SB 300

     03-04 16:57  1st Sub. (Green) S.B. 300
                          Nate Blouin proposes the following substitute bill:
1Single Payer Health Insurance Amendments
                                      2026 GENERAL SESSION
                                            STATE OF UTAH
                                     Chief Sponsor: Nate Blouin
                                              House Sponsor:
2
3   LONG TITLE
4   General Description:
5This bill establishes a state operated health financing program.
6   Highlighted Provisions:
7This bill:
8▸ establishes a state operated health financing program;
9▸ creates the Utah Health Services Commission;
10▸ establishes duties for the Utah Health Services Commission;
11▸ moves health workforce councils and offices from the Department of Health and Human
12   Services to the Utah Health Services Commission;
13▸ directs the Department of Health and Human Services to begin transitioning the operation
14   and management of the Medicaid program to the state operated health financing
15   program;
16▸ transitions the Public Employees' Benefit and Insurance Program into a state operated
17   health financing program that is open to the public;
     ▸ allows all state residents to enroll in the state operated health financing program;
                                                                                                     1st Sub. S.B. 300
18
19▸ prohibits billing by health care facilities;
20▸ requires the state operated health financing program to begin billing on behalf of health
21   care facilities;
22▸ requires all government entities to transition government employees to the state operated
23   health financing program;
24▸ repeals certain unnecessary or obsolete programs; and
25▸ creates a tax to fund the state operated health financing program.
26   Money Appropriated in this Bill:
27None
28   Other Special Clauses:
     1st Sub. (Green) S.B. 300  03-04 16:57
29This bill provides a special effective date.
30   Utah Code Sections Affected:
31   AMENDS:
3217-63-706 (Effective 01/01/28), as renumbered and amended by Laws of Utah 2025,
33First Special Session, Chapter 13
3426B-2-101 (Effective 01/01/28), as last amended by Laws of Utah 2025, First Special
35Session, Chapter 16
3626B-2-201 (Effective 01/01/27), as last amended by Laws of Utah 2024, Chapters 113,
37240
3826B-2-206 (Effective 01/01/27), as last amended by Laws of Utah 2024, Chapter 313
3926B-3-908 (Effective 01/01/27), as renumbered and amended by Laws of Utah 2023,
40Chapter 306
4131A-22-605.5 (Effective 01/01/28), as last amended by Laws of Utah 2012, Chapter 127
4231A-22-613.5 (Effective 01/01/28), as last amended by Laws of Utah 2023, Chapter 327
4331A-22-635 (Effective 01/01/28), as last amended by Laws of Utah 2017, Chapter 292
4431A-22-647 (Effective 01/01/28), as enacted by Laws of Utah 2018, Chapter 181
4531A-22-654 (Effective 01/01/28), as last amended by Laws of Utah 2021, Chapter 252
4631A-46-311 (Effective 01/01/28), as enacted by Laws of Utah 2025, Chapter 514
4749-21-105 (Effective 01/01/28), as last amended by Laws of Utah 2013, Chapter 66
4853-2d-703 (Effective 01/01/28), as last amended by Laws of Utah 2025, Chapter 240
4953-17-201 (Effective 01/01/28), as last amended by Laws of Utah 2025, Chapter 56
5058-1-112 (Effective 01/01/28), as last amended by Laws of Utah 2023, Chapter 328
5158-17b-802 (Effective 01/01/28), as last amended by Laws of Utah 2016, Chapter 159
5258-37-6.5 (Effective 01/01/28), as last amended by Laws of Utah 2023, Chapter 329
5363A-17-804 (Effective 01/01/28), as renumbered and amended by Laws of Utah 2021,
54Chapter 344
5563C-31-102 (Effective 01/01/28) (Repealed 07/01/28), as enacted by Laws of Utah 2023,
56Chapter 489
5763E-1-102 (Effective 01/01/28), as last amended by Laws of Utah 2023, Chapters 16,
58431 and 502
5963G-2-103 (Effective 01/01/28), as last amended by Laws of Utah 2025, First Special
60Session, Chapter 17
6163H-9-101 (Effective 01/01/28), as last amended by Laws of Utah 2025, First Special
62Session, Chapters 9, 11
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     03-04 16:57  1st Sub. (Green) S.B. 300
63      63I-1-226 (Effective 01/01/28), as last amended by Laws of Utah 2025, Chapters 47, 277
64      and 366
65      63I-2-249 (Effective 01/01/28), as last amended by Laws of Utah 2024, Chapter 385
66      63J-1-602.2 (Effective 01/01/28) (Partially Repealed 07/01/29), as last amended by Laws
67      of Utah 2025, First Special Session, Chapter 17
68      63J-7-102 (Effective 01/01/28), as last amended by Laws of Utah 2023, Chapters 330,
69      502
70      64-13-30 (Effective 01/01/28), as last amended by Laws of Utah 2016, Chapter 243
71      67-19d-201.5 (Effective 01/01/28), as enacted by Laws of Utah 2012, Chapter 376
72   ENACTS:
73      26B-3-104.1 (Effective 01/01/27), Utah Code Annotated 1953
74      26C-1-101 (Effective 07/01/27), Utah Code Annotated 1953
75      26C-1-102 (Effective 07/01/27), Utah Code Annotated 1953
76      26C-1-103 (Effective 07/01/27), Utah Code Annotated 1953
77      26C-1-104 (Effective 07/01/27), Utah Code Annotated 1953
78      26C-2-101 (Effective 07/01/27), Utah Code Annotated 1953
79      26C-2-102 (Effective 07/01/27), Utah Code Annotated 1953
80      26C-2-103 (Effective 07/01/27), Utah Code Annotated 1953
81      26C-2-104 (Effective 07/01/27), Utah Code Annotated 1953
82      26C-3-101 (Effective 07/01/27), Utah Code Annotated 1953
83      26C-3-102 (Effective 01/01/28), Utah Code Annotated 1953
84      26C-4-101 (Effective 01/01/28), Utah Code Annotated 1953
85      26C-4-102 (Effective 01/01/28), Utah Code Annotated 1953
86      26C-5-101 (Effective 01/01/28), Utah Code Annotated 1953
87      26C-6-101 (Effective 01/01/28), Utah Code Annotated 1953
88      26C-6-102 (Effective 01/01/28), Utah Code Annotated 1953
89      31A-22-663 (Effective 01/01/28), Utah Code Annotated 1953
90      59-35-101 (Effective 01/01/28), Utah Code Annotated 1953
91      59-35-102 (Effective 01/01/28), Utah Code Annotated 1953
92      59-35-103 (Effective 01/01/28), Utah Code Annotated 1953
93      59-35-104 (Effective 01/01/28), Utah Code Annotated 1953
94      59-35-105 (Effective 01/01/28), Utah Code Annotated 1953
95      59-35-106 (Effective 01/01/28), Utah Code Annotated 1953
96      59-35-107 (Effective 01/01/28), Utah Code Annotated 1953
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1st Sub. (Green) S.B. 300  03-04 16:57
9759-35-108 (Effective 01/01/28), Utah Code Annotated 1953
9859-35-109 (Effective 01/01/28), Utah Code Annotated 1953
99   RENUMBERS AND AMENDS:
10026C-2-105 (Effective 07/01/27) (Repealed 07/01/27), (Renumbered from 26B-1-425,
101as last amended by Laws of Utah 2024, Chapter 245)
10226C-2-106 (Effective 07/01/27), (Renumbered from 26B-4-705, as last amended by
103Laws of Utah 2025, First Special Session, Chapter 9)
10426C-2-107 (Effective 07/01/27), (Renumbered from 26B-4-706, as last amended by
105Laws of Utah 2023, Chapter 139 and renumbered and amended by Laws of Utah 2023,
106Chapter 307)
10726C-2-108 (Effective 07/01/27), (Renumbered from 26B-4-707, as renumbered and
108amended by Laws of Utah 2023, Chapter 307)
10926C-2-109 (Effective 07/01/27), (Renumbered from 26B-4-708, as renumbered and
110amended by Laws of Utah 2023, Chapter 307)
11126C-2-110 (Effective 07/01/27), (Renumbered from 26B-4-709, as renumbered and
112amended by Laws of Utah 2023, Chapter 307)
11326C-2-111 (Effective 07/01/27), (Renumbered from 26B-4-711, as last amended by
114Laws of Utah 2024, Chapters 250, 303)
11526C-2-112 (Effective 07/01/27), (Renumbered from 26B-4-712, as last amended by
116Laws of Utah 2024, Chapter 303)
11726C-5-102 (Effective 01/01/28), (Renumbered from 49-20-416, as enacted by Laws of
118Utah 2017, Chapter 180)
11926C-5-103 (Effective 01/01/28), (Renumbered from 49-20-418, as last amended by
120Laws of Utah 2025, Chapter 52)
12126C-5-104 (Effective 01/01/28), (Renumbered from 49-20-419, as enacted by Laws of
122Utah 2019, Chapter 320)
12326C-5-105 (Effective 01/01/28) (Partially Repealed 01/01/30), (Renumbered from
12449-20-420, as enacted by Laws of Utah 2020, Chapter 187)
12526C-5-106 (Effective 01/01/28) (Repealed 07/01/27), (Renumbered from 49-20-422,
126as enacted by Laws of Utah 2023, Chapter 292)
12726C-7-101 (Effective 01/01/28), (Renumbered from 49-20-406, as last amended by
128Laws of Utah 2025, Chapter 56)
12967-19d-201.6 (Effective 01/01/28), (Renumbered from 49-20-404, as last amended by
130Laws of Utah 2013, Chapter 410)
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03-04 16:57  1st Sub. (Green) S.B. 300
131   REPEALS:
132      26B-4-701 (Effective 07/01/27), as last amended by Laws of Utah 2025, First Special
133      Session, Chapter 16
134      31A-22-626 (Effective 01/01/28), as last amended by Laws of Utah 2020, Chapter 310
135      31A-22-656 (Effective 01/01/28), as enacted by Laws of Utah 2021, Chapter 255
136      49-20-101 (Effective 01/01/28), as renumbered and amended by Laws of Utah 2002,
137      Chapter 250
138      49-20-102 (Effective 01/01/28), as renumbered and amended by Laws of Utah 2002,
139      Chapter 250
140      49-20-103 (Effective 01/01/28), as last amended by Laws of Utah 2017, Chapter 141
141      49-20-104 (Effective 01/01/28), as renumbered and amended by Laws of Utah 2002,
142      Chapter 250
143      49-20-105 (Effective 01/01/28), as last amended by Laws of Utah 2012, Chapter 406
144      49-20-201 (Effective 01/01/28), as last amended by Laws of Utah 2024, Chapter 138
145      49-20-202 (Effective 01/01/28), as last amended by Laws of Utah 2025, First Special
146      Session, Chapter 9
147      49-20-301 (Effective 01/01/28), as last amended by Laws of Utah 2003, Chapter 240
148      49-20-401 (Effective 01/01/28), as last amended by Laws of Utah 2023, Chapters 194,
149      328
150      49-20-402 (Effective 01/01/28), as last amended by Laws of Utah 2007, Chapter 130
151      49-20-403 (Effective 01/01/28), as enacted by Laws of Utah 2002, Chapter 250
152      49-20-405 (Effective 01/01/28), as renumbered and amended by Laws of Utah 2002,
153      Chapter 250
154      49-20-407 (Effective 01/01/28), as last amended by Laws of Utah 2017, Chapter 292
155      49-20-407.1 (Effective 01/01/28), as enacted by Laws of Utah 2025, Chapter 55
156      49-20-409 (Effective 01/01/28), as last amended by Laws of Utah 2007, Chapter 130
157      49-20-410 (Effective 01/01/28), as last amended by Laws of Utah 2021, Chapters 344,
158      382
159      49-20-413 (Effective 01/01/28), as enacted by Laws of Utah 2015, Chapter 68
160      49-20-414 (Effective 01/01/28), as last amended by Laws of Utah 2023, Chapter 328
161      49-20-417 (Effective 01/01/28), as enacted by Laws of Utah 2017, Chapter 349
162      49-20-421 (Effective 01/01/28), as last amended by Laws of Utah 2025, Chapter 122
163      49-20-501 (Effective 01/01/28), as enacted by Laws of Utah 2011, Chapter 83
164      49-20-502 (Effective 01/01/28), as last amended by Laws of Utah 2021, Chapter 340
                                            -5-
1st Sub. (Green) S.B. 300  03-04 16:57
16549-20-503 (Effective 01/01/28), as last amended by Laws of Utah 2012, Chapter 265
16653G-11-203 (Effective 01/01/28), as last amended by Laws of Utah 2019, Chapter 293
16753H-3-505 (Effective 01/01/28), as renumbered and amended by Laws of Utah 2025,
168First Special Session, Chapter 8
169
170   Be it enacted by the Legislature of the state of Utah:
171Section 1. Section 17-63-706 is amended to read:
17217-63-706 (Effective 01/01/28). County charges enumerated.
173   (1) County charges are:
174(a) charges incurred against the county by any law;
175(b) the necessary expenses of the county attorney or district attorney incurred in criminal
176cases arising in the county, and all other expenses necessarily incurred by the county
177or district attorney in the prosecution of criminal cases, except jury and witness fees;
178(c) the expenses of health care as described in Section 17-72-501, and other expenses
179necessarily incurred in the support of prisoners committed to the county jail, except
180as provided in Subsection (2);
181(d) for a county not within the state district court administrative system, the sum
182required by law to be paid jurors in civil cases;
183(e) all charges and accounts for services rendered by any justice court judge for services
184in the trial and examination of persons charged with a criminal offense not otherwise
185provided for by law;
186(f) the contingent expenses necessarily incurred for the use and benefit of the county;
187(g) every other sum directed by law to be raised for any county purposes under the
188direction of the county legislative body or declared a county charge;
189(h) the fees of constables for services rendered in criminal cases;
190(i) the necessary expenses of the sheriff and deputies incurred in civil and criminal cases
191arising in the county, and all other expenses necessarily incurred by the sheriff and
192deputies in performing the duties imposed upon the sheriff and deputies by law;
193(j) the sums required by law to be paid by the county to jurors and witnesses serving at
194inquests and in criminal cases in justice courts; and
195(k) subject to Subsection (2), expenses incurred by a health care facility or health care
196provider in providing health care services, treatment, hospitalization, or related
197transportation, at the request of a county sheriff for:
198(i) prisoners booked into a county jail on a charge of a criminal offense; or
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03-04 16:57  1st Sub. (Green) S.B. 300
199(ii) inmates convicted of a criminal offense and committed to a county jail.
200   (2)(a) Expenses described in Subsections (1)(c) and (1)(k) are a charge to the county
201only to the extent that the charge exceeds any private insurance in effect that covers
202the expenses described in Subsections (1)(c) and (1)(k).
203(b) The county may collect costs of health care, treatment, hospitalization, and related
204transportation provided to a person described in Subsection (1)(k) who has the
205resources or the ability to pay, subject to the following priorities for payment:
206(i) first priority shall be given to restitution; and
207(ii) second priority shall be given to family support obligations.
208(c) A county may seek reimbursement from a prisoner or inmate described in Subsection
209(1)(k) for expenses incurred by the county in behalf of the prisoner or inmate for
210health care, treatment, hospitalization, or related transportation by:
211(i) deducting the cost from the prisoner's or inmate's cash account on deposit with the
212detention facility during the prisoner's or inmate's incarceration or during a
213subsequent incarceration if:
214(A) the subsequent incarceration occurs within the same county; and
215(B) the incarceration is within 10 years of the date of the expense in behalf of the
216prisoner or inmate;
217(ii) placing a lien for the amount of the expense against the prisoner's or inmate's
218personal property held by the jail; and
219(iii) adding the amount of expenses incurred to any other amount owed by the
220prisoner or inmate to the jail upon the prisoner's or inmate's release in accordance
221with Subsection 76-3-201(4)(c).
222(d)(i) A jail shall ensure that each prisoner or inmate is enrolled in the Utah Cares
223Health Financing Program, created in Title 26C, Utah Cares Act, to cover health
224care expenses if the inmate is eligible for enrollment when enrollment opens on
225January 1, 2029.
226(ii) A prisoner or inmate who receives health care, treatment, hospitalization, or
227related transportation shall cooperate with the jail facility seeking payment or
228reimbursement under this section for the prisoner's or inmate's expenses.
229(e) If there is no contract between a county jail and a health care facility or health care
230provider that establishes a fee schedule for services rendered or the individual is not
231an enrollee described in Subsection (2)(d)(i), expenses under Subsection (1)(k) shall
232be commensurate with:
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1st Sub. (Green) S.B. 300  03-04 16:57
233(i) for a health care facility, the current noncapitated state Medicaid rates; and
234(ii) for a health care provider, 65% of the amount that would be paid to the health
235care provider:
236(A) under the [Public Employees' Benefit and Insurance Program] Utah Cares
237Health Financing Program, created in [Section 49-20-103] Title 26C, Utah
238Cares Act; and
239(B) if the person receiving the health care service were [a covered employee under
240the Public Employees' Benefit and Insurance Program] an enrollee of the Utah
241Cares Health Financing Program.
242(f) Subsection (1)(k) does not apply to expenses of an individual held at the county jail
243at the request of an agency of the United States.
244(g) [A county that receives information from the Public Employees' Benefit and
245Insurance Program to enable the county to ] The Utah Cares Health Financing
246Program shall calculate the amount to be paid to a health care provider under
247Subsection (2)(e)(ii)[ shall keep that information confidential].
248Section 2. Section 26B-2-101 is amended to read:
24926B-2-101 (Effective 01/01/28). Definitions.
250      As used in this part:
251   (1) "Abuse" means the same as that term is defined in Section 80-1-102.
252   (2) "Adoption services" means the same as that term is defined in Section 80-2-801.
253   (3) "Adult day care" means nonresidential care and supervision:
254(a) for three or more adults for at least four but less than 24 hours a day; and
255(b) that meets the needs of functionally impaired adults through a comprehensive
256program that provides a variety of health, social, recreational, and related support
257services in a protective setting.
258   (4) "Applicant" means a person that applies for an initial license or a license renewal under
259this part.
260   (5)(a) "Associated with the licensee" means that an individual is:
261(i) affiliated with a licensee as an owner, director, member of the governing body,
262employee, agent, provider of care, department contractor, or volunteer; or
263(ii) applying to become affiliated with a licensee in a capacity described in
264Subsection (5)(a)(i).
265(b) "Associated with the licensee" does not include:
266(i) service on the following bodies, unless that service includes direct access to a
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03-04 16:57  1st Sub. (Green) S.B. 300
267child or a vulnerable adult:
268(A) a local mental health authority described in Section 17-77-301;
269(B) a local substance abuse authority described in Section 17-77-201; or
270(C) a board of an organization operating under a contract to provide mental health
271or substance use programs, or services for the local mental health authority or
272substance abuse authority; or
273(ii) a guest or visitor whose access to a child or a vulnerable adult is directly
274supervised at all times.
275   (6) "Behavioral health receiving center" means a 23-hour non-secure program or facility
276that is responsible for, and provides mental health crisis services to, an individual
277experiencing a mental health crisis.
278   (7)(a) "Boarding school" means a private school that:
279(i) uses a regionally accredited education program;
280(ii) provides a residence to the school's students:
281(A) for the purpose of enabling the school's students to attend classes at the
282school; and
283(B) as an ancillary service to educating the students at the school;
284(iii) has the primary purpose of providing the school's students with an education, as
285defined in Subsection (7)(b)(i); and
286(iv)(A) does not provide the treatment or services described in Subsection (49)(a);
287or
288(B) provides the treatment or services described in Subsection (49)(a) on a limited
289basis, as described in Subsection (7)(b)(ii).
290(b)(i) For purposes of Subsection (7)(a)(iii), "education" means a course of study for
291one or more grades from kindergarten through grade 12.
292(ii) For purposes of Subsection (7)(a)(iv)(B), a private school provides the treatment
293or services described in Subsection (49)(a) on a limited basis if:
294(A) the treatment or services described in Subsection (49)(a) are provided only as
295an incidental service to a student; and
296(B) the school does not:
297(I) specifically solicit a student for the purpose of providing the treatment or
298services described in Subsection (49)(a); or
299(II) have a primary purpose of providing the treatment or services described in
300Subsection (49)(a).
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301(c) "Boarding school" does not include a therapeutic school.
302   (8) "Certification" means a less restrictive level of licensure issued by the department.
303   (9) "Child" means an individual under 18 years old.
304   (10) "Child placing" means receiving, accepting, or providing custody or care for any child,
305temporarily or permanently, for the purpose of:
306(a) finding a person to adopt the child;
307(b) placing the child in a home for adoption; or
308(c) foster home placement.
309   (11) "Child-placing agency" means a person that engages in child placing.
310   (12) "Client" means an individual who receives or has received services from a licensee.
311   (13)(a) "Congregate care program" means any of the following that provide services to a
312child:
313(i) an outdoor youth program;
314(ii) a residential support program;
315(iii) a residential treatment program; or
316(iv) a therapeutic school.
317(b) "Congregate care program" does not include a human services program that:
318(i) is licensed to serve adults; and
319(ii) is approved by the office to service a child for a limited time.
320   (14) "Day treatment" means specialized treatment that is provided to:
321(a) a client less than 24 hours a day; and
322(b) four or more persons who:
323(i) are unrelated to the owner or provider; and
324(ii) have emotional, psychological, developmental, physical, or behavioral
325dysfunctions, impairments, or chemical dependencies.
326   (15) "Department contractor" means an individual who:
327(a) provides services under a contract with the department; and
328(b) due to the contract with the department, has or will likely have direct access to a
329child or vulnerable adult.
330   (16) "Direct access" means that an individual has, or likely will have:
331(a) contact with or access to a child or vulnerable adult that provides the individual with
332an opportunity for personal communication or touch; or
333(b) an opportunity to view medical, financial, or other confidential personal identifying
334information of the child, the child's parents or legal guardians, or the vulnerable adult.
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03-04 16:57  1st Sub. (Green) S.B. 300
335   (17) "Directly supervised" means that an individual is being supervised under the
336uninterrupted visual and auditory surveillance of another individual who has a current
337background check approval issued by the office.
338   (18) "Director" means the director of the office.
339   (19) "Division" means the Division of Licensing and Background Checks created under
340Section 26B-2-103.
341   (20) "Domestic violence" means the same as that term is defined in Section 77-36-1.
342   (21) "Domestic violence treatment program" means a nonresidential program designed to
343provide psychological treatment and educational services to perpetrators and victims of
344domestic violence.
345   (22) "Elder adult" means a person 65 years old or older.
346   (23) "Emergency safety intervention" means a tactic used to protect staff or a client from
347being physically injured, utilized by an appropriately trained direct care staff and only
348performed in accordance with a nationally or regionally recognized curriculum in the
349least restrictive manner to restore staff or client safety.
350   (24) "Foster home" means a residence that is licensed or certified by the office for the
351full-time substitute care of a child.
352   (25) "Harm" means the same as that term is defined in Section 80-1-102.
353   (26) "Health benefit plan" means the same as that term is defined in Section 31A-1-301.
354   (27) "Health care provider" means the same as that term is defined in Section 78B-3-403.
355   (28) "Health insurer" means:
356(a) an insurer who offers health care insurance as that term is defined in Section
35731A-1-301;
358(b) health benefits offered [to state employees under Section 49-20-202] under Title 26C,
359Utah Cares Act; and
360(c) a workers' compensation insurer:
361(i) authorized to provide workers' compensation insurance in the state; or
362(ii) that is a self-insured employer as defined in Section 34A-2-201.5.
363   (29)(a) "Human services program" means:
364(i) a foster home;
365(ii) a therapeutic school;
366(iii) a youth program;
367(iv) an outdoor youth program;
368(v) a residential treatment program;
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369(vi) a residential support program;
370(vii) a resource family home;
371(viii) a recovery residence;
372(ix) a behavioral health receiving center; or
373(x) a facility or program that provides:
374(A) adult day care;
375(B) day treatment;
376(C) outpatient treatment;
377(D) domestic violence treatment;
378(E) child-placing services;
379(F) social detoxification; or
380(G) any other human services that are required by contract with the department to
381be licensed with the department.
382(b) "Human services program" does not include:
383(i) a boarding school;
384(ii) a residential vocational or life skills program, as defined in Section 13-53-102; or
385(iii) a short-term relief care provider.
386   (30) "Indian child" means the same as that term is defined in 25 U.S.C. Sec. 1903.
387   (31) "Indian country" means the same as that term is defined in 18 U.S.C. Sec. 1151.
388   (32) "Indian tribe" means the same as that term is defined in 25 U.S.C. Sec. 1903.
389   (33) "Intermediate secure treatment" means 24-hour specialized residential treatment or
390care for an individual who:
391(a) cannot live independently or in a less restrictive environment; and
392(b) requires, without the individual's consent or control, the use of locked doors to care
393for the individual.
394   (34) "Licensee" means an individual or a human services program licensed by the office.
395   (35) "Local government" means a city, town, or county.
396   (36) "Mental health treatment program" means a program that:
397(a) is a structured intervention; and
398(b) is used to improve mental health, prevent mental disorders, and treat mental health
399conditions.
400   (37) "Medication assisted treatment" means the use of a prescribed medication approved by
401the United States Food and Drug Administration, such as buprenorphine, methadone, or
402naltrexone, to treat substance use withdrawal symptoms or a substance use disorder.
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03-04 16:57  1st Sub. (Green) S.B. 300
403   (38) "Minor" means child.
404   (39) "Office" means, except as provided in Section 26B-2-120, the Office of Licensing
405within the department.
406   (40) "Ombudsman" means the congregate care ombudsman created in Section 26B-2-124.2.
407   (41) "Outdoor youth program" means a program that provides:
408(a) services to a child who has:
409(i) a chemical dependency; or
410(ii) a dysfunction or impairment that is emotional, psychological, developmental,
411physical, or behavioral;
412(b) a 24-hour outdoor group living environment; and
413(c)(i) regular therapy, including group, individual, or supportive family therapy; or
414(ii) informal therapy or similar services, including wilderness therapy, adventure
415therapy, or outdoor behavioral healthcare.
416   (42) "Outpatient treatment" means individual, family, or group therapy or counseling
417designed to improve and enhance social or psychological functioning for those whose
418physical and emotional status allows them to continue functioning in their usual living
419environment.
420   (43) "Practice group" or "group practice" means two or more health care providers legally
421organized as a partnership, professional corporation, or similar association, for which:
422(a) substantially all of the services of the health care providers who are members of the
423group are provided through the group and are billed in the name of the group and
424amounts received are treated as receipts of the group; and
425(b) the overhead expenses of and the income from the practice are distributed in
426accordance with methods previously determined by members of the group.
427   (44) "Private-placement child" means a child whose parent or guardian enters into a
428contract with a congregate care program for the child to receive services.
429   (45) "Qualifying residential treatment program" means a residential treatment program that
430is licensed under this part and:
431(a) is operated as a nonprofit corporation or foreign nonprofit corporation, as those terms
432are defined in Section 16-6a-102; or
433(b) receives any local, state, or federal government funding, government grant money, or
434any other form of government assistance to operate or provide services or training in
435the ordinary course of business.
436   (46) "Qualifying recovery residence" means a recovery residence that is licensed under this
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1st Sub. (Green) S.B. 300  03-04 16:57
437part and:
438(a) is operated as a nonprofit corporation or foreign nonprofit corporation, as those terms
439are defined in Section 16-6a-102; or
440(b) receives any local, state, or federal government funding, government grant money, or
441any other form of government assistance to operate or provide services or training in
442the ordinary course of business.
443   (47)(a) "Recovery residence" means a home, residence, or facility that meets at least two
444of the following requirements:
445(i) provides a supervised living environment for individuals recovering from a
446substance use disorder;
447(ii) provides a living environment in which more than half of the individuals in the
448residence are recovering from a substance use disorder;
449(iii) provides or arranges for residents to receive services related to the resident's
450recovery from a substance use disorder, either on or off site;
451(iv) is held out as a living environment in which individuals recovering from
452substance abuse disorders live together to encourage continued sobriety; or
453(v)(A) receives public funding; or
454(B) is run as a business venture, either for-profit or not-for-profit.
455(b) "Recovery residence" does not mean:
456(i) a residential treatment program;
457(ii) residential support program;
458(iii) a residential vocational or life skills program; or
459(iv) a home, residence, or facility, in which:
460(A) residents, by a majority vote of the residents, establish, implement, and
461enforce policies governing the living environment, including the manner in
462which applications for residence are approved and the manner in which
463residents are expelled;
464(B) residents equitably share rent and housing-related expenses; and
465(C) a landlord, owner, or operator does not receive compensation, other than fair
466market rental income, for establishing, implementing, or enforcing policies
467governing the living environment.
468   (48) "Regular business hours" means:
469(a) the hours during which services of any kind are provided to a client; or
470(b) the hours during which a client is present at the facility of a licensee.
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03-04 16:57  1st Sub. (Green) S.B. 300
471   (49)(a) "Residential support program" means a program that arranges for or provides the
472necessities of life as a protective service to individuals or families who have a
473disability or who are experiencing a dislocation or emergency that prevents them
474from providing these services for themselves or their families.
475(b) "Residential support program" includes a program that provides a supervised living
476environment for individuals with dysfunctions or impairments that are:
477(i) emotional;
478(ii) psychological;
479(iii) developmental; or
480(iv) behavioral.
481(c) Treatment is not a necessary component of a residential support program.
482(d) "Residential support program" does not include:
483(i) a recovery residence; or
484(ii) a program that provides residential services that are performed:
485(A) exclusively under contract with the department and provided to individuals
486through the Division of Services for People with Disabilities; or
487(B) in a facility that serves fewer than four individuals.
488   (50)(a) "Residential treatment" means a 24-hour group living environment for four or
489more individuals unrelated to the owner or provider that offers room or board and
490specialized treatment, behavior modification, rehabilitation, discipline, emotional
491growth, or habilitation services for persons with emotional, psychological,
492developmental, or behavioral dysfunctions, impairments, or chemical dependencies.
493(b) "Residential treatment" does not include a:
494(i) boarding school;
495(ii) foster home; or
496(iii) recovery residence.
497   (51) "Residential treatment program" means a program or facility that provides:
498(a) residential treatment; or
499(b) intermediate secure treatment.
500   (52) "Seclusion" means the involuntary confinement of an individual in a room or an area:
501(a) away from the individual's peers; and
502(b) in a manner that physically prevents the individual from leaving the room or area.
503   (53) "Short-term relief care provider" means an individual who:
504(a) provides short-term and temporary relief care to a foster parent:
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505(i) for less than six consecutive nights; and
506(ii) in the short-term relief care provider's home;
507(b) is an immediate family member or relative, as those terms are defined in Section
50880-3-102, of the foster parent;
509(c) is direct access qualified, as that term is defined in Section 26B-2-120;
510(d) has been approved to provide short-term relief care by the department;
511(e) is not reimbursed by the department for the temporary relief care provided; and
512(f) is not an immediate family member or relative, as those terms are defined in Section
51380-3-102, of the foster child.
514   (54) "Social detoxification" means short-term residential services for persons who are
515experiencing or have recently experienced drug or alcohol intoxication, that are provided
516outside of a health care facility licensed under Part 2, Health Care Facility Licensing and
517Inspection, and that include:
518(a) room and board for persons who are unrelated to the owner or manager of the facility;
519(b) specialized rehabilitation to acquire sobriety; and
520(c) aftercare services.
521   (55) "Substance abuse disorder" or "substance use disorder" mean the same as "substance
522use disorder" is defined in Section 26B-5-501.
523   (56) "Substance abuse treatment program" or "substance use disorder treatment program"
524means a program:
525(a) designed to provide:
526(i) specialized drug or alcohol treatment;
527(ii) rehabilitation; or
528(iii) habilitation services; and
529(b) that provides the treatment or services described in Subsection (56)(a) to persons
530with:
531(i) a diagnosed substance use disorder; or
532(ii) chemical dependency disorder.
533   (57) "Therapeutic school" means a residential group living facility:
534(a) for four or more individuals that are not related to:
535(i) the owner of the facility; or
536(ii) the primary service provider of the facility;
537(b) that serves students who have a history of failing to function:
538(i) at home;
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03-04 16:57  1st Sub. (Green) S.B. 300
539(ii) in a public school; or
540(iii) in a nonresidential private school; and
541(c) that offers:
542(i) room and board; and
543(ii) an academic education integrated with:
544(A) specialized structure and supervision; or
545(B) services or treatment related to:
546(I) a disability;
547(II) emotional development;
548(III) behavioral development;
549(IV) familial development; or
550(V) social development.
551   (58) "Unrelated persons" means persons other than parents, legal guardians, grandparents,
552brothers, sisters, uncles, or aunts.
553   (59) "Vulnerable adult" means an elder adult or an adult who has a temporary or permanent
554mental or physical impairment that substantially affects the person's ability to:
555(a) provide personal protection;
556(b) provide necessities such as food, shelter, clothing, or mental or other health care;
557(c) obtain services necessary for health, safety, or welfare;
558(d) carry out the activities of daily living;
559(e) manage the adult's own resources; or
560(f) comprehend the nature and consequences of remaining in a situation of abuse,
561neglect, or exploitation.
562   (60)(a) "Youth program" means a program designed to provide behavioral, substance
563use, or mental health services to minors that:
564(i) serves adjudicated or nonadjudicated youth;
565(ii) charges a fee for the program's services;
566(iii) may provide host homes or other arrangements for overnight accommodation of
567the youth;
568(iv) may provide all or part of the program's services in the outdoors;
569(v) may limit or censor access to parents or guardians; and
570(vi) prohibits or restricts a minor's ability to leave the program at any time of the
571minor's own free will.
572(b) "Youth program" does not include recreational programs such as Boy Scouts, Girl
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1st Sub. (Green) S.B. 300  03-04 16:57
573Scouts, 4-H, and other such organizations.
574   (61)(a) "Youth transportation company" means any person that transports a child for
575payment to or from a congregate care program in Utah.
576(b) "Youth transportation company" does not include:
577(i) a relative of the child;
578(ii) a state agency; or
579(iii) a congregate care program's employee who transports the child from the
580congregate care program that employs the employee and returns the child to the
581same congregate care program.
582Section 3. Section 26B-2-201 is amended to read:
58326B-2-201 (Effective 01/01/27). Definitions.
584      As used in this part:
585   (1) "Abortion clinic" means a type I abortion clinic or a type II abortion clinic.
586   (2) "Activities of daily living" means essential activities including:
587(a) dressing;
588(b) eating;
589(c) grooming;
590(d) bathing;
591(e) toileting;
592(f) ambulation;
593(g) transferring; and
594(h) self-administration of medication.
595   (3) "Ambulatory surgical facility" means a freestanding facility, which provides surgical
596services to patients not requiring hospitalization.
597   (4) "Assistance with activities of daily living" means providing of or arranging for the
598provision of assistance with activities of daily living.
599   (5)(a) "Assisted living facility" means:
600(i) a type I assisted living facility, which is a residential facility that provides
601assistance with activities of daily living and social care to two or more residents
602who:
603(A) require protected living arrangements; and
604(B) are capable of achieving mobility sufficient to exit the facility without the
605assistance of another person; and
606(ii) a type II assisted living facility, which is a residential facility with a home-like
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03-04 16:57  1st Sub. (Green) S.B. 300
607setting that provides an array of coordinated supportive personal and health care
608services available 24 hours per day to residents who have been assessed under
609department rule to need any of these services.
610(b) Each resident in a type I or type II assisted living facility shall have a service plan
611based on the assessment, which may include:
612(i) specified services of intermittent nursing care;
613(ii) administration of medication; and
614(iii) support services promoting residents' independence and self-sufficiency.
615   (6) "Birthing center" means a facility that:
616(a) receives maternal clients and provides care during pregnancy, delivery, and
617immediately after delivery; and
618(b)(i) is freestanding; or
619(ii) is not freestanding, but meets the requirements for an alongside midwifery unit
620described in Subsection 26B-2-228(7).
621   (7) "Committee" means the Health Facility Committee created in Section 26B-1-204.
622   (8) "Consumer" means any person not primarily engaged in the provision of health care to
623individuals or in the administration of facilities or institutions in which such care is
624provided and who does not hold a fiduciary position, or have a fiduciary interest in any
625entity involved in the provision of health care, and does not receive, either directly or
626through his spouse, more than 1/10 of his gross income from any entity or activity
627relating to health care.
628   (9) "End stage renal disease facility" means a facility which furnishes staff-assisted kidney
629dialysis services, self-dialysis services, or home-dialysis services on an outpatient basis.
630   (10) "Freestanding" means existing independently or physically separated from another
631health care facility by fire walls and doors and administrated by separate staff with
632separate records.
633   (11) "General acute hospital" means a facility which provides diagnostic, therapeutic, and
634rehabilitative services to both inpatients and outpatients by or under the supervision of
635physicians.
636   (12) "Governmental unit" means the state, or any county, municipality, or other political
637subdivision or any department, division, board, or agency of the state, a county,
638municipality, or other political subdivision.
639   (13)(a) "Health care facility" means general acute hospitals, specialty hospitals, home
640health agencies, hospices, nursing care facilities, residential-assisted living facilities,
                                                 - 19 -
1st Sub. (Green) S.B. 300  03-04 16:57
641birthing centers, ambulatory surgical facilities, small health care facilities, abortion
642clinics, facilities owned or operated by health maintenance organizations, end stage
643renal disease facilities, and any other health care facility which the committee
644designates by rule.
645(b) "Health care facility" does not include the offices of private physicians or dentists,
646whether for individual or group practice, except that it does include an abortion clinic.
647   (14) "Health maintenance organization" means an organization, organized under the laws of
648any state which:
649(a) is a qualified health maintenance organization under 42 U.S.C. Sec. 300e-9; or
650(b)(i) provides or otherwise makes available to enrolled participants at least the
651following basic health care services: usual physician services, hospitalization,
652laboratory, x-ray, emergency, and preventive services and out-of-area coverage;
653(ii) is compensated, except for copayments, for the provision of the basic health
654services listed in Subsection (14)(b)(i) to enrolled participants by a payment
655which is paid on a periodic basis without regard to the date the health services are
656provided and which is fixed without regard to the frequency, extent, or kind of
657health services actually provided;
658(iii) provides physicians' services primarily directly through physicians who are
659either employees or partners of such organizations, or through arrangements with
660individual physicians or one or more groups of physicians organized on a group
661practice or individual practice basis; and
662(iv) provides physician assistant services.
663   (15)(a) "Home health agency" means an agency, organization, or facility or a
664subdivision of an agency, organization, or facility which employs two or more direct
665care staff persons who provide licensed nursing services, therapeutic services of
666physical therapy, speech therapy, occupational therapy, medical social services, or
667home health aide services on a visiting basis.
668(b) "Home health agency" does not mean an individual who provides services under the
669authority of a private license.
670   (16) "Hospice" means a program of care for the terminally ill and their families which
671occurs in a home or in a health care facility and which provides medical, palliative,
672psychological, spiritual, and supportive care and treatment.
673   (17) "Nursing care facility" means a health care facility, other than a general acute or
674specialty hospital, constructed, licensed, and operated to provide patient living
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03-04 16:57  1st Sub. (Green) S.B. 300
675accommodations, 24-hour staff availability, and at least two of the following patient
676services:
677(a) a selection of patient care services, under the direction and supervision of a registered
678nurse, ranging from continuous medical, skilled nursing, psychological, or other
679professional therapies to intermittent health-related or paraprofessional personal care
680services;
681(b) a structured, supportive social living environment based on a professionally designed
682and supervised treatment plan, oriented to the individual's habilitation or
683rehabilitation needs; or
684(c) a supervised living environment that provides support, training, or assistance with
685individual activities of daily living.
686   (18) "Person" means any individual, firm, partnership, corporation, company, association,
687or joint stock association, and the legal successor thereof.
688   (19) "Resident" means a person 21 years old or older who:
689(a) as a result of physical or mental limitations or age requires or requests services
690provided in an assisted living facility; and
691(b) does not require intensive medical or nursing services as provided in a hospital or
692nursing care facility.
693   (20) "Small health care facility" means a four to 16 bed facility that provides licensed
694health care programs and services to residents.
695   (21) "Specialty hospital" means a facility which provides specialized diagnostic,
696therapeutic, or rehabilitative services in the recognized specialty or specialties for which
697the hospital is licensed.
698   (22) "Substantial compliance" means in a department survey of a licensee, the department
699determines there is an absence of deficiencies which would harm the physical health,
700mental health, safety, or welfare of patients or residents of a licensee.
701   (23) "Type I abortion clinic" means a facility, including a physician's office, but not
702including a general acute or specialty hospital, that:
703(a) performs abortions, as defined in Section 76-7-301, during the first trimester of
704pregnancy; and
705(b) does not perform abortions, as defined in Section 76-7-301, after the first trimester of
706pregnancy.
707   (24) "Type II abortion clinic" means a facility, including a physician's office, but not
708including a general acute or specialty hospital, that:
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1st Sub. (Green) S.B. 300  03-04 16:57
709(a) performs abortions, as defined in Section 76-7-301, after the first trimester of
710pregnancy; or
711(b) performs abortions, as defined in Section 76-7-301, during the first trimester of
712pregnancy and after the first trimester of pregnancy.
713   (25) "Utah Cares program" means the Utah Cares Health Financing Program created in
714Title 26C, Utah Cares Act.
715Section 4. Section 26B-2-206 is amended to read:
71626B-2-206 (Effective 01/01/27). License required -- Not assignable or
717   transferable -- Posting -- Expiration and renewal -- Time for compliance by operating
718   facilities.
719   (1)(a) A person or governmental unit acting severally or jointly with any other person or
720governmental unit, may not establish, conduct, or maintain a health care facility in
721this state without receiving a license from the department as provided by this part and
722the rules[ ] adopted pursuant to this part .
723(b) This Subsection (1) does not apply to facilities that are exempt under Section
72426B-2-205.
725   (2) A license issued under this part is not assignable or transferable.
726   (3) The current license shall at all times be posted in each health care facility in a place
727readily visible and accessible to the public.
728   (4)(a) The department may issue a license for a period of time not to exceed 12 months
729from the date of issuance for an abortion clinic and not to exceed 24 months from the
730date of issuance for other health care facilities that meet the provisions of this part
731and department rules adopted pursuant to this part.
732(b) Each license expires at midnight on the day designated on the license as the
733expiration date, unless previously revoked by the department.
734(c) The license shall be renewed upon completion of the application requirements,
735unless the department finds the health care facility has not complied with the
736provisions of this part or the rules adopted pursuant to this part.
737   (5) A license may be issued under this section only for the operation of a specific facility at
738a specific site by a specific person.
739   (6) Any health care facility in operation at the time of adoption of any applicable rules as
740provided under this part shall be given a reasonable time for compliance as determined
741by the committee.
742   (7)(a) Beginning November 1, 2030, the department may not issue or renew a health
                                                 - 22 -
03-04 16:57  1st Sub. (Green) S.B. 300
743care facility license unless the licensee has:
744(i) agreed to a payment structure described in Section 26C-4-102 with the Utah Cares
745program; and
746(ii) authorized the Utah Cares program to conduct all billing operations on behalf of
747the health care facility.
748(b) Subsection (7)(a) does not apply to a health care facility licensed as a long-term care
749facility.
750Section 5. Section 26B-3-104.1 is enacted to read:
75126B-3-104.1 (Effective 01/01/27). Medicaid transition to Utah Cares Health
752   Financing Program.
753   (1) Notwithstanding any other provision of law, the department shall amend the state plan
754and any necessary Medicaid waivers to transition the Medicaid program to using the
755Utah Cares Health Financing Program described in Title 26C, Utah Cares Act, for
756payment of all Medicaid services.
757   (2) The department and the Utah Cares Health Financing Program shall apply for any
758waivers and make necessary state plan amendments to transition the Utah Cares Health
759Financing Program as the primary entity for maintaining and administering the Medicaid
760program, including the state plan.
761   (3) When necessary waivers and state plan amendments are approved, the department shall
762transition the operation of the Medicaid program and all Medicaid services to the Utah
763Cares Health Financing Program.
764Section 6. Section 26B-3-908 is amended to read:
76526B-3-908 (Effective 01/01/27). Managed care -- Contracting for services.
766   (1) Program benefits provided to a member under the program, as described in Section
76726B-3-904, shall be delivered by a managed care organization if the department
768determines that adequate services are available where the member lives or resides.
769   (2) The department may contract with a managed care organization to provide program
770benefits. The department shall evaluate a potential contract with a managed care
771organization based on:
772(a) the managed care organization's:
773(i) ability to manage medical expenses, including mental health costs;
774(ii) proven ability to handle accident and health insurance;
775(iii) efficiency of claim paying procedures;
776(iv) proven ability for managed care and quality assurance;
                                                 - 23 -
1st Sub. (Green) S.B. 300  03-04 16:57
777(v) provider contracting and discounts;
778(vi) pharmacy benefit management;
779(vii) estimated total charges for administering the pool;
780(viii) ability to administer the pool in a cost-efficient manner;
781(ix) ability to provide adequate providers and services in the state; and
782(x) ability to meet quality measures for emergency room use and access to primary
783care established by the department under Subsection 26B-3-204(4); and
784(b) other factors established by the department.
785   (3) The department may enter into separate managed care organization contracts to provide
786dental benefits required by Section 26B-3-904.
787   (4) The department's contract with a managed care organization for the program's benefits
788shall include risk sharing provisions in which the plan shall accept at least 75% of the
789risk for any difference between the department's premium payments per member and
790actual medical expenditures.
791   (5) Notwithstanding any other provision of law, all program benefits shall be provided by
792the Utah Cares Health Financing Program once the department obtains necessary
793approval from CMS to provide services through the Utah Cares Health Financing
794Program.
795   [(5)(a) The department may contract with the Group Insurance Division within the Utah
796State Retirement Office to provide services under Subsection (1) if no managed care
797organization is willing to contract with the department or the department determines
798no managed care organization meets the criteria established under Subsection (2).]
799[(b) In accordance with Section 49-20-201, a contract awarded under Subsection (5)(a)
800is not subject to the risk sharing required by Subsection (4).]
801Section 7. Section 26C-1-101 is enacted to read:
802TITLE 26C. Utah Cares Act
803CHAPTER 1. General Provisions
80426C-1-101 (Effective 07/01/27). Utah Cares Act.
805      This title is known as the "Utah Cares Act."
806Section 8. Section 26C-1-102 is enacted to read:
80726C-1-102 (Effective 07/01/27). Definitions.
808      As used in this title:
809   (1) "Accredited clinical education program" means a clinical education program for a health
                                                - 24 -
03-04 16:57  1st Sub. (Green) S.B. 300
810care profession that is accredited by the Accreditation Council on Graduate Medical
811Education.
812   (2) "Accredited clinical training program" means a clinical training program that is
813accredited by an entity recognized within medical education circles as an accrediting
814body for medical education, advanced practice nursing education, physician assistant
815education, doctor of pharmacy education, dental education, or registered nursing
816education.
817   (3) "Centers for Medicare and Medicaid Services" means the Centers for Medicare and
818Medicaid Services within the United States Department of Health and Human Services.
819   (4) "Commission" means the Utah Health Services Commission created in Section
82026C-2-101.
821   (5) "Enrollee" means an individual enrolled in the program.
822   (6) "Executive director" means the executive director of the program.
823   (7) "Fund" means the Utah Cares Trust Fund, created in Section 26C-1-103.
824   (8) "General acute hospital" means the same as that term is defined in Section 26B-2-201.
825   (9) "Health care facility" means the same as that term is defined in Section 26B-2-201.
826   (10) "Health care professionals in training" means medical students and residents, advanced
827practice nursing students, physician assistant students, doctor of pharmacy students,
828dental students, and registered nursing students.
829   (11)(a) "Health workforce" means the individuals, collectively and by profession, who
830deliver health care services or assist in the delivery of health care services.
831(b) "Health workforce" includes any health care professional who does not work in the
832health sector and any non-health care professional who works in the health sector.
833   (12) "Medical education program" means the program created in Section 26C-2-108.
834   (13) "Nursing care facility" means the same as that term is defined in Section 26B-2-201.
835   (14) "Operating and capital budget facility" means any of the following:
836(a) a nursing care facility;
837(b) a general acute hospital; and
838(c) a specialty hospital.
839   (15) "Pharmacist" means the same as that term is defined in Section 58-17b-102.
840   (16) "Pharmacy" means the same as that term is defined in Section 58-17b-102.
841   (17) "Pharmacy service" means a product, good, or service provided by a pharmacy or
842pharmacist to an individual.
843   (18) "Physician" means an individual:
                                                 - 25 -
1st Sub. (Green) S.B. 300  03-04 16:57
844(a) licensed as a physician under Title 58, Chapter 67, Utah Medical Practice Act; or
845(b) licensed as a physician under Title 58, Chapter 68, Utah Osteopathic Medical
846Practice Act.
847   (19) "Program" means the Utah Cares Health Financing Program.
848   (20) "Rural county" means a county of the third, fourth, fifth, or sixth class under Section
84917-60-104.
850   (21) "Rural hospital" means a general acute hospital located within a rural county.
851   (22) "Specialty hospital" means the same as that term is defined in Section 26B-2-201.
852   (23) "UMEC" means the Utah Medical Education Council created in Section 26C-2-107.
853Section 9. Section 26C-1-103 is enacted to read:
85426C-1-103 (Effective 07/01/27). Utah Cares Trust Fund -- Audit.
855   (1) There is created the "Utah Cares Trust Fund" for the purpose of paying the benefits and
856the costs of administering this program.
857   (2) The fund shall consist of:
858(a) money appropriated to the fund by the Legislature;
859(b) money provided under Section 26C-3-101;
860(c) tax revenue deposited under Title 59, Chapter 35, Utah Health Care Tax;
861(d) money paid by non-enrollees to the program for health care services provided by an
862operating and capital budget facility;
863(e) any federal funds received from the federal government for federal savings resulting
864from 42 U.S.C. Sec. 18052; and
865(f) the reserve funds of private insurers.
866   (3) The fund shall be used to pay for:
867(a) health care provided to enrollees of the program;
868(b) enrollees of Medicaid when all waivers are approved as described in Section
86926B-3-104.1;
870(c) payments to a operating and capital budget facility;
871(d) administering the program; and
872(e) benefits provided under this title.
873   (4) Every two years, the Insurance Department shall audit the Utah Cares Trust Fund and
874programs authorized under this chapter and report the Insurance Department's findings
875to the governor and the Legislature, but the commissioner may accept the annual audited
876statement of the programs under this chapter in lieu of the biennial audit requirement.
877Section 10. Section 26C-1-104 is enacted to read:
                                                   - 26 -
03-04 16:57  1st Sub. (Green) S.B. 300
87826C-1-104 (Effective 07/01/27). Social security number prohibition.
879      Notwithstanding the provisions of Subsection 31A-1-103(3)(f), the program shall
880   comply with the provisions of Section 31A-22-634.
881Section 11. Section 26C-2-101 is enacted to read:
882CHAPTER 2. Utah Health Service Commission
88326C-2-101 (Effective 07/01/27). Utah Health Services Commission -- Creation --
884   Members -- Terms -- Quorum -- Compensation.
885   (1) Notwithstanding Section 63E-1-302, there is created an independent state agency
886known as the Utah Health Services Commission.
887   (2) The commission shall consist of seven members appointed by the governor, with the
888advice and consent of the Senate and in accordance with Title 63G, Chapter 24, Part 2,
889Vacancies.
890   (3)(a) Subject to Subsection (3)(e), the term of office of each appointed commission
891member is six years.
892(b) A member may be appointed to more than one term.
893(c) When a vacancy occurs in the membership for any reason, the replacement shall be
894appointed for the unexpired term by the governor with advice and consent of the
895Senate.
896(d) Any member of the commission may be removed for cause by the governor.
897(e) The terms of the members shall be staggered to ensure that at least two
898commissioners are appointed for a term of six years on February 1 of each
899odd-numbered year.
900   (4)(a) A majority of the commission members constitutes a quorum.
901(b) The action of a majority of a quorum constitutes the action of the commission.
902(c) One member of the commission shall be designated by the governor as chair of the
903commission.
904   (5) Commissioners shall receive compensation as established by the governor within the
905salary range fixed by the Legislature in Title 67, Chapter 22, State Officer
906Compensation, and all actual and necessary expenses incurred in attending to official
907business.
908   (6) Each commissioner at the time of appointment and qualification shall be a resident
909citizen of the United States and of this state.
910   (7) Except as provided by law, no commissioner may hold any other office either under the
911government of the United States or of this state or of any municipal corporation within
                                                 - 27 -
1st Sub. (Green) S.B. 300  03-04 16:57
912this state.
913   (8) A commissioner shall comply with the conflict of interest provisions described in Title
91463G, Chapter 24, Part 3, Conflicts of Interest.
915Section 12. Section 26C-2-102 is enacted to read:
91626C-2-102 (Effective 07/01/27). Commission duties.
917      The commission shall:
918   (1) design and administer the program;
919   (2) establish a budget for the program;
920   (3) ensure the delivery of quality health care services to all enrollees;
921   (4) conduct regular audits and evaluations of the system's performance and
922cost-effectiveness;
923   (5) provide an annual report to the governor and the Legislature on the status and
924performance of the program;
925   (6) promote cooperation among providers;
926   (7) create advisory boards to address health care needs regarding health care quality
927improvement, health care modernization, and financial budgeting;
928   (8) create regional advisory boards to solicit information regarding the various health care
929needs in the different regions of the state;
930   (9) adjudicate disputes between patients, the program, health care providers, and health care
931facilities;
932   (10) develop a no-fault medical injury payment system as an alternative to litigation;
933   (11) establish and conduct public meetings where patients, health care providers, and health
934care facilities may provide feedback to the commission; and
935   (12) make rules in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking
936Act, to implement and administer this chapter.
937Section 13. Section 26C-2-103 is enacted to read:
93826C-2-103 (Effective 07/01/27). Planning and forecasting health care needs.
939   (1) The commission shall:
940(a) coordinate health care resources and capital expenditures to ensure all enrollees have
941reasonable access to covered services;
942(b) develop short term and long term plans to meet health care needs;
943(c) complete an annual review of health care needs, including:
944(i) evaluating health care workforce needs;
945(ii) establishing a budget for all operating and capital budget facilities;
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03-04 16:57  1st Sub. (Green) S.B. 300
946(iii) evaluating all capital expenses in excess of a threshold amount to be determined
947annually by the commission; and
948(iv) collaborating with local and statewide government and health care institutions to
949coordinate capital health planning and investment;
950(d) develop short term and long term plans to meet capital expenditure needs; and
951(e) develop plans to improve access to care in rural and frontier counties in the state.
952   (2) When conducting the review described in Subsection (1)(c), the commission shall:
953(a) consult with:
954(i) advisory boards created by the commission; and
955(ii) the Utah Health Workforce Advisory Council; and
956(b) hold public hearings across the state.
957   (3) The commission may request assistance from the program to carry out the duties
958described in this section.
959Section 14. Section 26C-2-104 is enacted to read:
96026C-2-104 (Effective 07/01/27). Health care best practices.
961   (1) The commission shall establish a best practices standard of care regarding:
962(a) appropriate hospital staffing levels;
963(b) evidence-based best clinical practices, including for primary care and mental health
964care;
965(c) appropriate medical technology;
966(d) design and scope of work in the health workplace;
967(e) development of clinical practices that lead toward the elimination of medical errors
968or medical waste;
969(f) timely access to needed medical and dental care; and
970(g) compassionate end-of-life care to provide comfort and relieve pain.
971   (2) The commission may request assistance from the program to carry out the duties
972described in this section.
973Section 15. Section 26C-2-105, which is renumbered from Section 26B-1-425 is renumbered
974   and amended to read:
975[26B-1-425] 26C-2-105 (Effective 07/01/27) (Repealed 07/01/27). Utah Health
976   Workforce Advisory Council -- Creation and membership.
977   (1) There is created within the [department] commission the Utah Health Workforce
978Advisory Council.
979   (2) The council shall be comprised of at least [14] 15 but not more than [19] 20 members.
                                                  - 29 -
 1st Sub. (Green) S.B. 300  03-04 16:57
980   (3) The following are members of the council:
981(a) the executive director of the Department of Health and Human Services or that
982individual's designee;
983(b) the executive director of the Department of Workforce Services or that individual's
984designee;
985(c) the commissioner of higher education of the Utah System of Higher Education or
986that individual's designee;
987(d) the state superintendent of the State Board of Education or that individual's designee;
988(e) the executive director of the Department of Commerce or that individual's designee;
989(f) the director of the Division of Multicultural Affairs or that individual's designee;
990(g) the director of the Utah Substance Use and Mental Health Advisory Committee or
991that individual's designee;
992(h) the chair of the Utah Indian Health Advisory Board;[ and]
993(i) the chair of the Utah Medical Education Council created in Section [26B-4-706.]
99426C-2-107; and
995(j) the executive director or that individual's designee.
996   (4) The executive director shall appoint at least five but not more than ten additional
997members that represent diverse perspectives regarding Utah's health workforce as
998defined in Section [26B-4-705] 26C-2-106.
999   (5)(a) A member appointed by the executive director under Subsection (4) shall serve a
1000  four-year term.
1001  (b) Notwithstanding Subsection (5)(a) for the initial appointments of members described
1002  in Subsection (4) the executive director shall appoint at least three but not more than
1003  five members to a two-year appointment to ensure that approximately half of the
1004  members appointed by the executive director rotate every two years.
1005     (6) The executive director or the executive director's designee shall chair the council.
1006  [(7)(a) As used in this Subsection (7), "health workforce" means the same as that term
1007  is defined in Section 26B-4-705.]
1008     [(b)] (7) The council shall:
1009  [(i)] (a) meet at least once each quarter;
1010  [(ii)] (b) study and provide recommendations to an entity described in Subsection (8)
1011  regarding:
1012  [(A)] (i) health workforce supply;
1013  [(B)] (ii) health workforce employment trends and demand;
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 03-04 16:57  1st Sub. (Green) S.B. 300
1014  [(C)] (iii) options for training and educating the health workforce; and
1015  [(D)] (iv) the implementation or improvement of strategies that entities in the state are
1016  using or may use to address health workforce needs including shortages,
1017  recruitment, retention, and other Utah health workforce priorities as determined by
1018  the council;
1019  [(iii)] (c) provide guidance to an entity described in Subsection (8) regarding health
1020  workforce related matters;
1021  [(iv)] (d) review and comment on legislation relevant to Utah's health workforce; and
1022  [(v)] (e) advise the Utah Board of Higher Education and the Legislature on the status and
1023  needs of the health workforce who are in training.
1024     (8) The council shall provide information described in Subsections [(7)(b)(ii)] (7)(b) and [
1025  (iii)] (c) to:
1026  (a) the Legislature;
1027  (b) the [department] Department of Health and Human Services;
1028  (c) the Department of Workforce Services;
1029  (d) the Department of Commerce;
1030  (e) the Utah Medical Education Council; and
1031  (f) any other entity the council deems appropriate upon the entity's request.
1032     (9)(a) The Utah Medical Education Council created in Section [26B-4-706] 26C-2-107 is
1033  a subcommittee of the council.
1034  (b) The council may establish subcommittees to support the work of the council.
1035  (c) A member of the council shall chair a subcommittee created by the council.
1036  (d) Except for the Utah Medical Education Council, the chair of the subcommittee may
1037  appoint any individual to the subcommittee.
1038     (10) For any report created by the council that pertains to any duty described in Subsection
1039  (7), the council shall:
1040  (a) provide the report to:
1041  (i) the [department] commission; and
1042  (ii) any appropriate legislative committee; and
1043  (b) post the report on the council's website.
1044     (11) The executive director shall:
1045  (a) ensure the council has adequate staff to support the council and any subcommittee
1046  created by the council; and
1047  (b) provide any available information upon the council's request if:
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 1st Sub. (Green) S.B. 300  03-04 16:57
1048  (i) that information is necessary for the council to fulfill a duty described in
1049  Subsection (7); and
1050  (ii) the [department] commission has access to the information.
1051     (12) A member of the council or a subcommittee created by the council may not receive
1052  compensation or benefits for the member's service but may receive per diem and travel
1053  expenses as allowed in:
1054  (a) Section 63A-3-106;
1055  (b) Section 63A-3-107; and
1056  (c) rules made by the Division of Finance according to Sections 63A-3-106 and
1057  63A-3-107.
1058  Section 16. Section 26C-2-106, which is renumbered from Section 26B-4-705 is renumbered
1059     and amended to read:
1060  [26B-4-705] 26C-2-106 (Effective 07/01/27). Utah Health Workforce Information
1061     Center.
1062     (1) As used in this section:
1063  (a) "Council" means the Utah Health Workforce Advisory Council created in Section [
1064  26B-1-425] 26C-2-105.
1065  (b) "Health sector" means any place of employment where the primary function is the
1066  delivery of health care services.
1067  [(c)(i) "Health workforce" means the individuals, collectively and by profession,
1068  who deliver health care services or assist in the delivery of health care services.]
1069  [(ii) "Health workforce" includes any health care professional who does not work in
1070  the health sector and any non-health care professional who works in the health
1071  sector.]
1072     (2) There is created within the department the Utah Health Workforce Information Center.
1073     (3) The information center shall:
1074  (a) under the guidance of the council, work with the Department of Commerce to collect
1075  data described in Section 58-1-112;
1076  (b) analyze data from any available source regarding Utah's health workforce including
1077  data collected by the Department of Commerce under Section 58-1-112;
1078  (c) send a report to the council regarding any analysis of health workforce data;
1079  (d) conduct research on Utah's health workforce as directed by the council;
1080  (e) notwithstanding the provisions of Subsection 35A-4-312(3), receive information
1081  obtained by the Department of Workforce Services under the provisions of Section
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 03-04 16:57  1st Sub. (Green) S.B. 300
1082  35A-4-312 for purposes consistent with the information center's duties, including
1083  identifying changes in Utah's health workforce numbers, types, and geographic
1084  distribution;
1085  (f) subject to data sharing limitations the program creates that are the same or
1086  substantially similar to limitations described in Section 26B-8-406, share data with
1087  any appropriate person as determined by the information center; and
1088  (g) conduct research and provide analysis for any state agency as approved by the [
1089  executive director or the executive director's designee] commission.
1090     (4) Notwithstanding any other provision of state law, the information center is authorized to
1091  obtain data from any state agency if:
1092  (a) the council and the information center deem receiving the data necessary to perform
1093  a duty listed under Subsection (3) or [26B-1-425(7)] 26C-2-105(7); and
1094  (b) the information center's access to the data will not:
1095  (i) violate any federal statute or federal regulation; or
1096  (ii) violate a condition a state agency must follow:
1097  (A) to participate in a federal program; or
1098  (B) to receive federal funds.
1099  Section 17. Section 26C-2-107, which is renumbered from Section 26B-4-706 is renumbered
1100     and amended to read:
1101  [26B-4-706] 26C-2-107 (Effective 07/01/27). Utah Medical Education Council.
1102     (1)(a) There is created the Utah Medical Education Council, which is a subcommittee of
1103  the Utah Health Workforce Advisory Council.
1104  (b) The membership of UMEC shall consist of the following appointed by the governor:
1105  (i) the dean of the school of medicine at the University of Utah;
1106  (ii) an individual who represents graduate medical education at the University of
1107  Utah;
1108  (iii) an individual from each institution, other than the University of Utah, that
1109  sponsors an accredited clinical education program; and
1110  [(iv) an individual from the health care insurance industry; and]
1111  [(v)] (iv)(A) three members of the general public who are not employed by or
1112  affiliated with any institution that offers, sponsors, or finances health care or
1113  medical education; and
1114  (B) if the number of individuals appointed under Subsection (1)(b)(iii) is more
1115  than two, the governor may appoint an additional member of the public under
                                                 - 33 -
 1st Sub. (Green) S.B. 300  03-04 16:57
1116  this Subsection [(1)(b)(v)] (1)(b)(iv) for each individual the governor appoints
1117  under Subsection (1)(b)(iii) beyond two.
1118     (2) Except as provided in Subsections (1)(b)(i) and (ii), no two UMEC members may be
1119  employed by or affiliated with the same:
1120  (a) institution of higher education;
1121  (b) state agency outside of higher education; or
1122  (c) private entity.
1123     (3) The dean of the school of medicine at the University of Utah:
1124  (a) shall chair UMEC;
1125  (b) may not be counted in determining the existence of a quorum; and
1126  (c) may only cast a vote on a matter before the council if the vote of the other council
1127  members results in a tied vote.
1128     (4) UMEC shall annually elect a vice chair from UMEC's members.
1129     (5)(a) [Consistent with Subsection (6)(b), a ] A majority of the members constitute a
1130  quorum.
1131  (b) The action of a majority of a quorum is the action of UMEC.
1132     (6)(a) Except as provided in Subsection (6)(b), members are appointed to four-year
1133  terms of office.
1134  (b) Notwithstanding Subsection (6)(a), the governor shall, at the time of the initial
1135  appointment, adjust the length of terms to ensure that the terms of UMEC members
1136  are staggered so that approximately half of the members are appointed every two
1137  years.
1138  (c) If a vacancy occurs in the membership for any reason, the replacement shall be
1139  appointed by the governor for the unexpired term in the same manner as the original
1140  appointment was made.
1141     (7) A member may not receive compensation or benefits for the member's service, but may
1142  receive per diem and travel expenses in accordance with:
1143  (a) Section 63A-3-106;
1144  (b) Section 63A-3-107; and
1145  (c) rules made by the Division of Finance pursuant to Sections 63A-3-106 and
1146  63A-3-107.
1147     (8) The council shall provide staff for UMEC.
1148  Section 18. Section 26C-2-108, which is renumbered from Section 26B-4-707 is renumbered
1149     and amended to read:
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 03-04 16:57  1st Sub. (Green) S.B. 300
1150  [26B-4-707] 26C-2-108 (Effective 07/01/27). Medical education program.
1151     (1) There is created a [Medical Education Program] medical education program to be
1152  administered by UMEC in cooperation with the Division of Finance.
1153     (2) The [program] medical education program shall be funded from money received for
1154  graduate medical education from:
1155  (a) the federal Centers for Medicare and Medicaid Services or other federal agency;
1156  (b) state appropriations; and
1157  (c) donation or private contributions.
1158     (3) All funding for this [program] medical education program shall be nonlapsing.
1159     (4) [Program ] Medical education program money may only be expended if:
1160  (a) approved by UMEC; and
1161  (b) used for graduate medical education in accordance with [Subsection 26B-4-708(4)]
1162  Section 26C-2-109.
1163  Section 19. Section 26C-2-109, which is renumbered from Section 26B-4-708 is renumbered
1164     and amended to read:
1165  [26B-4-708] 26C-2-109 (Effective 07/01/27). Duties of UMEC.
1166        UMEC shall:
1167     (1) seek private and public contributions for the [program] medical education program;
1168     (2) determine the method for reimbursing institutions that sponsor health care professionals
1169  in training;
1170     (3) determine the number and type of positions for health care professionals in training for
1171  which [program] medical education program money may be used;
1172     (4) distribute [program] medical education program money for graduate medical education
1173  in a manner that:
1174  (a) prepares postgraduate medical residents, as defined by the accreditation council on
1175  graduate medical education, for inpatient, outpatient, hospital, community, and
1176  geographically diverse settings;
1177  (b) encourages the coordination of interdisciplinary clinical training among health care
1178  professionals in training;
1179  (c) promotes stable funding for the clinical training of health care professionals in
1180  training; and
1181  (d) only funds accredited clinical training programs; and
1182     (5) advise on the implementation of the program.
1183  Section 20. Section 26C-2-110, which is renumbered from Section 26B-4-709 is renumbered
                                                - 35 -
 1st Sub. (Green) S.B. 300  03-04 16:57
1184     and amended to read:
1185  [26B-4-709] 26C-2-110 (Effective 07/01/27). Powers of UMEC.
1186        The UMEC may:
1187     (1) appoint advisory committees of broad representation on interdisciplinary clinical
1188  education, workforce mix planning and projections, funding mechanisms, and other
1189  topics as is necessary;
1190     (2) use federal money for necessary administrative expenses to carry out UMEC's duties
1191  and powers as permitted by federal law;
1192     (3) distribute program money in accordance with Subsection [26B-4-708(4)] 26C-2-109(4);
1193  and
1194     (4) as is necessary to carry out UMEC's duties under Section [26B-4-708] 26C-2-109, adopt
1195  rules in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act.
1196  Section 21. Section 26C-2-111, which is renumbered from Section 26B-4-711 is renumbered
1197     and amended to read:
1198  [26B-4-711] 26C-2-111 (Effective 07/01/27). Residency grant program.
1199     (1) As used in this section:
1200  (a) "D.O. program" means an osteopathic medical program that prepares a graduate to
1201  obtain licensure as a doctor of osteopathic medicine upon completing a state's
1202  licensing requirements.
1203  (b) "M.D. program" means a medical education program that prepares a graduate to
1204  obtain licensure as a doctor of medicine upon completing a state's licensing
1205  requirements.
1206  (c) "Residency program" means a program that provides training for graduates of a D.O.
1207  program or an M.D. program.
1208     (2) UMEC shall develop a grant program where a sponsoring institution in Utah may apply
1209  for a grant to establish a new residency program or expand a current residency program.
1210     (3) An applicant for a grant shall:
1211  (a) provide the proposed specialty area for each grant funded residency position;
1212  (b) identify where the grant funded residency position will provide care;
1213  (c)(i) provide proof that the residency program is accredited by the Accreditation
1214  Council for Graduate Medical Education; or
1215  (ii) identify what actions need to occur for the proposed residency program to
1216  become accredited by the Accreditation Council for Graduate Medical Education;
1217  (d) identify how a grant funded residency position will be funded once the residency
                                                 - 36 -
 03-04 16:57  1st Sub. (Green) S.B. 300
1218  program exhausts the grant money;
1219  (e) agree to implement selection processes for a residency position that treat applicants
1220  from D.O. programs and applicants from M.D. programs equally;
1221  (f) agree to provide information identified by UMEC that relates to post-residency
1222  employment outcomes for individuals who work in grant funded residency positions;
1223  and
1224  (g) provide any other information related to the grant application UMEC deems
1225  necessary.
1226     (4) UMEC shall prioritize awarding grants to new or existing residency programs that will:
1227  (a) address a workforce shortage, occurring in Utah, for a specialty; or
1228  (b) serve an underserved population, including a rural population.
1229     (5)(a) An applicant that receives a grant under this section may apply, every two years,
1230  to renew the grant for two years.
1231  (b) An applicant to renew a grant under Subsection (5)(a) shall provide a statement that:
1232  (i) the applicant applied for federal funding and was not awarded federal funding in
1233  an amount that fully funds each grant funded residency position; or
1234  (ii) the funding the applicant described in Subsection (3)(d) is unavailable to the
1235  applicant.
1236     (6) Each November 1 until November 2026 and then every three years thereafter, the
1237  Health Workforce Advisory Council, in consultation with UMEC, shall provide a
1238  written report to the Higher Education Appropriations Subcommittee and the Social
1239  Services Appropriations Subcommittee describing:
1240  (a) which sponsoring institutions received a grant;
1241  (b) the number of residency positions created; and
1242  (c) for each residency position created:
1243  (i) the type of specialty;
1244  (ii) where the residency position provides care; and
1245  (iii) an estimated date of when a grant funded residency position will no longer need
1246  grant funding.
1247  Section 22. Section 26C-2-112, which is renumbered from Section 26B-4-712 is renumbered
1248     and amended to read:
1249  [26B-4-712] 26C-2-112 (Effective 07/01/27). Forensic psychiatrist fellowship
1250     grant.
1251     (1) As used in this section, "forensic psychiatry" means the provision of services by an
                                                  - 37 -
 1st Sub. (Green) S.B. 300  03-04 16:57
1252  individual who:
1253  (a) is a licensed physician;
1254  (b) is board certified or board eligible for a psychiatry specialization recognized by the
1255  American Board of Medical Specialists or the American Osteopathic Association's
1256  Bureau of Osteopathic Specialists; and
1257  (c) uses scientific and clinical expertise in legal contexts involving the mental health of
1258  individuals.
1259     (2) UMEC shall establish a grant program that will facilitate the creation of a single
1260  forensic psychiatrist fellowship program.
1261     (3) An applicant for the grant shall:
1262  (a) demonstrate how the applicant is best suited for developing a forensic psychiatry
1263  fellowship program, including:
1264  (i) a description of resources that would be available to the program; and
1265  (ii) any resources or staff that need to be acquired for the program;
1266  (b) identify what needs to occur for the proposed residency program to become
1267  accredited by the Accreditation Council for Graduate Medical Education;
1268  (c) provide an estimate of how many individuals would be trained in the program at any
1269  one time;
1270  (d) provide any information related to the grant application UMEC deems necessary for
1271  awarding the grant; and
1272  (e) if awarded the grant, agree to:
1273  (i) enter into a contract with the Department of Corrections that the applicant will
1274  provide for the provision of forensic psychiatry services to an individual:
1275  (A) who needs psychiatric services; and
1276  (B) is under the Department of Corrections' jurisdiction; and
1277  (ii) ensure that any individual hired to provide forensic psychiatry services will
1278  comply with all relevant:
1279  (A) national licensing requirements; and
1280  (B) state licensing requirements under Title 58, Occupations and Professions.
1281  Section 23. Section 26C-3-101 is enacted to read:
1282  CHAPTER 3. Utah Cares Health Financing Program
1283  26C-3-101 (Effective 07/01/27). Program -- Executive director -- Duties.
1284     (1) The commission shall appoint an executive director who shall be the executive and
1285  administrative head of the program.
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 03-04 16:57  1st Sub. (Green) S.B. 300
1286     (2) The executive director:
1287  (a) may hire and remove employees and consultants as necessary to accomplish the
1288  duties described in this chapter and to assist with the commission's duties;
1289  (b) shall establish an enrollment system that will ensure that all eligible Utah residents
1290  are formally enrolled;
1291  (c) shall ensure the program carries out duties assigned to the program under this title;
1292  and
1293  (d) may utilize and shall coordinate with the offices, staff, and resources of any agencies
1294  of the executive branch.
1295     (3) The program shall:
1296  (a) act as a self-insurer of enrollee benefit plans and administer those plans;
1297  (b) indemnify benefit plans or purchase commercial reinsurance as considered
1298  appropriate by the program;
1299  (c) process claims by making prompt payments to health care providers and health care
1300  facilities for covered services;
1301  (d) invest trust fund assets consistent with state law;
1302  (e) establish and maintain a formulary of covered prescription drugs and negotiate prices
1303  with pharmaceutical companies;
1304  (f) obtain an annual actuarial review of all health and dental benefit plans and a periodic
1305  review of the program;
1306  (g) annually submit a budget and audited financial statements to the governor and
1307  Legislature that includes total projected benefit costs and administrative costs;
1308  (h) submit the program's recommended benefit and rate adjustments to:
1309  (i) the Legislature;
1310  (ii) the commission; and
1311  (iii) the director of the state Division of Human Resource Management;
1312  (i) administer benefits and rates upon ratification of the commission;
1313  (j)(i) require enrollees to participate in the electronic exchange of clinical health
1314  records in accordance with Section 26B-8-411 unless the enrollee opts out of
1315  participation; and
1316  (ii) before enrollment, each time the enrollee logs onto the program's website, and
1317  each time the enrollee receives written enrollment information from the program,
1318  provide notice to the enrollee of the enrollee's participation in the electronic
1319  exchange of clinical health records and the option to opt out of participation at any
                                                   - 39 -
 1st Sub. (Green) S.B. 300  03-04 16:57
1320  time;
1321  (k) develop an information management system that is compatible with medical and
1322  dental facilities and offices in the state;
1323  (l) develop a system to monitor the quality of care;
1324  (m) develop utilization management strategies;
1325  (n) be the state's primary entity for applying for and negotiating waivers described in 42
1326  U.S.C. Sec. 18052;
1327  (o) negotiate with the federal government to provide coverage for veterans, Native
1328  Americans, federal employees, and the military; and
1329  (p) take additional actions necessary or appropriate to carry out the purposes of this
1330  chapter.
1331     (4) The program may establish a partnership with a public entity in a different state to
1332  purchase or share services related to the administration of medical benefits if:
1333  (a) the program receives approval for the partnership from the commission; and
1334  (b) the partnership:
1335  (i) creates cost savings for Utah;
1336  (ii) does not commingle state funds with funds of the public entity in the other state;
1337  and
1338  (iii) does not pose a greater actuarial risk to Utah than the program has already
1339  assumed.
1340     (5) Before January 1, 2031, the program shall provide a report to the Legislature regarding
1341  the coordination and incorporation of benefits for medically necessary care between the
1342  program and the following:
1343  (a) workers' compensation;
1344  (b) automotive insurance carriers; and
1345  (c) other entities that provide indemnity insurance that involves medical care.
1346  Section 24. Section 26C-3-102 is enacted to read:
1347  26C-3-102 (Effective 01/01/28). Eligibility.
1348     (1) An individual is eligible to enroll in the program if the individual is:
1349  (a) a United States citizen;
1350  (b) lives in Utah as evidenced by an intent to continue to live in Utah and to return to
1351  Utah if temporarily absent, coupled with an act or acts consistent with that intent; and
1352  (c) not enrolled in Medicaid or Medicare.
1353     (2) Beginning January 1, 2028, the program shall enroll:
                                                   - 40 -
 03-04 16:57  1st Sub. (Green) S.B. 300
1354  (a) employees of:
1355  (i) the state;
1356  (ii) counties and municipalities;
1357  (iii) public school districts;
1358  (iv) charter schools; and
1359  (v) state institutions of higher education; and
1360  (b) individuals described in Section 53-2d-703.
1361     (3) Beginning January 1, 2028, and ending on January 1, 2030, entities described in
1362  Subsection (2)(a) shall transfer money to the fund equal to the annual amount the entity
1363  expended to provide employee health insurance as of January 1, 2026.
1364     (4) Beginning January 1, 2029, the program shall begin enrolling any eligible individual.
1365     (5) Beginning January 1, 2029, a nonprofit entity may choose to merge the nonprofit
1366  entity's health benefit plan with the program if the nonprofit entity transfers funds equal
1367  to the annual amount of funds the nonprofit entity expended to provide employee health
1368  care:
1369  (a) based on the immediate year before the transfer; and
1370  (b) for at least two years thereafter.
1371  Section 25. Section 26C-4-101 is enacted to read:
1372  CHAPTER 4. Rates and Payments
1373  26C-4-101 (Effective 01/01/28). Payments for non-enrollee health care --
1374     Out-of-state care -- Secondary coverage.
1375     (1) Beginning November 1, 2029, for health care services provided to a non-enrollee, the
1376  program will bill the individual and reimburse the health care provider at a reasonable
1377  rate.
1378     (2)(a) Payment for emergency care of an enrollee obtained out-of-state shall be paid at
1379  prevailing local rates of where the care was obtained.
1380  (b) Payment for non-emergency care of an enrollee obtained out-of-state shall be
1381  according to rates and conditions established by the commission.
1382  (c)(i) The commission may require that an enrollee be transported back to Utah when
1383  prolonged treatment of an emergency condition is necessary if transportation is
1384  safe for the patient in light of the patient's medical condition.
1385  (ii) The program shall pay for transporting an individual described in Subsection
1386  (2)(c)(i).
1387     (3) If an enrollee has other health insurance coverage for a service that is covered by the
                                                 - 41 -
 1st Sub. (Green) S.B. 300  03-04 16:57
1388  program, the program shall act as the secondary insurer for insurance coverage purposes.
1389  Section 26. Section 26C-4-102 is enacted to read:
1390  26C-4-102 (Effective 01/01/28). Health care provider and facility rates and
1391     payments.
1392     (1) Beginning November 1, 2029, a health care facility may not bill an individual for
1393  services performed by the health care facility.
1394     (2) Except for operating and capital budget facilities, the program shall negotiate and set
1395  rates for health care providers and health care facilities participating in the program in an
1396  amount equal to or exceeding the Medicare fee amount plus 10% of the Medicare fee.
1397     (3)(a) The program shall negotiate with each operating and capital budget facility
1398  independently to set a specific operating and capital budget for each facility.
1399  (b) The program shall make payments to an operating and capital budget facility on a
1400  monthly basis.
1401  Section 27. Section 26C-5-101 is enacted to read:
1402  CHAPTER 5. Covered Health Benefits
1403  26C-5-101 (Effective 01/01/28). Health plan.
1404     (1) The program shall provide a health plan that:
1405  (a) complies with 42 U.S.C. Sec. 18022(b)(1);
1406  (b) unless otherwise provided in this title, contains no cost-sharing for all
1407  non-pharmaceutical services;
1408  (c) provides the lowest possible cost-sharing for pharmaceutical services; and
1409  (d) maintains a benefits offering that is equivalent to the offering provided to state
1410  employees as of January 1, 2026.
1411     (2) As soon as practicable, the program shall develop a Medicare advantage plan for
1412  eligible individuals.
1413  Section 28. Section 26C-5-102, which is renumbered from Section 49-20-416 is renumbered
1414     and amended to read:
1415  [49-20-416] 26C-5-102 (Effective 01/01/28). Screening, Brief Intervention, and
1416     Referral to Treatment program reimbursement.
1417     (1) As used in this section:
1418  (a) "Controlled substance prescriber" means a controlled substance prescriber, as that
1419  term is defined in Section 58-37-6.5, who:
1420  (i) has a record of having completed SBIRT training, in accordance with Subsection
1421  58-37-6.5(2), before providing the SBIRT services; and
                                                 - 42 -
 03-04 16:57  1st Sub. (Green) S.B. 300
1422  (ii) is a program enrolled controlled substance prescriber.
1423  (b) "SBIRT" means the same as that term is defined in Section 58-37-6.5.
1424     (2) The [health ]program [offered to the state employee risk pool under Section 49-20-202 ]
1425  shall reimburse a controlled substance prescriber who provides SBIRT services to [a
1426  covered individual] an enrollee who is 13 years [of age] old or older for the SBIRT
1427  services.
1428  Section 29. Section 26C-5-103, which is renumbered from Section 49-20-418 is renumbered
1429     and amended to read:
1430  [49-20-418] 26C-5-103 (Effective 01/01/28). Expanded infertility treatment
1431     benefit.
1432     (1) As used in this section:
1433  (a) "Assisted reproductive technology" means the same as the term is defined in 42
1434  U.S.C. Sec. 263a-7.
1435  (b) "Physician" means the same as the term is defined in Section 58-67-102.
1436  (c) "Qualified assisted reproductive technology cycle" means the use of covered assisted
1437  reproductive technology to transfer a single embryo for implantation.
1438  (d) "Qualified individual" means an individual[:]
1439  [(i) covered within the state risk pool; and]
1440  [(ii)] eligible for maternity benefits under the program.
1441     (2)(a) The program shall provide coverage for qualified assisted reproductive technology
1442  cycles.
1443  (b) The benefit is subject to the same cost sharing requirements as the qualified
1444  individual's plan.
1445     (3) A qualified individual shall receive the benefit described in Subsection (2) if:
1446  (a) the qualified individual is the patient who will use the assisted reproductive
1447  technology;
1448  (b)(i) the patient's physician verifies that the patient or the patient's spouse has a
1449  demonstrated condition recognized by a physician as a cause of infertility; or
1450  (ii) the patient attests that the patient is unable to conceive a pregnancy or carry a
1451  pregnancy to a live birth after a year or more of regular sexual relations without
1452  contraception;
1453  (c) the patient attests that the patient has been unable to attain a successful pregnancy
1454  through any less-costly, potentially effective infertility treatments for which coverage
1455  is available under the health benefit plan; and
                                                    - 43 -
 1st Sub. (Green) S.B. 300  03-04 16:57
1456  (d) the use of the assisted reproductive technology procedure complies with the
1457  program's clinical policies and is performed by a health care provider who contracts
1458  with or is otherwise approved by the program.
1459     (4)(a) The provision of a benefit in accordance with this section shall satisfy, in
1460  accordance with Subsection 31A-22-610.1(1)(c)(ii), the requirement to provide an
1461  adoption indemnity benefit to a qualified individual under Section 31A-22-610.1.
1462  (b) If a qualified individual has received the adoption indemnity benefit required under
1463  Section 31A-22-610.1, the qualified individual may not receive a benefit in
1464  accordance with this section.
1465  Section 30. Section 26C-5-104, which is renumbered from Section 49-20-419 is renumbered
1466     and amended to read:
1467  [49-20-419] 26C-5-104 (Effective 01/01/28). Coverage of exome sequence testing.
1468     (1) As used in this section, "exome sequence testing" means a genomic technique for
1469  sequencing the genome of an individual for diagnostic purposes.
1470     (2) [Beginning July 1, 2019, the ] The program shall provide coverage for exome sequence
1471  testing:
1472  (a) for [a covered individual within the state risk pool] an enrollee who:
1473  (i) is younger than 21 years [of age] old; and
1474  (ii) who remains undiagnosed after exhausting all other appropriate diagnostic-related
1475  tests;
1476  (b) performed by a nationally recognized provider with significant experience in exome
1477  sequence testing;
1478  (c) that is medically necessary; and
1479  (d) at a rate set by the program.
1480  Section 31. Section 26C-5-105, which is renumbered from Section 49-20-420 is renumbered
1481     and amended to read:
1482  [49-20-420] 26C-5-105 (Effective 01/01/28) (Partially Repealed 01/01/30).
1483     Coverage for in vitro fertilization and genetic testing.
1484     (1) As used in this section:
1485  (a) "Qualified condition" means:
1486  (i) cystic fibrosis;
1487  (ii) spinal muscular atrophy;
1488  (iii) Morquio Syndrome;
1489  (iv) myotonic dystrophy; or
                                                 - 44 -
 03-04 16:57  1st Sub. (Green) S.B. 300
1490  (v) sickle cell anemia.
1491  (b) "Qualified individual" means [a covered individual ] an enrollee who:
1492  (i) has been diagnosed by a physician as having a genetic trait associated with a
1493  qualified condition; and
1494  (ii) intends to get pregnant with a partner who is diagnosed by a physician as having
1495  a genetic trait associated with the same qualified condition as the [covered
1496  individual] enrollee.
1497     (2) [For a plan year that begins on or after July 1, 2020, the ] The program shall provide
1498  coverage for a qualified individual for:
1499  (a) in vitro fertilization services; and
1500  (b) genetic testing of a qualified individual who receives in vitro fertilization services
1501  under Subsection (2)(a).
1502     (3) Before November 1, 2022, and before November 1 of every third year thereafter, the
1503  program shall:
1504  (a) calculate the change in state spending attributable to the coverage under this section;
1505  and
1506  (b) report the amount described in Subsection (3)(a) to the Health and Human Services
1507  Interim Committee and the Social Services Appropriations Subcommittee.
1508  Section 32. Section 26C-5-106, which is renumbered from Section 49-20-422 is renumbered
1509     and amended to read:
1510  [49-20-422] 26C-5-106 (Effective 01/01/28) (Repealed 07/01/27). Coverage of
1511     pregnancy and childbirth services, including doula, direct-entry midwife, and birthing
1512     center services.
1513     (1) As used in this section:
1514  (a) "Doula" means an individual who:
1515  (i) provides information and physical and emotional support:
1516  (A) to a pregnant or postpartum individual; and
1517  (B) related to the pregnant or postpartum individual's pregnancy; and
1518  (ii) is certified by one or more organizations approved by the program.
1519  (b) "Pregnancy and childbirth services" means services provided to a pregnant individual
1520  before, during, or shortly after childbirth:
1521  (i) by a doula for the services described in Subsections (1)(a)(i) and (ii); and
1522  (ii) at a birthing center that:
1523  (A) is licensed under Title 26B, Chapter 2, Licensing and Certifications, or
                                                  - 45 -
 1st Sub. (Green) S.B. 300  03-04 16:57
1524  accredited by the Commission for the Accreditation of Birth Centers; and
1525  (B) may include services by a direct-entry midwife licensed under Title 58,
1526  Chapter 77, Direct-Entry Midwife Act, if the direct-entry midwife is engaged
1527  in the practice of direct-entry midwifery, as defined in Section 58-77-102.
1528  (c) "Qualified individual" means [a covered individual] an enrollee who[ is]:
1529  [(i) within the state employees' risk pool; and]
1530  [(ii)(A)] (i) is pregnant; or
1531  [(B)] (ii) was pregnant within the past six months.
1532     (2) For a plan year that begins on or after July 1, 2023, and before July 1, 2026, the
1533  program shall cover pregnancy and childbirth services to a qualified individual.
1534     (3) The program may establish limits for coverage under Subsection (2), including limits
1535  based on:
1536  (a) the type or number of services provided;
1537  (b) a qualified individual's physical or emotional condition; and
1538  (c) conditions for provider participation.
1539     (4) The program shall report to the Health and Human Services Interim Committee on or
1540  before October 1 of each year regarding coverage provided under Subsection (2),
1541  including:
1542  (a) covered providers;
1543  (b) covered services;
1544  (c) provider payment rates;
1545  (d) covered-individual cost sharing;
1546  (e) total provider payments and covered-individual cost sharing; and
1547  (f) any indicators of whether pregnancy and childbirth services covered under
1548  Subsection (2) have:
1549  (i) reduced pregnancy or postpartum coverage costs; or
1550  (ii) improved pregnancy or postpartum care.
1551  Section 33. Section 26C-6-101 is enacted to read:
1552  CHAPTER 6. Medicaid Division
1553  26C-6-101 (Effective 01/01/28). Reserved.
1554        Reserved.
1555  Section 34. Section 26C-6-102 is enacted to read:
1556  26C-6-102 (Effective 01/01/28). Medicaid Division.
1557     (1) There is created within the program the Medicaid Division.
                                                - 46 -
 03-04 16:57  1st Sub. (Green) S.B. 300
1558     (2) The state Medicaid director shall be the head of the division and report to the executive
1559  director of the program.
1560     (3) The Medicaid Division shall administer the Medicaid program described in Title 26B,
1561  Health and Human Services Code.
1562     (4) This section does not take affect until necessary waivers and state plan amendments are
1563  approved under Section 26B-3-104.1.
1564  Section 35. Section 26C-7-101, which is renumbered from Section 49-20-406 is renumbered
1565     and amended to read:
1566  CHAPTER 7. Employee Benefits
1567  [49-20-406] 26C-7-101 (Effective 01/01/28). Insurance benefits for employees'
1568     beneficiaries.
1569     (1) As used in this section:
1570  (a) "Children" includes stepchildren and legally adopted children.
1571  (b) "Covered individual" means an employee of the state.
1572  [(b)] (c)(i) "Line-of-duty death" means a death resulting from:
1573  (A) external force or violence occasioned by an act of duty as an employee; or
1574  (B) strenuous activity, including a heart attack or stroke, that occurs during
1575  strenuous training or another strenuous activity required as an act of duty as an
1576  employee.
1577  (ii) "Line-of-duty death" does not include a death that:
1578  (A) occurs during an activity that is required as an act of duty as an employee if
1579  the activity is not a strenuous activity, including an activity that is clerical,
1580  administrative, or of a nonmanual nature contributes to the employee's death;
1581  (B) occurs during the commission of a crime committed by the employee;
1582  (C) the employee's intoxication or use of alcohol or drugs, whether prescribed or
1583  nonprescribed, contributes to the employee's death; or
1584  (D) occurs in a manner other than as described in Subsection [(1)(b)(i)] (1)(c)(i).
1585  [(c)] (d)(i) "Strenuous activity" means engagement involving a difficult, stressful, or
1586  vigorous fire suppression, rescue, hazardous material response, emergency
1587  medical service, physical law enforcement, prison security, disaster relief, or other
1588  emergency response activity.
1589  (ii) "Strenuous activity" includes participating in a participating employer sanctioned
1590  and funded training exercise that involves difficult, stressful, or vigorous physical
1591  activity.
                                                  - 47 -
 1st Sub. (Green) S.B. 300  03-04 16:57
1592     (2) The beneficiary of a covered individual [who is employed by the state ]and who has a
1593  line-of-duty death shall receive[:]
1594  [(a)] the proceeds of a $50,000 group term life insurance policy paid for by the state and
1595  administered and provided as part of the group life insurance program under this
1596  chapter[; and] .
1597  [(b) group health, dental, and vision coverage paid for by the state that covers the
1598  covered individual's:]
1599  [(i) surviving spouse until becoming eligible for Medicare as long as the surviving
1600  spouse continues coverage with the program; and]
1601  [(ii) unmarried children up to the age of 26.]
1602     (3) A covered employer not required to provide the benefits under Subsection (2) may
1603  provide any of the benefits described in Subsection (2) by paying rates established by
1604  the program.
1605     (4) The benefit provided under Subsection [(2)(a)] (2) is subject to the same terms and
1606  conditions as the group life insurance program provided under this chapter.
1607  Section 36. Section 31A-22-605.5 is amended to read:
1608  31A-22-605.5 (Effective 01/01/28). Application.
1609     (1) For purposes of this section "insurance mandate":
1610  (a) means a mandatory obligation with respect to coverage, benefits, or the number or
1611  types of providers imposed on policies of accident and health insurance; and
1612  (b) does not mean:
1613  (i) an administrative rule imposing a mandatory obligation with respect to coverage,
1614  benefits, or providers unless that mandatory obligation was specifically imposed
1615  on policies of accident and health insurance by statute; or
1616  (ii) an insurance mandate in an essential health benefits package imposed pursuant to
1617  the Patient Protection and Affordable Care Act, Pub. L. No. 111-148, and the
1618  Health Care Education Reconciliation Act of 2010, Pub. L. No. 111-152, and
1619  federal rules related to their implementation.
1620     (2)(a) Notwithstanding the provisions of Subsection 31A-1-103(3)(f), the following shall
1621  apply to health coverage offered [to the state employees' risk pool under Subsection
1622  49-20-202(1)(a)] through the program described in Section 26C-3-101:
1623  (i) any law enacted under this title that becomes effective after January 1, 2002,
1624  which provides for an insurance mandate for policies of accident and health
1625  insurance; and
                                                - 48 -
 03-04 16:57  1st Sub. (Green) S.B. 300
1626  (ii) in accordance with Section 31A-22-613.5, disclosure requirements for coverage
1627  limitations.
1628  (b) Notwithstanding the provisions of Subsection 31A-1-103(3)(f), a health insurance
1629  mandate enacted under this title after January 1, 2012, shall apply to[:] the program
1630  described in Section 26C-3-101.
1631  [(i) health coverage offered to the state employees' risk pool under Subsection
1632  49-20-202(1)(a); and]
1633  [(ii) health coverage offered to public school districts, charter schools, and
1634  institutions of higher education under Subsection 49-20-201(1)(b).]
1635     [(c)] (3) [If health coverage offered to the state employees' risk pool under Subsections
1636  49-20-201(1)(b) and 49-20-202(1)(a) offers coverage in the same manner and to the
1637  same extent as the coverage required by an insurance mandate enacted under this title or
1638  coverage that is greater than the insurance mandate enacted under this title, the coverage
1639  offered to state employees under Subsections 49-20-201(1)(b) and 49-20-202(1)(a) will
1640  be considered in compliance with the insurance mandate.] Beginning January 1, 2028, a
1641  political subdivision, a public school district, a charter school, and a state funded
1642  institution of higher education may provide a health benefit plan exclusively through the
1643  program described in Section 26C-3-101.
1644  [(d) The programs regulated under Subsections 49-20-201(1)(b) and 49-20-202(1)(a)
1645  shall report to the Retirement and Independent Entities Committee created under
1646  Section 63E-1-201 by November 30 of each year in which a mandate is enacted
1647  under the provisions of this section. The report shall include the costs and benefits of
1648  the particular mandatory obligation.]
1649     [(3)(a) An insurance mandate for policies of accident and health insurance enacted
1650  under this title after January 1, 2012, shall apply to a health plan offered by a public
1651  school district, a charter school, or a state funded institution of higher education that
1652  is not insured through the Public Employees' Benefit and Insurance Program.]
1653  [(b) If an insurance mandate for policies of accident and health insurance is enacted
1654  under this title after January 1, 2012, the state shall determine whether each entity
1655  described in Subsections (2) and (3)(a) offers coverage in the same manner and to the
1656  same extent, or greater than the insurance coverage required in the mandate enacted
1657  after January 1, 2012.]
1658  [(c) Before enacting an insurance mandate, the state shall, for each entity that does not
1659  offer coverage in accordance with Subsection (3)(b):]
                                                 - 49 -
 1st Sub. (Green) S.B. 300  03-04 16:57
1660  [(i) determine the cost to the entity of implementing the insurance mandate; and]
1661  [(ii) appropriate money necessary to fund the full cost to the entity of implementing
1662  the insurance mandate.]
1663  Section 37. Section 31A-22-613.5 is amended to read:
1664  31A-22-613.5 (Effective 01/01/28). Price and value comparisons of health
1665     insurance.
1666     (1)(a) This section applies to all health benefit plans.
1667  (b) Subsection (2) applies to[:]
1668  [(i)] all health benefit plans[; and] .
1669  [(ii) coverage offered to state employees under Subsection 49-20-202(1)(a).]
1670     (2) The commissioner shall promote informed consumer behavior and responsible health
1671  benefit plans by requiring an insurer issuing a health benefit plan to provide to all
1672  enrollees, before enrollment in the health benefit plan, written disclosure of:
1673  (a) restrictions or limitations on prescription drugs and biologics, including:
1674  (i) the use of a formulary;
1675  (ii) co-payments and deductibles for prescription drugs; and
1676  (iii) requirements for generic substitution;
1677  (b) coverage limits under the plan;
1678  (c) any limitation or exclusion of coverage, including:
1679  (i) a limitation or exclusion for a secondary medical condition related to a limitation
1680  or exclusion from coverage; and
1681  (ii) easily understood examples of a limitation or exclusion of coverage for a
1682  secondary medical condition;
1683  (d)(i)(A) each drug, device, and covered service that is subject to a
1684  preauthorization requirement as defined in Section 31A-22-650; or
1685  (B) if listing each device or covered service in accordance with Subsection
1686  (2)(d)(i)(A) is too numerous to list separately, all devices or covered services in
1687  a particular category where all devices or covered services have the same
1688  preauthorization requirement;
1689  (ii) each requirement for authorization as defined in Section 31A-22-650 for:
1690  (A) each drug, device, or covered service described in Subsection (2)(d)(i)(A); and
1691  (B) each category of devices or covered services described in Subsection
1692  (2)(d)(i)(B); and
1693  (iii) sufficient information to allow a network provider or enrollee to submit all of the
                                                  - 50 -
 03-04 16:57  1st Sub. (Green) S.B. 300
1694  information to the insurer necessary to meet each requirement for authorization
1695  described in Subsection (2)(d)(ii);
1696  (e) whether the insurer permits an exchange of the adoption indemnity benefit in Section
1697  31A-22-610.1 for infertility treatments, in accordance with Subsection
1698  31A-22-610.1(1)(c)(ii) and the terms associated with the exchange of benefits; and
1699  (f) whether the insurer provides coverage for telehealth services in accordance with
1700  Section 26B-3-123 and terms associated with that coverage.
1701     (3) An insurer shall provide the disclosure required by Subsection (2) in writing to the
1702  commissioner:
1703  (a) upon commencement of operations in the state; and
1704  (b) anytime the insurer amends any of the following described in Subsection (2):
1705  (i) treatment policies;
1706  (ii) practice standards;
1707  (iii) restrictions;
1708  (iv) coverage limits of the insurer's health benefit plan or health insurance policy; or
1709  (v) limitations or exclusions of coverage including a limitation or exclusion for a
1710  secondary medical condition related to a limitation or exclusion of the insurer's
1711  health insurance plan.
1712     (4)(a) An insurer shall provide the enrollee with notice of an increase in costs for
1713  prescription drug coverage due to a change in benefit design under Subsection (2)(a):
1714  (i) either:
1715  (A) in writing; or
1716  (B) on the insurer's website; and
1717  (ii) at least 30 days prior to the date of the implementation of the increase in cost, or
1718  as soon as reasonably possible.
1719  (b) If under Subsection (2)(a) a formulary is used, the insurer shall make available to
1720  prospective enrollees and maintain evidence of the fact of the disclosure of:
1721  (i) the drugs included;
1722  (ii) the patented drugs not included;
1723  (iii) any conditions that exist as a precedent to coverage; and
1724  (iv) any exclusion from coverage for secondary medical conditions that may result
1725  from the use of an excluded drug.
1726  (c) The commissioner shall develop examples of limitations or exclusions of a secondary
1727  medical condition that an insurer may use under Subsection (2)(c).
                                                   - 51 -
 1st Sub. (Green) S.B. 300  03-04 16:57
1728     (5) Examples of a limitation or exclusion of coverage provided under this section or
1729  otherwise are for illustrative purposes only, and the failure of a particular fact situation
1730  to fall within the description of an example does not, by itself, support a finding of
1731  coverage.
1732     (6) An insurer shall:
1733  (a) post the information described in Subsection (2)(d) on the insurer's website and
1734  provider portal;
1735  (b) if requested by an enrollee, provide the enrollee with the information required by this
1736  section by mail or email; and
1737  (c) if requested by a network provider for a specific drug, device, or covered service,
1738  provide the network provider with the information described in Subsection (2)(d) for
1739  the drug, device, or covered service by mail or email.
1740  Section 38. Section 31A-22-635 is amended to read:
1741  31A-22-635 (Effective 01/01/28). Uniform application -- Uniform waiver of
1742     coverage.
1743     (1) For purposes of this section, "insurer"[:] means the same as that term
1744  [(a)] is defined in Subsection 31A-22-634(1)[; and] .
1745  [(b) includes the state employee's risk pool under Section 49-20-202.]
1746     (2)(a) Insurers offering a health benefit plan to an individual or small employer shall use
1747  a uniform application form.
1748  (b) The uniform application form:
1749  (i) may not include questions about an applicant's health history; and
1750  (ii) shall be shortened and simplified in accordance with rules adopted by the
1751  commissioner.
1752  (c) Insurers offering a health benefit plan to a small employer shall use a uniform waiver
1753  of coverage form, which may not include health status related questions, and is
1754  limited to:
1755  (i) information that identifies the employee;
1756  (ii) proof of the employee's insurance coverage; and
1757  (iii) a statement that the employee declines coverage with a particular employer
1758  group.
1759     (3) Notwithstanding the requirements of Subsection (2)(a), the uniform application and
1760  uniform waiver of coverage forms may, if the combination or modification is approved
1761  by the commissioner, be combined or modified to facilitate a more efficient and
                                                  - 52 -
 03-04 16:57  1st Sub. (Green) S.B. 300
1762  consumer friendly experience for insurers using electronic applications.
1763     (4)(a) The uniform application form, and uniform waiver form, shall be adopted and
1764  approved by the commissioner in accordance with Title 63G, Chapter 3, Utah
1765  Administrative Rulemaking Act.
1766  (b) The commissioner shall regulate the fees charged by insurers to an enrollee for a
1767  uniform application form or electronic submission of the application forms.
1768  Section 39. Section 31A-22-647 is amended to read:
1769  31A-22-647 (Effective 01/01/28). Insurer shared savings program.
1770     (1) As used in this section:
1771  (a) "Insurer" means a person who offers health care insurance, including a health
1772  maintenance organization as that term is defined in Section 31A-8-101.
1773  [(b) "PEHP" means the Public Employees' Benefit and Insurance Program created in
1774  Section 49-20-103.]
1775  [(c)] (b) "Savings reward program" means a program to reward a health insurance
1776  enrollee if the enrollee receives services:
1777  (i) covered by the enrollee's health plan; and
1778  (ii) from a provider whose costs for services are lower than the average costs for the
1779  services.
1780     (2) An insurer may, in accordance with Subsection [(4)] (3), establish a savings reward
1781  program for a health benefit plan that is:
1782  (a) offered by the insurer; and
1783  (b) entered into or renewed on or after January 1, 2019.
1784     [(3) PEHP shall, in accordance with Subsection (4), establish a savings reward program for
1785  a health plan that is:]
1786  [(a) offered to state employees under Title 49, Chapter 20, Public Employees' Benefit
1787  and Insurance Program Act; and]
1788  [(b) entered into or renewed on or after July 1, 2019.]
1789     [(4)] (3) A savings reward program described in Subsection (2)[ or (3)] may include, in
1790  accordance with federal and state law, rewards to the enrollee through:
1791  (a) premium discounts;
1792  (b) rebates;
1793  (c) reduction of out-of-pocket costs; or
1794  (d) other rewards or incentives developed by the insurer.
1795  Section 40. Section 31A-22-654 is amended to read:
                                                    - 53 -
 1st Sub. (Green) S.B. 300  03-04 16:57
1796  31A-22-654 (Effective 01/01/28). Study of coverage for in vitro fertilization and
1797     genetic testing -- Reporting -- Coverage requirements.
1798     (1) As used in this section:
1799  (a) "Qualified condition" means the same as that term is defined in Section [49-20-420]
1800  26C-5-105.
1801  (b) "Qualified insurer" means an insurer that provides a health benefit plan as defined in
1802  Section 31A-1-301 to more than 25,000 enrollees in the state as of December 31 of
1803  the preceding reporting year.
1804  (c) "Qualified enrollee" means an enrollee of a qualified insurer who:
1805  (i) has been diagnosed by a physician as having a genetic trait associated with a
1806  qualified condition; and
1807  (ii) intends to get pregnant with a partner who is diagnosed by a physician as having
1808  a genetic trait associated with the same qualified condition as the enrollee.
1809     (2)(a) A qualified insurer shall submit the information described in this Subsection (2) to
1810  the department for a plan year beginning:
1811  (i) on or after January 1, 2022, but before December 31, 2022; and
1812  (ii) on or after January 1, 2025, but before December 31, 2025.
1813  (b) A qualified insurer shall study whether providing the coverage for the services
1814  described in Subsections (3)(a) and (b) for qualified enrollees will result in cost
1815  savings for the qualified insurer.
1816  (c)(i) If a qualified insurer determines that providing the coverage described in
1817  Subsection (3) for qualified enrollees will result in cost savings for the qualified
1818  insurer, the qualified insurer shall submit a summary of the results of the study
1819  described in Subsection (2)(b), and:
1820  (A) describe how the qualified insurer intends to provide the coverage described
1821  in Subsection (3); or
1822  (B) submit an explanation of why the insurer will not provide the coverage
1823  described in Subsection (3).
1824  (ii) If a qualified insurer determines that providing the coverage described in
1825  Subsection (3) will not result in cost savings to the qualified insurer, the qualified
1826  insurer shall submit a summary of the results of the study described in Subsection
1827  (2)(b).
1828  (d) A qualified insurer shall provide the information required under this Subsection (2)
1829  to the department no later than:
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1830  (i) January 1, 2022, for a plan year beginning on or after January 1, 2022, but before
1831  December 31, 2022; and
1832  (ii) January 1, 2025, for a plan year beginning on or after January 1, 2025, but before
1833  December 31, 2025.
1834     (3) A qualified insurer shall consider coverage for:
1835  (a) in vitro fertilization services for a qualified enrollee; and
1836  (b) genetic testing of a qualified enrollee who received in vitro fertilization services
1837  under Subsection (3)(a).
1838     (4) The department shall report the information received under Subsection (2) to the Health
1839  and Human Services Interim Committee on or before:
1840  (a) for information submitted under Subsection (2)(a)(i), November 1, 2022; and
1841  (b) for information submitted under Subsection (2)(a)(ii), November 1, 2025.
1842  Section 41. Section 31A-22-663 is enacted to read:
1843  31A-22-663 (Effective 01/01/28). Premium prohibition.
1844     (1) As used in this section, "program" means the Utah Cares Health Financing Program
1845  created Title 26C, Utah Cares Act.
1846     (2) Notwithstanding any other provision of law, beginning January 1, 2029, a health benefit
1847  plan may not charge premiums for services covered by the program to an individual who
1848  is eligible to receive health benefit coverage through the program.
1849     (3) If an insurer offering a health benefit plan leaves the Utah market, the insurer shall
1850  forfeit any cash reserves held by the insurer to the department for the provision of health
1851  benefit coverage of individuals in the state.
1852     (4) The department shall deposit money obtained under this section into the fund described
1853  in Section 26C-1-103.
1854  Section 42. Section 31A-46-311 is amended to read:
1855  31A-46-311 (Effective 01/01/28). Prohibited actions with respect to the 340B
1856     drug discount program.
1857     (1) As used in this section, "manufacturer" means a pharmaceutical manufacturer, including
1858  an agent or affiliate of a pharmaceutical manufacturer.
1859     (2) A manufacturer may not:
1860  (a) directly or indirectly restrict or prohibit:
1861  (i) a pharmacy from contracting with a 340B entity, including by denying the
1862  pharmacy access to a drug that is manufactured by the manufacturer;
1863  (ii) a 340B entity from contracting with a pharmacy, including by denying the 340B
                                                   - 55 -
 1st Sub. (Green) S.B. 300  03-04 16:57
1864  entity access to a drug that is manufactured by the manufacturer;
1865  (iii) the acquisition, dispensing, or delivery of a 340B drug to any location authorized
1866  by a 340B entity to receive the drug, unless prohibited by federal law; or
1867  (iv) a 340B entity from receiving 340B drug discount program pricing for a 340B
1868  drug, including by imposing a time limitation on a 340B entity to replenish or
1869  submit a claim for a 340B drug;
1870  (b) directly or indirectly:
1871  (i) require a 340B entity to purchase a 340B drug from a supplier if the manufacturer
1872  would otherwise permit the 340B entity to purchase a drug that is not a 340B drug
1873  from the supplier; or
1874  (ii) require a 340B entity to submit any claim data, utilization data, or information
1875  about a 340B entity's contracts with a third-party as a condition for allowing the
1876  acquisition of a 340B drug by, or delivery of a 340B drug to, a 340B entity, unless
1877  the data or information sharing is required by federal law; or
1878  (c) interfere with:
1879  (i) a contract between a pharmacy and a 340B entity; or
1880  (ii) the ability of a pharmacy and a 340B entity to enter into a contract.
1881     [(3) The Public Employees' Benefit and Insurance Program created in Section 49-20-103
1882  may adjust the program's business practices to mitigate any financial impacts resulting
1883  from this section.]
1884     [(4)] (3) Nothing in this section is to be construed to conflict with federal law.
1885  Section 43. Section 49-21-105 is amended to read:
1886  49-21-105 (Effective 01/01/28). Purpose -- Flexibility -- Administration.
1887     (1) The purpose of this chapter is to provide long-term disability benefits for an eligible
1888  employee.
1889     (2) Subject to the provisions of Section 49-21-201, the program may include one or more
1890  long-term disability benefit plans that differ from the benefit plan specified by this
1891  chapter for [an eligible employee of a covered employer as defined under Section
1892  49-20-102] employers who provided health benefits through the Public Employees'
1893  Benefit and Insurance Program as of January 1, 2027.
1894     (3) The program shall be administered by the office, under policies and rules adopted by the
1895  board.
1896  Section 44. Section 53-2d-703 is amended to read:
1897  53-2d-703 (Effective 01/01/28). Volunteer Emergency Medical Service Personnel
                                                  - 56 -
 03-04 16:57  1st Sub. (Green) S.B. 300
1898     Insurance Program -- Creation -- Administration -- Eligibility -- Benefits -- Rulemaking
1899     -- Advisory board.
1900     (1) As used in this section:
1901  (a) "Basic life insurance benefit" means the standard group life insurance benefit offered
1902  by PEHP that combines basic life, line-of-duty, accidental death and disability, and
1903  dependent coverage into one benefit package.
1904  (b) "Basic long-term disability benefit" means a $1,000 monthly benefit arising from a
1905  disability determined in accordance with Title 49, Chapter 21, Public Employees'
1906  Long-Term Disability Act, and excluding any coverage offered on a pilot basis.
1907  (c) "Dental plan" means the same as that term is defined in Section 31A-22-646.
1908  (d) "Health benefit plan" means the same as that term is defined in Section 31A-1-301.
1909  (e) "Local government entity" means a political subdivision that:
1910  (i) is licensed as a ground ambulance provider under Part 5, Ambulance and
1911  Paramedic Providers or a quick response provider as designated under 53-2d-403;
1912  and
1913  (ii) does not offer health insurance benefits to volunteer emergency medical service
1914  personnel.
1915  (f) "PEHP" means the Public Employees' Benefit and Insurance Program created in
1916  Section 49-20-103.
1917  (g) "Political subdivision" means a county, a municipality, a limited purpose government
1918  entity described in Title 17B, Limited Purpose Local Government Entities - Special
1919  Districts, or Title 17D, Limited Purpose Local Government Entities - Other Entities,
1920  or an entity created by an interlocal agreement under Title 11, Chapter 13, Interlocal
1921  Cooperation Act.
1922  (h) "Qualifying association" means an association that represents two or more political
1923  subdivisions in the state.
1924  (i) "Qualifying community" means any of the following located in a county of the
1925  second class:
1926  (i) a city of the fifth class; or
1927  (ii) a town.
1928     (2) The Volunteer Emergency Medical Service Personnel Insurance Program shall promote
1929  recruitment and retention of volunteer emergency medical service personnel by making
1930  insurance available to volunteer emergency medical service personnel in accordance
1931  with this section.
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 1st Sub. (Green) S.B. 300  03-04 16:57
1932     (3)(a) The bureau shall contract with a qualifying association to create, implement, and
1933  administer the Volunteer Emergency Medical Service Personnel Insurance Program
1934  described in this section.
1935  (b) The qualifying association will create promotional campaigns for the Volunteer
1936  Emergency Medical Service Personnel Insurance Program and volunteer emergency
1937  medical service recruitment and retention including outreach to local government
1938  entities through social media, video production, and other media platforms.
1939     (4) Participation in the program is limited to any individual who:
1940  (a) is licensed under Section 53-2d-402 as an emergency medical technician, an
1941  advanced emergency medical technician, or a paramedic;
1942  (b) is able to perform all necessary functions associated with the license;
1943  (c) provides emergency medical services under the direction of a local governmental
1944  entity:
1945  (i) by responding to 20% of calls for emergency medical services in a rolling
1946  twelve-month period; and
1947  (ii) within a qualifying community or a county of the third, fourth, fifth, or sixth class
1948  by responding to the number of calls described in Subsection (4)(c)(i); and
1949  (iii)(A) as a volunteer under the Fair Labor Standards Act, in accordance with 29
1950  C.F.R. Sec. 553.106; or
1951  (B) as a part-time unbenefited employee, as classified by the employing local
1952  government entity;
1953  (d) if seeking health insurance:
1954  (i)(A) is not eligible for a health benefit plan through an employer or a spouse's
1955  employer; and
1956  (B) is not eligible for medical coverage under a government sponsored healthcare
1957  program; or
1958  (ii) the individual's premium cost for individual, double, or family coverage through
1959  another source exceeds 20% or greater of the premium cost of the program created
1960  by this section;
1961  (e) if seeking dental insurance:
1962  (i)(A) is not eligible for a dental plan through an employer or a spouse's employer;
1963  and
1964  (B) is not eligible for dental coverage under a government sponsored healthcare
1965  program; or
                                                 - 58 -
 03-04 16:57  1st Sub. (Green) S.B. 300
1966  (ii) the individual's premium cost for individual, double, or family coverage exceeds
1967  20% or greater of the premium cost of the program created by this section; and
1968  (f) resides in the state.
1969     (5)(a) A participant in the program is eligible to participate in PEHP in accordance with
1970  Subsection (5)(b) and Subsection 49-20-201(3).
1971  (b) Health and dental benefits available to program participants under PEHP are limited
1972  to health insurance and dental insurance that:
1973  (i) covers the program participant and the program participant's eligible dependents
1974  on a July 1 plan year;
1975  (ii) accepts enrollment during an open enrollment period or for a special enrollment
1976  event, including the initial eligibility of a program participant;
1977  (iii) if the program participant is no longer eligible for benefits, terminates on the last
1978  day of the last month for which the individual is a participant in the Volunteer
1979  Emergency Medical Service Personnel Insurance Program; and
1980  (iv) is not subject to continuation rights under state or federal law.
1981  (c) Within existing appropriations, the Volunteer Emergency Medical Service Personnel
1982  Insurance Program may offer basic life insurance and long-term disability insurance
1983  to participants to enhance recruitment and retention efforts.
1984     (6)(a) The bureau may make rules in accordance with Title 63G, Chapter 3, Utah
1985  Administrative Rulemaking Act, to define additional criteria regarding benefit
1986  design, eligibility for the program, and to implement this section.
1987  (b) The bureau shall convene an advisory board:
1988  (i) to advise the bureau on making rules under Subsection (6)(a); and
1989  (ii) that includes representation from at least the following entities:
1990  (A) the qualifying association that receives the contract under Subsection (3); and
1991  (B) PEHP.
1992     (7) For purposes of this section, the qualifying association that receives the contract under
1993  Subsection (3) shall be considered the public agency for whom the program participant
1994  is volunteering under 29 C.F.R. Sec. 553.101.
1995     (8) Notwithstanding any other provision of law, coverage provided under this section shall
1996  be provided under Title 26C, Utah Cares Act, beginning January 1, 2028.
1997  Section 45. Section 53-17-201 is amended to read:
1998  53-17-201 (Effective 01/01/28). Surviving spouse and children health, dental, and
1999     vision coverage for line-of-duty death.
                                                  - 59 -
 1st Sub. (Green) S.B. 300  03-04 16:57
2000     (1)(a) Subject to Subsection (1)(b), and in accordance with this section, an employer
2001  shall allow the surviving spouse and children of a member whose death is classified
2002  by the Utah State Retirement Office as a line-of-duty death under the provisions of
2003  Title 49, Utah State Retirement and Insurance Benefit Act, to remain eligible for the
2004  following coverage, if offered by the employer, as if the surviving spouse was an
2005  employee of the employer:
2006  (i) health coverage;
2007  (ii) dental coverage; and
2008  (iii) vision coverage.
2009  (b) Except as provided in Subsection (1)(d), the employer shall pay:
2010  (i) 100% of the premium costs for the coverage described in Subsection (1)(a); and
2011  (ii) if the health coverage is a high-deductible plan, the employer share of any
2012  contribution into a health savings account for the surviving spouse and dependent
2013  children as described under Subsections (1)(a) and (2).
2014  (c) The employer may not require the surviving spouse to pay for premium costs or
2015  health savings account contributions as a condition of qualifying to continue to
2016  receive the coverage described in Subsection (1)(a).
2017  (d) An employer may pay the amount specified under Subsection (1)(b) through a
2018  cost-sharing agreement under Section 53-17-301 associated with the trust fund
2019  created under Section 53-17-401.
2020     (2) An employer shall allow a surviving spouse and children to remain eligible to receive
2021  coverage from the employer under this section at the option of the surviving spouse:
2022  (a) for the surviving spouse, until the surviving spouse becomes eligible for Medicare;
2023  and
2024  (b) for a child, until the child reaches the age of 26.
2025     (3) This section does not apply to:
2026  (a) a member who does not qualify for a line-of-duty death benefit under Title 49, Utah
2027  State Retirement and Insurance Benefit Act;
2028  (b) coverage for which, at the time of death, the member did not receive or qualify to
2029  receive; or
2030  [(c) a member who is covered under Section 49-20-406.]
2031  (c) an individual eligible for coverage under Title 26C, Utah Cares Act.
2032  Section 46. Section 58-1-112 is amended to read:
2033  58-1-112 (Effective 01/01/28). Data collection.
                                                  - 60 -
 03-04 16:57  1st Sub. (Green) S.B. 300
2034     (1) As used in this section:
2035  (a) "Council" means the Utah Health Workforce Advisory Council created in Section [
2036  26B-1-425] 26C-2-105.
2037  (b) "Information center" means the Utah Health Workforce Information Center created
2038  in Section [26B-4-705] 26C-2-106.
2039     (2)(a) In accordance with Subsection [26B-4-705(3)(a)] 26C-2-106(3)(a), the department
2040  shall work with the information center to identify relevant data pertaining to a
2041  profession described in Subsection (3).
2042  (b) The data should focus on:
2043  (i) identifying workforce shortages;
2044  (ii) identifying labor market indicators;
2045  (iii) determining the educational background of a licensee; and
2046  (iv) determining whether Utah is retaining a stable health workforce.
2047  (c) After the council approves data to be collected, the department shall request the data
2048  from a licensee when a licensee applies for a license or renews the licensee's license.
2049  (d) The department shall send the obtained data to the information center.
2050  (e) A licensee may not be denied a license for failing to provide the data described in
2051  Subsection (2)(c) to the department.
2052     (3)(a) The department shall prioritize data collection for each profession licensed under:
2053  (i) Chapter 31b, Nurse Practice Act;
2054  (ii) Chapter 60, Mental Health Professional Practice Act;
2055  (iii) Chapter 61, Psychologist Licensing Act;
2056  (iv) Chapter 67, Utah Medical Practice Act;
2057  (v) Chapter 68, Utah Osteopathic Medical Practice Act;
2058  (vi) Chapter 69, Dentist and Dental Hygienist Practice Act; or
2059  (vii) Chapter 70a, Utah Physician Assistant Act.
2060  (b) After the department has collected data for each profession described in Subsection
2061  (3)(a), the department shall collect data for each profession licensed under:
2062  (i) Chapter 5a, Podiatric Physician Licensing Act;
2063  (ii) Chapter 17b, Pharmacy Practice Act;
2064  (iii) Chapter 24b, Physical Therapy Practice Act;
2065  (iv) Chapter 40, Recreational Therapy Practice Act;
2066  (v) Chapter 41, Speech-Language Pathology and Audiology Licensing Act;
2067  (vi) Chapter 42a, Occupational Therapy Practice Act;
                                                  - 61 -
 1st Sub. (Green) S.B. 300  03-04 16:57
2068  (vii) Chapter 44a, Nurse Midwife Practice Act;
2069  (viii) Chapter 54, Radiologic Technologist, Radiologist Assistant, and Radiology
2070  Practical Technician Licensing Act; or
2071  (ix) Chapter 57, Respiratory Care Practices Act.
2072  (c) The department shall collect data in accordance with this section for any
2073  health-related occupation or profession that is regulated by the department and is not
2074  described in Subsection (3)(a) or (b) if:
2075  (i) funding is available;
2076  (ii) the council has identified a need for the data; and
2077  (iii) data has been collected for each profession described in Subsections (3)(a) and
2078  (3)(b).
2079  Section 47. Section 58-17b-802 is amended to read:
2080  58-17b-802 (Effective 01/01/28). Definitions.
2081        As used in this part:
2082     (1)(a) "Cosmetic drug" means a prescription drug that:
2083  (i) is for the purpose of promoting attractiveness or altering the appearance of an
2084  individual; and
2085  (ii)(A) is listed as a cosmetic drug subject to the exemption under this section by
2086  the division by administrative rule; or
2087  (B) has been expressly approved for online dispensing, whether or not it is
2088  dispensed online or through a physician's office.
2089  (b) "Cosmetic drug" does not include a prescription drug that is:
2090  (i) a controlled substance;
2091  (ii) compounded by the physician; or
2092  (iii) prescribed for or used by the patient for the purpose of diagnosing, curing, or
2093  preventing a disease.
2094     (2) "Employer sponsored clinic" means[:]
2095  [(a)] an entity that has a medical director who is licensed as a physician as defined in
2096  Section 58-67-102 and offers health care only to the employees of an exclusive group
2097  of employers and the employees' dependents[; or] .
2098  [(b) a clinic designated as a clinic for state employees and their dependents by the Public
2099  Employees' Benefit and Insurance Program under the pilot program created by
2100  Section 49-20-413 including all the patients at that clinic, regardless of the patients'
2101  participation in the pilot program.]
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2102     (3) "Health care" is as defined in Section 31A-1-301.
2103     (4)(a) "Injectable weight loss drug" means an injectable prescription drug:
2104  (i) prescribed to promote weight loss; and
2105  (ii) listed as an injectable prescription drug subject to exemption under this section by
2106  the division by administrative rule.
2107  (b) "Injectable weight loss drug" does not include a prescription drug that is a controlled
2108  substance.
2109     (5) "Prepackaged drug" means a prescription drug that:
2110  (a) is not listed under federal or state law as a Schedule I, II, III, IV, or V drug; and
2111  (b) is packaged in a fixed quantity per package by:
2112  (i) the drug manufacturer;
2113  (ii) a pharmaceutical wholesaler or distributor; or
2114  (iii) a pharmacy licensed under this title.
2115  Section 48. Section 58-37-6.5 is amended to read:
2116  58-37-6.5 (Effective 01/01/28). Continuing education for controlled substance
2117     prescribers.
2118     (1) For the purposes of this section:
2119  (a) "Controlled substance prescriber" means an individual, other than a veterinarian,
2120  who:
2121  (i) is licensed to prescribe a controlled substance under this chapter; and
2122  (ii) possesses the authority, in accordance with the individual's scope of practice, to
2123  prescribe schedule II controlled substances and schedule III controlled substances
2124  that are applicable to opioid narcotics, hypnotic depressants, or psychostimulants.
2125  (b) "D.O." means an osteopathic physician and surgeon licensed under Chapter 68, Utah
2126  Osteopathic Medical Practice Act.
2127  (c) "FDA" means the United States Food and Drug Administration.
2128  (d) "M.D." means a physician and surgeon licensed under Chapter 67, Utah Medical
2129  Practice Act.
2130  (e) "SBIRT" means the Screening, Brief Intervention, and Referral to Treatment
2131  approach used by the federal Substance Abuse and Mental Health Services
2132  Administration or defined by the division, in consultation with the Office of
2133  Substance Use and Mental Health, by administrative rule, in accordance with Title
2134  63G, Chapter 3, Utah Administrative Rulemaking Act.
2135     (2)(a) Beginning with the licensing period that begins after January 1, 2014, as a
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2136  condition precedent for license renewal, each controlled substance prescriber shall
2137  complete at least 3.5 continuing education hours per licensing period that satisfy the
2138  requirements of Subsection (3).
2139  (b)(i) Beginning with the licensing period that begins after January 1, 2024, as a
2140  condition precedent for license renewal, each controlled substance prescriber shall
2141  complete at least 3.5 continuing education hours in an SBIRT-training class that
2142  satisfies the requirements of Subsection (4).
2143  (ii) Completion of the SBIRT-training class, in compliance with Subsection (2)(b)(i),
2144  fulfills the continuing education hours requirement in Subsection (3) for the
2145  licensing period in which the class was completed.
2146  (iii) A controlled substance prescriber:
2147  (A) need only take the SBIRT-training class once during the controlled substance
2148  prescriber's licensure in the state; and
2149  (B) shall provide a completion record of the SBIRT-training class in order to be
2150  reimbursed for SBIRT services to patients, in accordance with Sections
2151  26B-3-131 and [49-20-416] 26C-5-102.
2152     (3) A controlled substance prescriber shall complete at least 3.5 hours of continuing
2153  education in one or more controlled substance prescribing classes, except dentists who
2154  shall complete at least two hours, that satisfy the requirements of Subsections (4) and (6).
2155     (4) A controlled substance prescribing class shall:
2156  (a) satisfy the division's requirements for the continuing education required for the
2157  renewal of the controlled substance prescriber's respective license type;
2158  (b) be delivered by an accredited or approved continuing education provider recognized
2159  by the division as offering continuing education appropriate for the controlled
2160  substance prescriber's respective license type; and
2161  (c) include a postcourse knowledge assessment.
2162     (5) An M.D. or D.O. completing continuing professional education hours under Subsection
2163  (4) shall complete those hours in classes that qualify for the American Medical
2164  Association Physician's Recognition Award Category 1 Credit.
2165     (6) The 3.5 hours of the controlled substance prescribing classes under Subsection (4) shall
2166  include educational content covering the following:
2167  (a) the scope of the controlled substance abuse problem in Utah and the nation;
2168  (b) all elements of the FDA Blueprint for Prescriber Education under the FDA's
2169  Extended-Release and Long-Acting Opioid Analgesics Risk Evaluation and
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2170  Mitigation Strategy, as published July 9, 2012, or as it may be subsequently revised;
2171  (c) the national and Utah-specific resources available to prescribers to assist in
2172  appropriate controlled substance and opioid prescribing;
2173  (d) patient record documentation for controlled substance and opioid prescribing;
2174  (e) office policies, procedures, and implementation; and
2175  (f) some training regarding medical cannabis, as that term is defined in Section
2176  26B-4-201.
2177     (7)(a) The division, in consultation with the Utah Medical Association Foundation, shall
2178  determine whether a particular controlled substance prescribing class satisfies the
2179  educational content requirements of Subsections (4) and (6) for an M.D. or D.O.
2180  (b) The division, in consultation with the applicable professional licensing boards, shall
2181  determine whether a particular controlled substance prescribing class satisfies the
2182  educational content requirements of Subsections (4) and (6) for a controlled
2183  substance prescriber other than an M.D. or D.O.
2184  (c) The division may by rule establish a committee that may audit compliance with the
2185  Utah Risk Evaluation and Mitigation Strategy (REMS) Educational Programming
2186  Project grant, that satisfies the educational content requirements of Subsections (4)
2187  and (6) for a controlled substance prescriber.
2188  (d) The division shall consult with the Department of Health and Human Services
2189  regarding the medical cannabis training described in Subsection (6)(f).
2190     (8) A controlled substance prescribing class required under this section:
2191  (a) may be held:
2192  (i) in conjunction with other continuing professional education programs; and
2193  (ii) online; and
2194  (b) does not increase the total number of state-required continuing professional
2195  education hours required for prescriber licensing.
2196     (9) The division may establish rules, in accordance with Title 63G, Chapter 3, Utah
2197  Administrative Rulemaking Act, to implement this section.
2198     (10) A controlled substance prescriber who, on or after July 1, 2017, obtains a waiver to
2199  treat opioid dependency with narcotic medications, in accordance with the Drug
2200  Addiction Treatment Act of 2000, 21 U.S.C. Sec. 823 et seq., may use the waiver to
2201  satisfy the 3.5 hours of the continuing education requirement under Subsection (3) for
2202  two consecutive licensing periods.
2203  Section 49. Section 59-35-101 is enacted to read:
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2204  CHAPTER 35. Utah Health Care Tax
2205  59-35-101 (Effective 01/01/28). Definitions.
2206        As used in this section:
2207     (1) "Corporation" means any of the following:
2208  (a) a domestic corporation; or
2209  (b) a foreign corporation.
2210     (2) "Domestic corporation" means the same as that term is defined in Section 59-7-101.
2211     (3) "Foreign corporation" means the same as that term is defined in Section 59-7-101.
2212     (4) "Fund" means the Utah Cares Trust Fund created in Section 26C-1-103.
2213     (5)(a) "Gross margin" means the direct cost of producing a good or providing a service.
2214  (b) "Gross margin" does not include any indirect cost that may be used to calculate net
2215  margin.
2216     (6) "Gross receipts" means the totality of the money that an entity receives for any good or
2217  service produced or rendered in the state without any deduction.
2218     (7) "Pass-through entity" means the same as that term is defined in Section 59-10-1402.
2219  Section 50. Section 59-35-102 is enacted to read:
2220  59-35-102 (Effective 01/01/28). Application -- Utah source-- Credit.
2221     (1) There is created a tax on gross receipts of corporations and pass-through entities.
2222     (2) For a domestic corporation or a pass-through entity that is commercially domiciled in
2223  this state, the tax is applicable to all gross receipts of the domestic corporation or
2224  pass-through entity.
2225     (3) For a foreign corporation or a pass-through entity not described in Subsection (2), the
2226  tax on gross receipts is applicable to gross receipts derived from Utah sources
2227  attributable to or resulting from:
2228  (a) the ownership in this state of any interest in real or tangible personal property,
2229  including real property or property rights from which gross receipts from mining as
2230  described by Section 613(c), Internal Revenue Code, is derived; and
2231  (b) the carrying on of a business, trade, profession, or occupation in this state.
2232     (4) If a domestic corporation or pass-through entity described in Subsection (2) pays a gross
2233  receipts tax in another state for sales deriving in that state, the domestic corporation or
2234  pass-through entity described in Subsection (2) may claim a credit for a tax collected
2235  under this chapter in an amount equal to the amount of gross receipts tax paid in the
2236  other state.
2237  Section 51. Section 59-35-103 is enacted to read:
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2238  59-35-103 (Effective 01/01/28). Rates.
2239     (1) Except as provided in Subsection (2), the gross receipts tax shall be calculated as
2240  follows on each dollar of gross receipts:
2241  (a) 0% on the first $10,000;
2242  (b) 2% on the amount between $10,001 and $100,000;
2243  (c) 2.5% on the amount between $100,001 and $1,000,000; and
2244  (d) 2.85% on any amount over $1,000,000.
2245     (2) If the total amount of the tax required by Subsection (1) that a corporation or
2246  pass-through entity is liable for exceeds the corporation's or pass-through entity's gross
2247  margin, the corporation or pass-through entity shall pay an amount in tax that is equal to
2248  the entity's gross margin.
2249  Section 52. Section 59-35-104 is enacted to read:
2250  59-35-104 (Effective 01/01/28). Commission duties -- Rulemaking.
2251     (1) The commission shall deposit all revenue collected or received by the commission
2252  under this chapter into the fund at least monthly.
2253     (2) The commission may make rules in accordance with Title 63G, Chapter 3,
2254  Administrative Rulemaking Act, to effectuate this chapter.
2255  Section 53. Section 59-35-105 is enacted to read:
2256  59-35-105 (Effective 01/01/28). Filing -- Taxable year.
2257     (1) Each taxpayer upon whom a gross receipts tax is imposed under this chapter shall file a
2258  return with and pay the tax reflected in the return to the commission annually.
2259     (2) A taxpayer's taxable year under this chapter is the taxpayer's fiscal year.
2260     (3) A taxpayer shall file a return no later than 90 days from the day on which the tax payer's
2261  fiscal year ends.
2262  Section 54. Section 59-35-106 is enacted to read:
2263  59-35-106 (Effective 01/01/28). Timely mailing treating as timely filing.
2264     (1)(a) A return, claim, statement, other document, or payment is considered mailed on
2265  the date of the postmark.
2266  (b) Subsection (1)(a) shall apply only if:
2267  (i) the postmark date falls within the prescribed period or on or before the prescribed
2268  date:
2269  (A) for the filing of the return, claim, statement, or other document; or
2270  (B) for making the payment; and
2271  (ii) the return, claim, statement, other document, or payment, was, within the time
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2272  prescribed in Subsection (1)(b)(i), deposited in the mail in the United States in an
2273  envelope or other appropriate wrapper, postage prepaid, properly addressed to the
2274  agency, officer, or office with which the return, claim, statement, or other
2275  document is required to be filed, or to which such payment is required to be made.
2276     (2) This section shall apply in the case of postmarks not made by the United States Postal
2277  Service only if and to the extent provided by rules prescribed by the commission.
2278     (3)(a) For purposes of this section, if any such return, claim, statement, other document,
2279  or payment is sent by United States registered mail:
2280  (i) such registration shall be prima facie evidence that the return, claim, statement, or
2281  other document was delivered to the agency, officer, or office to which addressed;
2282  and
2283  (ii) the date of registration shall be deemed the postmark date.
2284  (b) The commission may provide by rule the extent to which the provisions of
2285  Subsection (3)(a) with respect to prima facie evidence of delivery and the postmark
2286  date shall apply to certified mail.
2287     (4) This section does not apply with respect to currency or other medium of payment unless
2288  actually received and accounted for.
2289     (5)(a) If any deposit required to be made on or before a prescribed date is, after such
2290  date, delivered by the United States mail to the commission, such deposit shall be
2291  deemed received by the commission on the date the deposit was mailed.
2292  (b) Subsection (5)(a) applies only if the person required to make the deposit establishes
2293  that:
2294  (i) the date of mailing falls on or before the second day before the prescribed date for
2295  making the deposit, including any extension of time granted for making the
2296  deposit; and
2297  (ii) the deposit was, on or before such second day, mailed in the United States in an
2298  envelope or other appropriate wrapper, postage prepaid, properly addressed to the
2299  commission.
2300  Section 55. Section 59-35-107 is enacted to read:
2301  59-35-107 (Effective 01/01/28). Place for filing returns.
2302  When not otherwise provided for by this chapter, the commission shall by rule made in
2303     accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, prescribe the
2304     place and for the filing of any return, statement, or other documents, required by this chapter
2305     or rules.
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2306  Section 56. Section 59-35-108 is enacted to read:
2307  59-35-108 (Effective 01/01/28). Time and place for paying tax.
2308     (1) If a taxpayer under this chapter obtains an extension under Section 59-35-109, the
2309  taxpayer shall pay an amount equal to the previous year's tax required under this chapter
2310  when the tax is due.
2311     (2) The taxpayer that pays under Subsection (1) shall pay the difference of the tax owed or
2312  receive a refund of the amount of tax overpaid when the taxpayer files the return.
2313  Section 57. Section 59-35-109 is enacted to read:
2314  59-35-109 (Effective 01/01/28). Extension.
2315     (1) The commission shall allow a taxpayer an extension of time for filing a return.
2316     (2) An extension described in Subsection (1) may be up to six months.
2317  Section 58. Section 63A-17-804 is amended to read:
2318  63A-17-804 (Effective 01/01/28). Continuation of Insurance Benefits Program --
2319     Creation -- Coverage following death in the line of duty.
2320     (1) There is created the "Continuation of Insurance Benefits Program" to provide a
2321  continuation of insurance to the surviving spouse and family of any state employee
2322  whose death occurs in the line of duty.
2323     (2) The insurance coverage shall be the same coverage as provided under Section [
2324  49-20-406] 26C-7-101.
2325     (3) The program provides that unused accumulated sick leave of a deceased employee may
2326  be used for additional medical coverage in the same manner as provided under Section
2327  63A-17-507 or 63A-17-508 as applicable.
2328  Section 59. Section 63C-31-102 is amended to read:
2329  63C-31-102 (Effective 01/01/28) (Repealed 07/01/28). Creation of State Employee
2330     Benefits Advisory Commission -- Membership.
2331     (1) There is created the State Employee Benefits Advisory Commission consisting of the
2332  following members:
2333  (a) one member of the Senate, appointed by the president of the Senate;
2334  (b) one member of the House of Representatives, appointed by the speaker of the House
2335  of Representatives;
2336  (c) the director of the Division of Human Resource Management, created in Section
2337  63A-17-105, or the director's designee;
2338  (d) the executive director of the Governor's Office of Planning and Budget, created in
2339  Section 63J-4-201, or the executive director's designee;
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2340  (e) the following four individuals who are not employed by the state or another public
2341  entity and are appointed jointly by the president of the Senate and speaker of the
2342  House of Representatives:
2343  (i) an individual who has experience in health insurance benefits in the private sector;
2344  (ii) an individual who has experience in business and employee benefits in the private
2345  sector; and
2346  (iii) a representative of an organization that represents the interests of state
2347  employees; and
2348  (f) a representative of the [Public Employees' Benefit and Insurance Program] Utah
2349  Cares Health Financing Program, created in [Section 49-20-103] Title 26C, Utah
2350  Cares Act, appointed by the [executive director of the Utah State Retirement Office]
2351  Utah Health Services Commission.
2352     (2)(a) The member of the Senate appointed under Subsection (1)(a) is a cochair of the
2353  benefits advisory commission.
2354  (b) The member of the House of Representatives appointed under Subsection (1)(b) is a
2355  cochair of the benefits advisory commission.
2356     (3)(a) Each position described in Subsection (1)(e) is for a term of four years.
2357  (b) A vacancy in a position appointed under Subsection (1)(a), (b), (e), or (f) shall be
2358  filled by appointing a replacement member in the same manner as the member
2359  creating the vacancy was appointed under Subsection (1)(a), (b), (e), or (f),
2360  respectively.
2361  (c) If a position described in Subsection (1)(e) is vacant, the president of the Senate and
2362  speaker of the House of Representatives shall jointly appoint the replacement
2363  member for the remainder of the unexpired term.
2364     (4)(a) A majority of members constitute a quorum.
2365  (b) The action of a majority of a quorum constitutes the action of the benefits advisory
2366  commission.
2367     (5) The benefits advisory commission shall meet as necessary to effectively conduct the
2368  commission's business and duties as prescribed by statute, but not less than twice a year.
2369     (6) The Division of Human Resource Management shall provide staff support to facilitate
2370  the function of the benefits advisory commission and record the benefits advisory
2371  commission's action and recommendations.
2372     (7)(a) The salary and expenses of a benefits advisory commission member who is a
2373  legislator shall be paid in accordance with Section 36-2-2 and Legislative Joint Rules,
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2374  Title 5, Legislative Compensation and Expenses.
2375  (b) A benefits advisory commission member who is not a legislator may not receive
2376  compensation or benefits for the member's service on the benefits advisory
2377  commission, but may receive per diem and reimbursement for travel expenses
2378  incurred as a benefits advisory commission member at the rates established by the
2379  Division of Finance under:
2380  (i) Sections 63A-3-106 and 63A-3-107; and
2381  (ii) rules made by the Division of Finance under Sections 63A-3-106 and 63A-3-107.
2382     (8) The benefits advisory commission shall comply with the provisions of Title 52, Chapter
2383  4, Open and Public Meetings Act.
2384  Section 60. Section 63E-1-102 is amended to read:
2385  63E-1-102 (Effective 01/01/28). Definitions -- List of independent entities.
2386        As used in this title:
2387     (1) "Authorizing statute" means the statute creating an entity as an independent entity.
2388     (2) "Committee" means the Retirement and Independent Entities Committee created by
2389  Section 63E-1-201.
2390     (3) "Independent corporation" means a corporation incorporated in accordance with
2391  Chapter 2, Independent Corporations Act.
2392     (4)(a) "Independent entity" means an entity having a public purpose relating to the state
2393  or its citizens that is individually created by the state or is given by the state the right
2394  to exist and conduct its affairs as an:
2395  (i) independent state agency; or
2396  (ii) independent corporation.
2397  (b) For purposes of this title, the independent entities are the:
2398  (i) Utah Beef Council, created by Section 4-21-103;
2399  (ii) Utah Dairy Commission created by Section 4-22-103;
2400  (iii) Heber Valley Historic Railroad Authority created by Section 63H-4-102;
2401  (iv) Utah Housing Corporation created by Section 63H-8-201;
2402  (v) Utah State Retirement Office created by Section 49-11-201;
2403  (vi) School and Institutional Trust Lands Administration created by Section
2404  53C-1-201;
2405  (vii) School and Institutional Trust Fund Office created by Section 53D-1-201;
2406  (viii) Utah Communications Authority created by Section 63H-7a-201;
2407  (ix) Utah Capital Investment Corporation created by Section 63N-6-301;
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 1st Sub. (Green) S.B. 300  03-04 16:57
2408  (x) Military Installation Development Authority created by Section 63H-1-201;[ and]
2409  (xi) Public Service Commission of Utah created by Section 54-1-1[.] ; and
2410  (xii) Utah Health Services Commission created by Section 26C-2-101.
2411  (c) Notwithstanding this Subsection (4), "independent entity" does not include:
2412  (i) an institution within the state system of higher education;
2413  (ii) a city, county, or town;
2414  (iii) a local school district;
2415  (iv) a special district under Title 17B, Limited Purpose Local Government Entities -
2416  Special Districts; or
2417  (v) a special service district under Title 17D, Chapter 1, Special Service District Act.
2418     (5) "Independent state agency" means an entity that is created by the state, but is
2419  independent of the governor's direct supervisory control.
2420     (6) "Money held in trust" means money maintained for the benefit of:
2421  (a) one or more private individuals, including public employees;
2422  (b) one or more public or private entities; or
2423  (c) the owners of a quasi-public corporation.
2424     (7) "Public corporation" means an artificial person, public in ownership, individually
2425  created by the state as a body politic and corporate for the administration of a public
2426  purpose relating to the state or its citizens.
2427     (8) "Quasi-public corporation" means an artificial person, private in ownership, individually
2428  created as a corporation by the state, which has accepted from the state the grant of a
2429  franchise or contract involving the performance of a public purpose relating to the state
2430  or its citizens.
2431  Section 61. Section 63G-2-103 is amended to read:
2432  63G-2-103 (Effective 01/01/28). Definitions.
2433        As used in this chapter:
2434     (1) "Audit" means:
2435  (a) a systematic examination of financial, management, program, and related records for
2436  the purpose of determining the fair presentation of financial statements, adequacy of
2437  internal controls, or compliance with laws and regulations; or
2438  (b) a systematic examination of program procedures and operations for the purpose of
2439  determining their effectiveness, economy, efficiency, and compliance with statutes
2440  and regulations.
2441     (2) "Chief administrative officer" means the chief administrative officer of a governmental
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 03-04 16:57  1st Sub. (Green) S.B. 300
2442  entity who is responsible to fulfill the duties described in Section 63A-12-103.
2443     (3) "Chronological logs" mean the regular and customary summary records of law
2444  enforcement agencies and other public safety agencies that show:
2445  (a) the time and general nature of police, fire, and paramedic calls made to the agency;
2446  and
2447  (b) any arrests or jail bookings made by the agency.
2448     (4) "Classification," "classify," and their derivative forms mean determining whether a
2449  record series, record, or information within a record is public, private, controlled,
2450  protected, or exempt from disclosure under Subsection 63G-2-201(3)(b).
2451     (5)(a) "Computer program" means:
2452  (i) a series of instructions or statements that permit the functioning of a computer
2453  system in a manner designed to provide storage, retrieval, and manipulation of
2454  data from the computer system; and
2455  (ii) any associated documentation and source material that explain how to operate the
2456  computer program.
2457  (b) "Computer program" does not mean:
2458  (i) the original data, including numbers, text, voice, graphics, and images;
2459  (ii) analysis, compilation, and other manipulated forms of the original data produced
2460  by use of the program; or
2461  (iii) the mathematical or statistical formulas, excluding the underlying mathematical
2462  algorithms contained in the program, that would be used if the manipulated forms
2463  of the original data were to be produced manually.
2464     (6)(a) "Contractor" means:
2465  (i) any person who contracts with a governmental entity to provide goods or services
2466  directly to a governmental entity; or
2467  (ii) any private, nonprofit organization that receives funds from a governmental entity.
2468  (b) "Contractor" does not mean a private provider.
2469     (7) "Controlled record" means a record containing data on individuals that is controlled as
2470  provided by Section 63G-2-304.
2471     (8) "Designation," "designate," and their derivative forms mean indicating, based on a
2472  governmental entity's familiarity with a record series or based on a governmental entity's
2473  review of a reasonable sample of a record series, the primary classification that a
2474  majority of records in a record series would be given if classified and the classification
2475  that other records typically present in the record series would be given if classified.
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 1st Sub. (Green) S.B. 300  03-04 16:57
2476     (9) "Elected official" means each person elected to a state office, county office, municipal
2477  office, school board or school district office, special district office, or special service
2478  district office, but does not include judges.
2479     (10) "Explosive" means a chemical compound, device, or mixture:
2480  (a) commonly used or intended for the purpose of producing an explosion; and
2481  (b) that contains oxidizing or combustive units or other ingredients in proportions,
2482  quantities, or packing so that:
2483  (i) an ignition by fire, friction, concussion, percussion, or detonator of any part of the
2484  compound or mixture may cause a sudden generation of highly heated gases; and
2485  (ii) the resultant gaseous pressures are capable of:
2486  (A) producing destructive effects on contiguous objects; or
2487  (B) causing death or serious bodily injury.
2488     (11) "Government audit agency" means any governmental entity that conducts an audit.
2489     (12)(a) "Governmental entity" means:
2490  (i) executive department agencies of the state, the offices of the governor, lieutenant
2491  governor, state auditor, attorney general, and state treasurer, the Board of Pardons
2492  and Parole, the Board of Examiners, the National Guard, the Career Service
2493  Review Office, the State Board of Education, the Utah Board of Higher
2494  Education, and the State Archives;
2495  (ii) the Office of the Legislative Auditor General, Office of the Legislative Fiscal
2496  Analyst, Office of Legislative Research and General Counsel, the Legislature, and
2497  legislative committees, except any political party, group, caucus, or rules or sifting
2498  committee of the Legislature;
2499  (iii) courts, the Judicial Council, the Administrative Office of the Courts, and similar
2500  administrative units in the judicial branch;
2501  (iv) any state-funded institution of higher education or public education; or
2502  (v) any political subdivision of the state, but, if a political subdivision has adopted an
2503  ordinance or a policy relating to information practices pursuant to Section
2504  63G-2-701, this chapter shall apply to the political subdivision to the extent
2505  specified in Section 63G-2-701 or as specified in any other section of this chapter
2506  that specifically refers to political subdivisions.
2507  (b) "Governmental entity" also means:
2508  (i) every office, agency, board, bureau, committee, department, advisory board, or
2509  commission of an entity listed in Subsection (12)(a) that is funded or established
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2510  by the government to carry out the public's business;
2511  (ii) as defined in Section 11-13-103, an interlocal entity or joint or cooperative
2512  undertaking, except for the Water District Water Development Council created
2513  pursuant to Section 11-13-228;
2514  (iii) as defined in Section 11-13a-102, a governmental nonprofit corporation;
2515  (iv) an association as defined in Section 53G-7-1101;
2516  (v) the Utah Independent Redistricting Commission; and
2517  (vi) a law enforcement agency, as defined in Section 53-1-102, that employs one or
2518  more law enforcement officers, as defined in Section 53-13-103.
2519  (c) "Governmental entity" does not include the Utah Educational Savings Plan created in
2520  Section 53H-10-202.
2521     (13) "Government Records Office" means the same as that term is defined in Section
2522  63A-12-201.
2523     (14) "Gross compensation" means every form of remuneration payable for a given period to
2524  an individual for services provided including salaries, commissions, vacation pay,
2525  severance pay, bonuses, and any board, rent, housing, lodging, payments in kind, and
2526  any similar benefit received from the individual's employer.
2527     (15) "Individual" means a human being.
2528     (16)(a) "Initial contact report" means an initial written or recorded report, however
2529  titled, prepared by peace officers engaged in public patrol or response duties
2530  describing official actions initially taken in response to either a public complaint
2531  about or the discovery of an apparent violation of law, which report may describe:
2532  (i) the date, time, location, and nature of the complaint, the incident, or offense;
2533  (ii) names of victims;
2534  (iii) the nature or general scope of the agency's initial actions taken in response to the
2535  incident;
2536  (iv) the general nature of any injuries or estimate of damages sustained in the incident;
2537  (v) the name, address, and other identifying information about any person arrested or
2538  charged in connection with the incident; or
2539  (vi) the identity of the public safety personnel, except undercover personnel, or
2540  prosecuting attorney involved in responding to the initial incident.
2541  (b) Initial contact reports do not include follow-up or investigative reports prepared after
2542  the initial contact report. However, if the information specified in Subsection (16)(a)
2543  appears in follow-up or investigative reports, it may only be treated confidentially if
                                                 - 75 -
 1st Sub. (Green) S.B. 300  03-04 16:57
2544  it is private, controlled, protected, or exempt from disclosure under Subsection
2545  63G-2-201(3)(b).
2546  (c) Initial contact reports do not include accident reports, as that term is described in
2547  Title 41, Chapter 6a, Part 4, Accident Responsibilities.
2548     (17) "Legislative body" means the Legislature.
2549     (18) "Notice of compliance" means a statement confirming that a governmental entity has
2550  complied with an order of the director of the Government Records Office.
2551     (19) "Person" means:
2552  (a) an individual;
2553  (b) a nonprofit or profit corporation;
2554  (c) a partnership;
2555  (d) a sole proprietorship;
2556  (e) other type of business organization; or
2557  (f) any combination acting in concert with one another.
2558     (20) "Private provider" means any person who contracts with a governmental entity to
2559  provide services directly to the public.
2560     (21) "Private record" means a record containing data on individuals that is private as
2561  provided by Section 63G-2-302.
2562     (22) "Protected record" means a record that is classified protected as provided by Section
2563  63G-2-305.
2564     (23) "Public record" means a record that is not private, controlled, or protected and that is
2565  not exempt from disclosure as provided in Subsection 63G-2-201(3)(b).
2566     (24) "Reasonable search" means a search that is:
2567  (a) reasonable in scope and intensity; and
2568  (b) not unreasonably burdensome for the government entity.
2569     (25)(a) "Record" means a book, letter, document, paper, map, plan, photograph, film,
2570  card, tape, recording, electronic data, or other documentary material regardless of
2571  physical form or characteristics:
2572  (i) that is prepared, owned, received, or retained by a governmental entity or political
2573  subdivision; and
2574  (ii) where all of the information in the original is reproducible by photocopy or other
2575  mechanical or electronic means.
2576  (b) "Record" does not include:
2577  (i) a personal note or personal communication prepared or received by an employee
                                                  - 76 -
 03-04 16:57  1st Sub. (Green) S.B. 300
2578  or officer of a governmental entity:
2579  (A) in a capacity other than the employee's or officer's governmental capacity; or
2580  (B) that is unrelated to the conduct of the public's business;
2581  (ii) a temporary draft or similar material prepared for the originator's personal use or
2582  prepared by the originator for the personal use of an individual for whom the
2583  originator is working;
2584  (iii) material that is legally owned by an individual in the individual's private capacity;
2585  (iv) material to which access is limited by the laws of copyright or patent unless the
2586  copyright or patent is owned by a governmental entity or political subdivision;
2587  (v) proprietary software;
2588  (vi) junk mail or a commercial publication received by a governmental entity or an
2589  official or employee of a governmental entity;
2590  (vii) a book that is cataloged, indexed, or inventoried and contained in the collections
2591  of a library open to the public;
2592  (viii) material that is cataloged, indexed, or inventoried and contained in the
2593  collections of a library open to the public, regardless of physical form or
2594  characteristics of the material;
2595  (ix) a daily calendar ;
2596  (x) a note prepared by the originator for the originator's own use or for the sole use of
2597  an individual for whom the originator is working;
2598  (xi) a computer program that is developed or purchased by or for any governmental
2599  entity for its own use;
2600  (xii) a note or internal memorandum prepared as part of the deliberative process by:
2601  (A) a member of the judiciary;
2602  (B) an administrative law judge;
2603  (C) a member of the Board of Pardons and Parole; or
2604  (D) a member of any other body, other than an association or appeals panel as
2605  defined in Section 53G-7-1101, charged by law with performing a
2606  quasi-judicial function;
2607  (xiii) a telephone number or similar code used to access a mobile communication
2608  device that is used by an employee or officer of a governmental entity, provided
2609  that the employee or officer of the governmental entity has designated at least one
2610  business telephone number that is a public record as provided in Section
2611  63G-2-301;
                                                  - 77 -
 1st Sub. (Green) S.B. 300  03-04 16:57
2612  [(xiv) information provided by the Public Employees' Benefit and Insurance
2613  Program, created in Section 49-20-103, to a county to enable the county to
2614  calculate the amount to be paid to a health care provider under Subsection
2615  17-63-706(2)(e)(ii);]
2616  [(xv)] (xiv) information that an owner of unimproved property provides to a local
2617  entity as provided in Section 11-42-205;
2618  [(xvi)] (xv) a video or audio recording of an interview, or a transcript of the video or
2619  audio recording, that is conducted at a Children's Justice Center established under
2620  Section 67-5b-102;
2621  [(xvii)] (xvi) child sexual abuse material, as defined by Section 76-5b-103;
2622  [(xviii)] (xvii) before final disposition of an ethics complaint occurs, a video or audio
2623  recording of the closed portion of a meeting or hearing of:
2624  (A) a Senate or House Ethics Committee;
2625  (B) the Independent Legislative Ethics Commission;
2626  (C) the Independent Executive Branch Ethics Commission, created in Section
2627  63A-14-202; or
2628  (D) the Political Subdivisions Ethics Review Commission established in Section
2629  63A-15-201;
2630  [(xix)] (xviii) confidential communication described in Section 58-60-102, 58-61-102,
2631  or 58-61-702;
2632  [(xx)] (xix) any item described in Subsection (25)(a) that is:
2633  (A) described in Subsection 63G-2-305(17), (18), or (23)(b); and
2634  (B) shared between any of the following entities:
2635  (I) the Division of Risk Management;
2636  (II) the Office of the Attorney General;
2637  (III) the governor's office; or
2638  (IV) the Legislature;
2639  [(xxi)] (xx) the email address that a candidate for elective office provides to a filing
2640  officer under Subsection 20A-9-201(5)(c)(ii) or 20A-9-203(4)(c)(iv); or
2641  [(xxii)] (xxi) except as provided in Sections 31A-16-105, 31A-16-107.5, and
2642  27a-3-303, an investment policy, or information related to an investment policy,
2643  provided to the insurance commissioner as described in Title 31A, Chapter 18,
2644  Investments.
2645     (26) "Record series" means a group of records that may be treated as a unit for purposes of
                                                 - 78 -
 03-04 16:57  1st Sub. (Green) S.B. 300
2646  designation, description, management, or disposition.
2647     (27) "Records officer" means the individual appointed by the chief administrative officer of
2648  each governmental entity, or the political subdivision to work with state archives in the
2649  care, maintenance, scheduling, designation, classification, disposal, and preservation of
2650  records.
2651     (28) "Schedule," "scheduling," and their derivative forms mean the process of specifying
2652  the length of time each record series should be retained by a governmental entity for
2653  administrative, legal, fiscal, or historical purposes and when each record series should be
2654  transferred to the state archives or destroyed.
2655     (29) "Sponsored research" means research, training, and other sponsored activities as
2656  defined by the federal Executive Office of the President, Office of Management and
2657  Budget:
2658  (a) conducted:
2659  (i) by an institution within the state system of higher education described in Section
2660  53H-1-102; and
2661  (ii) through an office responsible for sponsored projects or programs; and
2662  (b) funded or otherwise supported by an external:
2663  (i) person that is not created or controlled by the institution within the state system of
2664  higher education; or
2665  (ii) federal, state, or local governmental entity.
2666     (30) "State archives" means the Division of Archives and Records Service created in
2667  Section 63A-12-101.
2668     (31) "State archivist" means the director of the state archives.
2669     (32) "Summary data" means statistical records and compilations that contain data derived
2670  from private, controlled, or protected information but that do not disclose private,
2671  controlled, or protected information.
2672  Section 62. Section 63H-9-101 is amended to read:
2673  63H-9-101 (Effective 01/01/28). Definitions.
2674        As used in this chapter:
2675     (1) "Best practices toolbox" means the collection of resources for governmental entities
2676  provided on the website of the Office of the Legislative Auditor General that includes a
2677  best practice self-assessment and other resources, tools, surveys, and reports designed to
2678  help government organizations better serve the citizens of the state.
2679     (2) "Consensus group" means the Office of Legislative Research and General Counsel, the
                                                 - 79 -
 1st Sub. (Green) S.B. 300  03-04 16:57
2680  Office of the Legislative Auditor General, and the Office of the Legislative Fiscal
2681  Analyst.
2682     (3)(a) "Independent entity" means an entity that:
2683  (i) has a public purpose relating to the state or its citizens;
2684  (ii) is individually created by the state;
2685  (iii) is separate from the judicial and legislative branches of state government; and
2686  (iv) is not under the direct supervisory control of the governor.
2687  (b) "Independent entity" does not include an entity that is:
2688  (i) a county;
2689  (ii) a municipality as defined in Section 10-1-104;
2690  (iii) an institution of higher education as defined in Section 53H-1-101;
2691  (iv) a public school as defined in Section 53G-8-701;
2692  (v) a special district as defined in Section 17B-1-102;
2693  (vi) a special service district as defined in Section 17D-1-102;
2694  (vii) created by an interlocal agreement as described in Section 11-13-203; or
2695  (viii) an elective constitutional office, including the state auditor, the state treasurer,
2696  and the attorney general.
2697  (c) Independent entities that are subject to the provisions of this chapter include the:
2698  (i) Career Service Review Office created in Section 67-19a-201;
2699  (ii) State Capitol Preservation Board created in Section [63C-9-201] 63O-2-201;
2700  (iii) Heber Valley Historic Railroad Authority created in Section 63H-4-102;
2701  (iv) Military Installation Development Authority created in Section 63H-1-201;
2702  (v) Office of Inspector General of Medicaid Services created in Section 63A-13-201;
2703  (vi) Point of the Mountain State Land Authority created in Section 11-59-201;
2704  (vii) Public Service Commission created in Section 54-1-1;
2705  (viii) School and Institutional Trust Fund Office created in Section [53C-1-201]
2706  53D-1-201;
2707  (ix) School and Institutional Trust Lands Administration created in Section [
2708  53D-1-201] 53C-1-201;
2709  (x) Utah Beef Council created in Section 4-21-103;
2710  (xi) Utah Capital Investment Corporation created in Section 63N-6-301;
2711  (xii) Utah Communications Authority created in Section 63H-7a-201;
2712  (xiii) Utah Dairy Commission created in Section 4-22-103;
2713  (xiv) Utah Education and Telehealth Network created in Section 53H-4-213.4;
                                                  - 80 -
 03-04 16:57  1st Sub. (Green) S.B. 300
2714  (xv) Utah Housing Corporation created in Section 63H-8-201;
2715  (xvi) Utah Inland Port Authority created in Section 11-58-201;
2716  (xvii) Utah Lake Authority created in Section 11-65-201;
2717  (xviii) Utah Retirement Systems created in Section 49-11-201;[ and]
2718  (xix) [Utah ]State Fair Park Authority created in Section 11-68-201[.] ; and
2719  (xx) Utah Health Services Commission created in Section 26C-2-101.
2720  Section 63. Section 63I-1-226 is amended to read:
2721  63I-1-226 (Effective 01/01/28). Repeal dates: Titles 26 through 26C.
2722     (1) Subsection 26B-1-204(2)(g), regarding the Youth Electronic Cigarette, Marijuana, and
2723  Other Drug Prevention Committee, is repealed July 1, 2030.
2724     (2) Subsection 26B-1-204(2)(h), regarding the Primary Care Grant Committee, is repealed
2725  July 1, 2035.
2726     (3) Section 26B-1-315, Medicaid ACA Fund, is repealed July 1, 2034.
2727     (4) Section 26B-1-318, Brain and Spinal Cord Injury Fund, is repealed July 1, 2029.
2728     (5) Section 26B-1-402, Rare Disease Advisory Council Grant Program -- Creation --
2729  Reporting, is repealed July 1, 2026.
2730     (6) Section 26B-1-409, Utah Digital Health Service Commission -- Creation -- Membership
2731  -- Duties, is repealed July 1, 2025.
2732     (7) Section 26B-1-410, Primary Care Grant Committee, is repealed July 1, 2035.
2733     (8) Section 26B-1-417, Brain and Spinal Cord Injury Advisory Committee -- Membership
2734  -- Duties, is repealed July 1, 2029.
2735     (9) Section 26B-1-422, Early Childhood Utah Advisory Council -- Creation --
2736  Compensation -- Duties, is repealed July 1, 2029.
2737     [(10) Section 26B-1-425, Utah Health Workforce Advisory Council -- Creation and
2738  membership, is repealed July 1, 2027.]
2739     [(11)] (10) Section 26B-1-428, Youth Electronic Cigarette, Marijuana, and Other Drug
2740  Prevention Committee and Program -- Creation -- Membership -- Duties, is repealed
2741  July 1, 2030.
2742     [(12)] (11) Section 26B-1-430, Coordinating Council for Persons with Disabilities -- Policy
2743  regarding services to individuals with disabilities -- Creation -- Membership --
2744  Expenses, is repealed July 1, 2027.
2745     [(13)] (12) Section 26B-1-432, Newborn Hearing Screening Committee, is repealed July 1,
2746  2026.
2747     [(14)] (13) Section 26B-2-407, Drinking water quality in child care centers, is repealed July
                                                - 81 -
 1st Sub. (Green) S.B. 300  03-04 16:57
2748  1, 2027.
2749     [(15)] (14) Subsection 26B-3-107(9), regarding reimbursement for dental hygienists, is
2750  repealed July 1, 2028.
2751     [(16)] (15) Section 26B-3-136, Children's Health Care Coverage Program, is repealed July
2752  1, 2025.
2753     [(17)] (16) Section 26B-3-137, Reimbursement for diabetes prevention program, is repealed
2754  June 30, 2027.
2755     [(18)] (17) Subsection 26B-3-213(2)(b), regarding consultation with the Behavioral Health
2756  Crisis Response Committee, is repealed December 31, 2026.
2757     [(19)] (18) Section 26B-3-302, DUR Board -- Creation and membership -- Expenses, is
2758  repealed July 1, 2027.
2759     [(20)] (19) Section 26B-3-303, DUR Board -- Responsibilities, is repealed July 1, 2027.
2760     [(21)] (20) Section 26B-3-304, Confidentiality of records, is repealed July 1, 2027.
2761     [(22)] (21) Section 26B-3-305, Drug prior approval program, is repealed July 1, 2027.
2762     [(23)] (22) Section 26B-3-306, Advisory committees, is repealed July 1, 2027.
2763     [(24)] (23) Section 26B-3-307, Retrospective and prospective DUR, is repealed July 1, 2027.
2764     [(25)] (24) Section 26B-3-308, Penalties, is repealed July 1, 2027.
2765     [(26)] (25) Section 26B-3-309, Immunity, is repealed July 1, 2027.
2766     [(27)] (26) Title 26B, Chapter 3, Part 5, Inpatient Hospital Assessment, is repealed July 1,
2767  2034.
2768     [(28)] (27) Title 26B, Chapter 3, Part 6, Medicaid Expansion Hospital Assessment, is
2769  repealed July 1, 2034.
2770     [(29)] (28) Title 26B, Chapter 3, Part 7, Hospital Provider Assessment, is repealed July 1,
2771  2028.
2772     [(30)] (29) Section 26B-3-910, Alternative eligibility -- Report -- Alternative Eligibility
2773  Expendable Revenue Fund, is repealed July 1, 2028.
2774     [(31)] (30) Section 26B-4-710, Rural residency training program, is repealed July 1, 2025.
2775     [(32)] (31) Subsection 26B-5-112(1)(b), regarding consultation with the Behavioral Health
2776  Crisis Response Committee, is repealed December 31, 2026.
2777     [(33)] (32) Subsection 26B-5-112(5)(b), regarding consultation with the Behavioral Health
2778  Crisis Response Committee, is repealed December 31, 2026.
2779     [(34)] (33) Section 26B-5-112.5, Mobile Crisis Outreach Team Grant Program, is repealed
2780  December 31, 2026.
2781     [(35)] (34) Section 26B-5-114, Behavioral Health Receiving Center Grant Program, is
                                                 - 82 -
 03-04 16:57  1st Sub. (Green) S.B. 300
2782  repealed December 31, 2026.
2783     [(36)] (35) Section 26B-5-118, Collaborative care grant program, is repealed December 31,
2784  2024.
2785     [(37)] (36) Section 26B-5-120, Virtual crisis outreach team grant program, is repealed
2786  December 31, 2026.
2787     [(38)] (37) Subsection 26B-5-609(1)(a), regarding the Behavioral Health Crisis Response
2788  Committee, is repealed December 31, 2026.
2789     [(39)] (38) Subsection 26B-5-609(3)(b), regarding the Behavioral Health Crisis Response
2790  Committee, is repealed December 31, 2026.
2791     [(40)] (39) Subsection 26B-5-610(1)(b), regarding the Behavioral Health Crisis Response
2792  Committee, is repealed December 31, 2026.
2793     [(41)] (40) Subsection 26B-5-610(2)(b)(ii), regarding the Behavioral Health Crisis Response
2794  Committee, is repealed December 31, 2026.
2795     [(42)] (41) Section 26B-5-612, Integrated behavioral health care grant programs, is repealed
2796  December 31, 2025.
2797     [(43)] (42) Title 26B, Chapter 5, Part 7, Utah Behavioral Health Commission, is repealed
2798  July 1, 2029.
2799     [(44)] (43) Subsection 26B-5-704(2)(a), regarding the Behavioral Health Crisis Response
2800  Committee, is repealed December 31, 2026.
2801     [(45)] (44) Title 26B, Chapter 5, Part 8, Utah Substance Use and Mental Health Advisory
2802  Committee, is repealed January 1, 2033.
2803     [(46)] (45) Section 26B-7-119, Hepatitis C Outreach Pilot Program, is repealed July 1, 2028.
2804     [(47)] (46) Section 26B-7-122, Communication Habits to reduce Adolescent Threats Pilot
2805  Program, is repealed July 1, 2029.
2806     [(48)] (47) Section 26B-7-123, Report on CHAT campaign, is repealed July 1, 2029.
2807     [(49)] (48) Title 26B, Chapter 8, Part 5, Utah Health Data Authority, is repealed July 1,
2808  2026.
2809  Section 64. Section 63I-2-249 is amended to read:
2810  63I-2-249 (Effective 01/01/28). Repeal dates: Title 49.
2811  Reserved.
2812     [(1) Subsection 49-20-420(3), regarding a requirement to report to the Legislature, is
2813  repealed January 1, 2030.]
2814     [(2) Section 49-20-422, Coverage of pregnancy and childbirth services, including doula,
2815  direct- entry midwife, and birthing center services, is repealed July 1, 2027.]
                                                 - 83 -
 1st Sub. (Green) S.B. 300  03-04 16:57
2816  Section 65. Section 63J-1-602.2 is amended to read:
2817  63J-1-602.2 (Effective 01/01/28) (Partially Repealed 07/01/29). List of nonlapsing
2818     appropriations to programs.
2819        Appropriations made to the following programs are nonlapsing:
2820     (1) The Legislature and the Legislature's committees.
2821     (2) The State Board of Education, including all appropriations to agencies, line items, and
2822  programs under the jurisdiction of the State Board of Education, in accordance with
2823  Section 53F-9-103.
2824     (3) The Rangeland Improvement Act created in Section 4-20-101.
2825     (4) The Percent-for-Art Program created in Section 9-6-404.
2826     (5) The LeRay McAllister Working Farm and Ranch Fund Program created in Title 4,
2827  Chapter 46, Part 3, LeRay McAllister Working Farm and Ranch Fund.
2828     (6) The Utah Lake Authority created in Section 11-65-201.
2829     (7) Dedicated credits accrued to the Utah Marriage Commission as provided under
2830  Subsection 17-66-303(2)(d)(ii).
2831     (8) The Wildlife Land and Water Acquisition Program created in Section 23A-6-205.
2832     (9) Sanctions collected as dedicated credits from Medicaid providers under Subsection
2833  26B-3-108(7).
2834     (10) The primary care grant program created in Section 26B-4-310.
2835     (11) The Opiate Overdose Outreach Pilot Program created in Section 26B-4-512.
2836     (12) The Utah Health Care Workforce Financial Assistance Program created in Section
2837  26B-4-702.
2838     (13) The Rural Physician Loan Repayment Program created in Section 26B-4-703.
2839     (14) The Utah Medical Education Council for the:
2840  (a) administration of the Utah Medical Education Program created in Section [26B-4-707]
2841  26C-2-108;
2842  (b) provision of medical residency grants described in Section [26B-4-711] 26C-2-111;
2843  and
2844  (c) provision of the forensic psychiatric fellowship grant described in Section [26B-4-712]
2845  26C-2-112.
2846     (15) The Division of Services for People with Disabilities, as provided in Section 26B-6-402.
2847     (16) The Communication Habits to reduce Adolescent Threats (CHAT) Pilot Program
2848  created in Section 26B-7-122.
2849     (17) Funds that the Department of Alcoholic Beverage Services retains in accordance with
                                                - 84 -
 03-04 16:57  1st Sub. (Green) S.B. 300
2850  Subsection 32B-2-301(8)(a) or (b).
2851     (18) The General Assistance program administered by the Department of Workforce
2852  Services, as provided in Section 35A-3-401.
2853     (19) The Utah National Guard, created in Title 39A, National Guard and Militia Act.
2854     (20) The Search and Rescue Financial Assistance Program, as provided in Section
2855  53-2a-1102.
2856     (21) The Emergency Medical Services Grant Program, as provided in Section 53-2d-207.
2857     (22) The Motorcycle Rider Education Program, as provided in Section 53-3-905.
2858     (23) The Utah Board of Higher Education for teacher preparation programs, as provided in
2859  Section 53H-5-402.
2860     (24) Innovation grants under Section 53G-10-608, except as provided in Subsection
2861  53G-10-608(3).
2862     (25) The Division of Fleet Operations for the purpose of upgrading underground storage
2863  tanks under Section 63A-9-401.
2864     (26) The Division of Technology Services for technology innovation as provided under
2865  Section 63A-16-903.
2866     (27) The State Capitol Preservation Board created by Section 63O-2-201.
2867     (28) The Office of Administrative Rules for publishing, as provided in Section 63G-3-402.
2868     (29) The Colorado River Authority of Utah, created in Title 63M, Chapter 14, Colorado
2869  River Authority of Utah Act.
2870     (30) The Governor's Office of Economic Opportunity to fund the Enterprise Zone Act, as
2871  provided in Title 63N, Chapter 2, Part 2, Enterprise Zone Act.
2872     (31) The Governor's Office of Economic Opportunity's Rural Employment Expansion
2873  Program, as described in Title 63N, Chapter 4, Part 4, Rural Employment Expansion
2874  Program.
2875     (32) County correctional facility contracting program for state inmates as described in
2876  Section 64-13e-103.
2877     (33) County correctional facility reimbursement program for state probationary inmates and
2878  state parole inmates as described in Section 64-13e-104.
2879     (34) Programs for the Jordan River Recreation Area as described in Section 65A-2-8.
2880     (35) The Division of Human Resource Management user training program, as provided in
2881  Section 63A-17-106.
2882     (36) A public safety answering point's emergency telecommunications service fund, as
2883  provided in Section 69-2-301.
                                               - 85 -
 1st Sub. (Green) S.B. 300  03-04 16:57
2884     (37) The Traffic Noise Abatement Program created in Section 72-6-112.
2885     (38) The money appropriated from the Navajo Water Rights Negotiation Account to the
2886  Division of Water Rights, created in Section 73-2-1.1, for purposes of participating in a
2887  settlement of federal reserved water right claims.
2888     (39) The Judicial Council for compensation for special prosecutors, as provided in Section
2889  77-10a-19.
2890     (40) A state rehabilitative employment program, as provided in Section 78A-6-210.
2891     (41) The Utah Geological Survey, as provided in Section 79-3-401.
2892     (42) The Bonneville Shoreline Trail Program created under Section 79-5-503.
2893     (43) Adoption document access as provided in Sections 81-13-103, 81-13-504, and
2894  81-13-505.
2895     (44) Indigent defense as provided in Title 78B, Chapter 22, Part 4, Utah Indigent Defense
2896  Commission.
2897     (45) The program established by the Division of Facilities Construction and Management
2898  under Section 63A-5b-703 under which state agencies receive an appropriation and pay
2899  lease payments for the use and occupancy of buildings owned by the Division of
2900  Facilities Construction and Management.
2901     (46) The State Tax Commission for reimbursing counties for deferrals in accordance with
2902  Section 59-2-1802.5.
2903     (47) The Veterinarian Education Loan Repayment Program created in Section 4-2-902.
2904  Section 66. Section 63J-7-102 is amended to read:
2905  63J-7-102 (Effective 01/01/28). Scope and applicability of chapter.
2906     (1) Except as provided in Subsection (2), and except as otherwise provided by a statute
2907  superseding provisions of this chapter by explicit reference to this chapter, the
2908  provisions of this chapter apply to each agency and govern each grant received on or
2909  after May 5, 2008.
2910     (2) This chapter does not govern:
2911  (a) a grant deposited into a General Fund restricted account;
2912  (b) a grant deposited into a Fiduciary Fund as defined in Section 51-5-4;
2913  (c) a grant deposited into an Enterprise Fund as defined in Section 51-5-4;
2914  (d) a grant made to the state without a restriction or other designated purpose that is
2915  deposited into the General Fund as free revenue;
2916  (e) a grant made to the state that is restricted only to "education" and that is deposited
2917  into the Income Tax Fund or Uniform School Fund as free revenue;
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 03-04 16:57  1st Sub. (Green) S.B. 300
2918  (f) in-kind donations;
2919  (g) a tax, fees, penalty, fine, surcharge, money judgment, or other money due the state
2920  when required by state law or application of state law;
2921  (h) a contribution made under Title 59, Chapter 10, Part 13, Individual Income Tax
2922  Contribution Act;
2923  (i) a grant received by an agency from another agency or political subdivision;
2924  (j) a grant to the Utah Dairy Commission created in Section 4-22-103;
2925  (k) a grant to the Heber Valley Historic Railroad Authority created in Section 63H-4-102;
2926  (l) a grant to the Utah State Railroad Museum Authority created in Section 63H-5-102;
2927  (m) a grant to the Utah Housing Corporation created in Section 63H-8-201;
2928  (n) a grant to the State Fair Park Authority created in Section 11-68-201;
2929  (o) a grant to the Utah State Retirement Office created in Section 49-11-201;
2930  (p) a grant to the School and Institutional Trust Lands Administration created in Section
2931  53C-1-201;
2932  (q) a grant to the Utah Communications Authority created in Section 63H-7a-201;
2933  (r) a grant to the Medical Education Program created in Section [26B-4-707] 26C-2-108;
2934  (s) a grant to the Utah Capital Investment Corporation created in Section 63N-6-301;
2935  (t) a grant to the Utah Charter School Finance Authority created in Section 53G-5-602;
2936  (u) a grant to the State Building Ownership Authority created in Section 63B-1-304; or
2937  (v) a grant to the Military Installation Development Authority created in Section
2938  63H-1-201.
2939     (3) An agency need not seek legislative review or approval of grants under Part 2, Grant
2940  Approval Requirements, if:
2941  (a) the governor has declared a state of emergency; and
2942  (b) the grant is donated to the agency to assist victims of the state of emergency under
2943  Subsection 53-2a-204(1).
2944  Section 67. Section 64-13-30 is amended to read:
2945  64-13-30 (Effective 01/01/28). Expenses incurred by offenders -- Payment to
2946     department or county jail -- Medical care expenses and copayments.
2947     (1)(a) The department or county jail may require an inmate to make a copayment for
2948  medical and dental services provided by the department or county jail.
2949  (b) For services provided while in the custody of the department, the copayment by the
2950  inmate is $5 for primary medical care, $5 for dental care, and $2 for prescription
2951  medication.
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 1st Sub. (Green) S.B. 300  03-04 16:57
2952  (c) For services provided outside of a prison facility while in the custody of the
2953  department, the offender is responsible for 10% of the costs associated with hospital
2954  care with a cap on an inmate's share of hospital care expenses not to exceed $2,000
2955  per fiscal year.
2956     (2)(a) An inmate who has assets exceeding $200,000, as determined by the department
2957  upon entry into the department's custody, is responsible to pay the costs of all
2958  medical and dental care up to 20% of the inmate's total determined asset value.
2959  (b) After an inmate has received medical and dental care equal to 20% of the inmate's
2960  total asset value, the inmate is subject to the copayments provided in Subsection (1).
2961     (3) The department shall turn over to the Office of State Debt Collection any debt under
2962  this section that is unpaid at the time the offender is released from parole.
2963     (4) An inmate may not be denied medical treatment if the inmate is unable to pay for the
2964  treatment because of inadequate financial resources.
2965     (5) When an offender in the custody of the department receives medical care that is
2966  provided outside of a prison facility, the department shall pay the costs:
2967  (a) at the contracted rate; or
2968  (b)(i) if there is no contract between the department and a health care facility that
2969  establishes a fee schedule for medical services rendered or the individual is not an
2970  enrollee described in Subsection (6)(a), expenses shall be at the noncapitated state
2971  Medicaid rate in effect at the time the service was provided; and
2972  (ii) if there is no contract between the department and a health care provider that
2973  establishes a fee schedule for medical services rendered, expenses shall be 65% of
2974  the amount that would be paid under the [Public Employees' Benefit and
2975  Insurance Program, created in Section 49-20-103] Utah Cares Health Financing
2976  Program, created in Title 26C, Utah Cares Act.
2977     (6)(a) A jail shall ensure that each inmate is enrolled in the Utah Cares Health Financing
2978  Program if the inmate is eligible for enrollment when enrollment opens on January 1,
2979  2029.
2980  (b) Expenses described in Subsection (5) are a cost to the department only to the extent
2981  that they exceed an offender's private insurance that is in effect at the time of the
2982  service and that covers those expenses.
2983     (7)(a) The [Public Employees' Benefit and Insurance Program shall provide information
2984  to the department that enables the department to] Utah Cares Health Financing
2985  Program shall calculate the amount to be paid to a health care provider under
                                                 - 88 -
 03-04 16:57  1st Sub. (Green) S.B. 300
2986  Subsection (5)(b).
2987  (b) The department shall ensure that information provided under Subsection (7)(a) is
2988  confidential.
2989  Section 68. Section 67-19d-201.5 is amended to read:
2990  67-19d-201.5 (Effective 01/01/28). Elected Official Post-Retirement Benefits
2991     Trust Fund -- Creation -- Oversight -- Dissolution.
2992     (1) There is created the "Elected Official Post-Retirement Benefits Trust Fund."
2993     (2) The Elected Official Post-Retirement Benefits Trust Fund consists of:
2994  (a) appropriations made to the fund by the Legislature for the purpose of funding the
2995  post-retirement benefits in Section 49-20-404;
2996  (b) revenues received by the state treasurer from the investment of the Elected Official
2997  Post-Retirement Benefits Trust Fund; and
2998  (c) other revenues received from other sources.
2999     (3) The Division of Finance shall account for the receipt and expenditures of money in the
3000  Elected Official Post-Retirement Benefits Trust Fund.
3001     (4)(a) Except as provided in Subsection (4)(c), the state treasurer shall invest the Elected
3002  Official Post-Retirement Benefits Trust Fund money by following the same
3003  procedures and requirements for the investment of the State Post-Retirement Benefits
3004  Trust Fund in Part 3, Trust Fund Investments.
3005  (b)(i) The Elected Official Post-Retirement Benefits Trust Fund shall earn interest.
3006  (ii) The state treasurer shall deposit all interest or other income earned from
3007  investment of the Elected Official Post-Retirement Benefits Trust Fund back into
3008  the Elected Official Post-Retirement Benefits Trust Fund.
3009  (c) The Elected Official Post-Retirement Benefits Trust Fund is exempt from Title 51,
3010  Chapter 7, State Money Management Act.
3011     (5) The board of trustees created in Section 67-19d-202 may expend money from the
3012  Elected Official Post-Retirement Benefits Trust Fund for:
3013  (a) the employer portion of the cost of the program established in Section [49-20-404]
3014  67-19d-201.6; and
3015  (b) reasonable administrative costs that the board of trustees incurs in performing its
3016  duties as trustees of the Elected Official Post-Retirement Benefits Trust Fund.
3017     (6) The board of trustees shall ensure that:
3018  (a) money deposited into the Elected Official Post-Retirement Benefits Trust Fund is
3019  irrevocable and is expended only for the employer portion of the costs of
                                                  - 89 -
 1st Sub. (Green) S.B. 300  03-04 16:57
3020  post-retirement benefits under Section 49-20-404; and
3021  (b) creditors of the board of trustees and of employers liable for the post-retirement
3022  benefits may not seize, attach, or otherwise obtain assets of the Elected Official
3023  Post-Retirement Benefits Trust Fund.
3024     (7) When all of the liabilities for which the Elected Official Post-Retirement Benefits Trust
3025  Fund was created are paid, the Division of Finance shall transfer any assets remaining in
3026  the Elected Official Post-Retirement Benefits Trust Fund into the appropriate fund.
3027  Section 69. Section 67-19d-201.6, which is renumbered from Section 49-20-404 is renumbered
3028     and amended to read:
3029  [49-20-404] 67-19d-201.6 (Effective 01/01/28). Governors' and legislative paid-up
3030     group health coverage benefit -- Limitations -- Medicare supplemental coverage --
3031     Spouse coverage -- Limitations.
3032     (1)(a) Except as provided under Subsection (1)(b), the state shall pay the percentage of
3033  the cost of providing paid-up group health coverage under Subsection (3) for
3034  members and their surviving spouses covered under Title 49, Chapter 19, Utah
3035  Governors' and Legislators' Retirement Act, or governors and legislators, as defined
3036  in Section 49-19-102, and their surviving spouses covered under Chapter 22, New
3037  Public Employees' Tier II Contributory Retirement Act, who:
3038  (i) retire after January 1, 1998;
3039  (ii) are at least 62 but less than 65 years[ of age] old;
3040  (iii) elect to receive and apply for this benefit to the program; and
3041  (iv) are active members at the time of retirement or have continued coverage with the
3042  program until the date of eligibility for the benefit under this Subsection (1).
3043  (b) A governor or a legislator who begins service as a governor or legislator on or after
3044  January 1, 2012, and a surviving spouse of the governor or the legislator who begins
3045  service as a governor or legislator on or after January 1, 2012, is not eligible for the
3046  benefit provided under this Subsection (1).
3047     (2) The state shall pay the percentage of the cost of providing Medicare supplemental
3048  coverage under Subsection (3) for members and their surviving spouses covered under
3049  Title 49, Chapter 19, Utah Governors' and Legislators' Retirement Act who:
3050  (a) began service as a governor or legislator before July 1, 2013;
3051  (b) retire after January 1, 1998;
3052  (c) are at least 65 years[ of age] old; and
3053  (d) elect to receive and apply for this benefit to the program.
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 03-04 16:57  1st Sub. (Green) S.B. 300
3054     (3) The following percentages apply to the benefit described in Subsections (1)(a) and (2):
3055  (a) 100% if the member has accrued 10 or more years of service credit;
3056  (b) 80% if the member has accrued 8 or more years of service credit;
3057  (c) 60% if the member has accrued 6 or more years of service credit; and
3058  (d) 40% if the member has accrued 4 or more years of service credit.
3059  Section 70. Repealer.
3060  This bill repeals:
3061  Section 26B-4-701, Definitions.
3062  Section 31A-22-626, Coverage of diabetes.
3063  Section 31A-22-656, Coverage of epinephrine auto-injector.
3064  Section 49-20-101, Title.
3065  Section 49-20-102, Definitions.
3066  Section 49-20-103, Creation of insurance program.
3067  Section 49-20-104, Creation of fund.
3068  Section 49-20-105, Purpose -- Benefits are not a continuing obligation.
3069  Section 49-20-201, Program participation -- Eligibility -- Optional for certain groups.
3070  Section 49-20-202, Establishment of separate risk pools.
3071  Section 49-20-301, Payments made by employer and employee.
3072  Section 49-20-401, Program -- Powers and duties.
3073  Section 49-20-402, Reserves to be held -- Refunds.
3074  Section 49-20-403, Assistance to members in purchase of life, health, dental, and
3075     medical insurance after retirement -- Employment of personnel to administer section.
3076  Section 49-20-405, Audit required -- Report to governor and Legislature.
3077  Section 49-20-407, Insurance mandates.
3078  Section 49-20-407.1, Time to add child to plan.
3079  Section 49-20-409, Long-term disability -- Cost of health coverage benefit.
3080  Section 49-20-410, High deductible health plan -- Health savings account --
3081     Contributions.
3082  Section 49-20-413, Pilot program for on-site employee clinic.
3083  Section 49-20-414, Telemedicine services -- Reimbursement -- Reporting.
3084  Section 49-20-417, Insurance coverage for amino acid-based formula.
3085  Section 49-20-421, Prescription discount program.
3086  Section 49-20-501, Title.
3087  Section 49-20-502, Definitions.
                                                - 91 -
 1st Sub. (Green) S.B. 300  03-04 16:57
3088  Section 49-20-503, Request for proposals for pharmacy benefits manager for Public
3089     Employees' Benefit and Insurance Program.
3090  Section 53G-11-203, Health insurance mandates.
3091  Section 53H-3-505, Health insurance mandates.
3092  Section 71. Effective Date.
3093     (1) Except as provided in Subsections (2) and (3), this bill takes effect January 1, 2028.
3094     (2) The actions affecting the following sections take effect on January 1, 2027:
3095  (a) Section 26B-2-201(Effective 01/01/27);
3096  (b) Section 26B-2-206(Effective 01/01/27);
3097  (c) Section 26B-3-104.1(Effective 01/01/27); and
3098  (d) Section 26B-3-908(Effective 01/01/27).
3099     (3) The actions affecting the following sections take effect on July 1, 2027:
3100  (a) Section 26B-4-701;
3101  (b) Section 26C-1-101(Effective 07/01/27);
3102  (c) Section 26C-1-102(Effective 07/01/27);
3103  (d) Section 26C-1-103(Effective 07/01/27);
3104  (e) Section 26C-1-104(Effective 07/01/27);
3105  (f) Section 26C-2-101(Effective 07/01/27);
3106  (g) Section 26C-2-102(Effective 07/01/27);
3107  (h) Section 26C-2-103(Effective 07/01/27);
3108  (i) Section 26C-2-104(Effective 07/01/27);
3109  (j) Section 26C-2-105(Effective 07/01/27)(Repealed 07/01/27);
3110  (k) Section 26C-2-106(Effective 07/01/27);
3111  (l) Section 26C-2-107(Effective 07/01/27);
3112  (m) Section 26C-2-108(Effective 07/01/27);
3113  (n) Section 26C-2-109(Effective 07/01/27);
3114  (o) Section 26C-2-710(Effective 07/01/27);
3115  (p) Section 26C-2-111(Effective 07/01/27);
3116  (q) Section 26C-2-112(Effective 07/01/27); and
3117  (r) Section 26C-3-101(Effective 07/01/27).
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