special enrollment event, including the initial eligibility of a program participant;

(6)(a)(6) (a) The bureau may make rules in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, to define additional criteria regarding benefit design, eligibility for the program, and to implement this section.

(8) Notwithstanding any other provision of law, coverage provided under this section shall be provided under Title 26C, Utah {Care Act beginning } Cares Act, beginning January 1, 2028.

53-17-20153-17-201. (Effective 01/01/28).

(1) (a) Subject to Subsection (1)(b), and in accordance with this section, an employer shall allow the surviving spouse and children of a member whose death is classified by the Utah State Retirement Office as a line-of-duty death under the provisions of Title 49, Utah State Retirement and Insurance - 5962 - 1stSB0300 Sub.compared with SB0300S01 Benefit Act, to remain eligible for the following coverage, if offered by the employer, as if the surviving spouse was an employee of the employer:

(Green) S.B.

300 03-04 16:57 (1)(a) Subject to Subsection (1)(b), and in accordance with this section, an employer shall allow the surviving spouse and children of a member whose death is classified by the Utah State Retirement Office as a line-of-duty death under the provisions of Title 49, Utah State Retirement and Insurance Benefit Act, to remain eligible for the following coverage, if offered by the employer, as if the surviving spouse was an employee of the employer:

and (ii) if the health coverage is a high-deductible plan, the employer share of any contribution into a health savings account for the surviving spouse and dependent children as described under Subsections (1)(a)(1) (a) and (2).

or [(c) a member who is covered under Section 49-20-406.]{[} 49-20-406{] 26C-7-101}.] (c) an individual eligible for coverage under Title 26C, Utah Cares Act.

58-1-11258-1-112. (Effective 01/01/28).

-(1) 60As -used 03-04in 16:57this 1stsection: Sub.

(Green)(a) S.B."Council" means the Utah Health Workforce Advisory Council created in Section [26B-1-425] 26C-2-105.

300- (1)63 As- usedSB0300 compared with SB0300S01 (b) "Information center" means the Utah Health Workforce Information Center created in thisSection section:[26B-4-705] 26C-2-106.

(2) (a) "Council"In meansaccordance with Subsection [26B-4-705(3)(a)] 26C-2-106(3)(a), the Utahdepartment Healthshall Workforcework Advisorywith Councilthe createdinformation incenter Sectionto [identify 26B-1-425]relevant 26C-2-105.data pertaining to a profession described in Subsection (3).

(b) "Information center" means the Utah Health Workforce Information Center created in Section [26B-4-705] 26C-2-106.

(2)(a) In accordance with Subsection [26B-4-705(3)(a)] 26C-2-106(3)(a), the department shall work with the information center to identify relevant data pertaining to a profession described in Subsection (3).

(3)(a)(3) (a) The department shall prioritize data collection for each profession licensed under:

- 64 - SB0300 compared with SB0300S01 (v) Chapter 41, Speech-Language Pathology and Audiology Licensing Act;

-(vii) 61Chapter -44a, 1stNurse Sub.Midwife Practice Act;

(Green) S.B.

300 03-04 16:57 (vii) Chapter 44a, Nurse Midwife Practice Act;

58-17b-80258-17b-802. (Effective 01/01/28).

(1)(a)(1) (a) "Cosmetic drug" means a prescription drug that:

and (ii)(A)(ii) (A) is listed as a cosmetic drug subject to the exemption under this section by the division by administrative rule;

- 65 - SB0300 compared with SB0300S01 [(b) a clinic designated as a clinic for state employees and their dependents by the Public Employees' Benefit and Insurance Program under the pilot program created by Section 49-20-413 including all the patients at that clinic, regardless of the patients' participation in the pilot program.] -(3) 62"Health -care" 03-04is 16:57as 1stdefined Sub.in Section 31A-1-301.

(Green)(4) S.B.(a) "Injectable weight loss drug" means an injectable prescription drug:

300 (3) "Health care" is as defined in Section 31A-1-301.

(4)(a) "Injectable weight loss drug" means an injectable prescription drug:

58-37-6.558-37-6.5. (Effective 01/01/28).

(e) "SBIRT" means the Screening, Brief Intervention, and Referral to Treatment approach used by the federal Substance Abuse and Mental Health Services Administration or defined by the division, - 66 - SB0300 compared with SB0300S01 in consultation with the Office of Substance Use and Mental Health, by administrative rule, in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act.

(2)(a)(2) (a) Beginning with the licensing period that begins after January 1, 2014, as a -condition 63precedent -for 1stlicense Sub.renewal, each controlled substance prescriber shall complete at least 3.5 continuing education hours per licensing period that satisfy the requirements of Subsection (3).

(Green)(b) S.B.(i) Beginning with the licensing period that begins after January 1, 2024, as a condition precedent for license renewal, each controlled substance prescriber shall complete at least 3.5 continuing education hours in an SBIRT-training class that satisfies the requirements of Subsection (4).

300 03-04 16:57 condition precedent for license renewal, each controlled substance prescriber shall complete at least 3.5 continuing education hours per licensing period that satisfy the requirements of Subsection (3).

(b)(i) Beginning with the licensing period that begins after January 1, 2024, as a condition precedent for license renewal, each controlled substance prescriber shall complete at least 3.5 continuing education hours in an SBIRT-training class that satisfies the requirements of Subsection (4).

- 67 - SB0300 compared with SB0300S01 (6) The 3.5 hours of the controlled substance prescribing classes under Subsection (4) shall include educational content covering the following:

(b) all elements of the FDA Blueprint for Prescriber Education under the FDA's Extended-Release and Long-Acting Opioid Analgesics Risk Evaluation and -Mitigation 64Strategy, -as 03-04published 16:57July 1st9, Sub.2012, or as it may be subsequently revised;

(Green) S.B.

300 Mitigation Strategy, as published July 9, 2012, or as it may be subsequently revised;

(7)(a)(7) (a) The division, in consultation with the Utah Medical Association Foundation, shall determine whether a particular controlled substance prescribing class satisfies the educational content requirements of Subsections (4) and (6) for an M.D.

- 68 - SB0300 compared with SB0300S01 (9) The division may establish rules, in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, to implement this section.

Section 59-35-10149 is enacted to read:

-59-35-101. 65 - 1st Sub.

(Green) S.B.

300 03-04 16:57 CHAPTER 35.

Utah Health Care Tax 59-35-101 (Effective 01/01/28).

As35. used in this section:

Utah Health Care Tax As used in this section:

(5)(a)(5) (a) "Gross margin" means the direct cost of producing a good or providing a service.

Section 59-35-10250 is enacted to read:

59-35-10259-35-102. (Effective 01/01/28).

- 69 - SB0300 compared with SB0300S01 (a) the ownership in this state of any interest in real or tangible personal property, including real property or property rights from which gross receipts from mining as described by Section 613(c), Internal Revenue Code, is derived;

Section 59-35-10351 is enacted to read:

-59-35-103. 66 - 03-04 16:57 1st Sub.

(Green) S.B.

300 59-35-103 (Effective 01/01/28).

(2) If the total amount of the tax required by Subsection (1) that a corporation or pass-through entity is liable for exceeds the corporation's or pass-through entity's gross margin, the corporation or pass-throughpass- through entity shall pay an amount in tax that is equal to the entity's gross margin.

Section 59-35-10452 is enacted to read:

59-35-10459-35-104. (Effective 01/01/28).

Section 59-35-10553 is enacted to read:

59-35-10559-35-105. (Effective 01/01/28).

- 70 - SB0300 compared with SB0300S01 (3) A taxpayer shall file a return no later than 90 days from the day on which the tax payer's fiscal year ends.

Section 59-35-10654 is enacted to read:

59-35-10659-35-106. (Effective 01/01/28).

(1)(a)(1) (a) A return, claim, statement, other document, or payment is considered mailed on the date of the postmark.

and (ii) the return, claim, statement, other document, or payment, was, within the time -prescribed 67in -Subsection 1st(1)(b)(i), Sub.deposited in the mail in the United States in an envelope or other appropriate wrapper, postage prepaid, properly addressed to the agency, officer, or office with which the return, claim, statement, or other document is required to be filed, or to which such payment is required to be made.

(Green) S.B.

300 03-04 16:57 prescribed in Subsection (1)(b)(i), deposited in the mail in the United States in an envelope or other appropriate wrapper, postage prepaid, properly addressed to the agency, officer, or office with which the return, claim, statement, or other document is required to be filed, or to which such payment is required to be made.

(3)(a)(3) (a) For purposes of this section, if any such return, claim, statement, other document, or payment is sent by United States registered mail:

(5)(a)(5) - 71 - SB0300 compared with SB0300S01 (a) If any deposit required to be made on or before a prescribed date is, after such date, delivered by the United States mail to the commission, such deposit shall be deemed received by the commission on the date the deposit was mailed.

Section 59-35-10755 is enacted to read:

59-35-10759-35-107. (Effective 01/01/28).

-Section 6856. - 03-04 16:57 1st Sub.

(Green)Section S.B.56 is enacted to read:

30059-35-108. Section 56.

Section 59-35-108 is enacted to read:

59-35-108 (Effective 01/01/28).

Section 59-35-10957 is enacted to read:

59-35-10959-35-109. (Effective 01/01/28).

63A-17-80463A-17-804. (Effective 01/01/28).

- 72 - SB0300 compared with SB0300S01 (2) The insurance coverage shall be the same coverage as provided under Section [[49-20-406] 49-20-406] 26C-7-101.

63C-31-10263C-31-102. (Effective 01/01/28) (Repealed 07/01/28).

-(e) 69the -following 1stfour Sub.individuals who are not employed by the state or another public entity and are appointed jointly by the president of the Senate and speaker of the House of Representatives:

(Green) S.B.

300 03-04 16:57 (e) the following four individuals who are not employed by the state or another public entity and are appointed jointly by the president of the Senate and speaker of the House of Representatives:

(2)(a)(2) (a) The member of the Senate appointed under Subsection (1)(a) is a cochair of the benefits advisory commission.

(3)(a)(3) (a) Each position described in Subsection (1)(e) is for a term of four years.

- 73 - SB0300 compared with SB0300S01 (b) A vacancy in a position appointed under Subsection (1)(a), (b), (e), or (f) shall be filled by appointing a replacement member in the same manner as the member creating the vacancy was appointed under Subsection (1)(a), (b), (e), or (f), respectively.

(4)(a)(4) (a) A majority of members constitute a quorum.

(7)(a)(7) (a) The salary and expenses of a benefits advisory commission member who is a legislator shall be paid in accordance with Section 36-2-2 and Legislative Joint Rules, -Title 705, -Legislative 03-04Compensation 16:57and 1stExpenses. Sub.