Pharmacists for Fair Reimbursement What your state's PBM laws actually mean for community pharmacies
State Tracker Updated June 15, 2026

Utah: what the PBM reimbursement law requires

Utah bars a PBM from paying a network pharmacy less than it pays an affiliate, and — as of May 2026 — adds MAC-list transparency, a 21-day MAC appeal, and a spread-pricing ban; it sets no reimbursement floor tied to drug cost.

Status Partially enacted
Law Utah Code § 31A-46-305; MAC and spread-pricing rules added by HB 527 (2026)
Effective date Affiliate parity since May 12, 2020; HB 527 effective May 6, 2026
Reimbursement basis No reimbursement floor tied to drug cost. A PBM must reimburse a network pharmacy, in aggregate, no less than it reimburses an affiliate for the same or equivalent service (anti-self-dealing parity). HB 527 (2026) adds MAC-list rules, a MAC appeals process, and a spread-pricing ban.
Professional dispensing fee Not specified in statute
Appeal route Under HB 527, appeal limited to 21 days following claim adjudication; PBM investigates and resolves within 14 business days, with correction applied to similarly situated pharmacies

Utah protects pharmacies through anti-self-dealing parity rather than a drug-cost floor. Under Utah Code § 31A-46-305, a PBM must reimburse a network pharmacy, in aggregate, no less than it pays an affiliate in the same network for the same or equivalent service.

A 2026 law (HB 527, effective May 6, 2026) adds MAC-list transparency, a 21-day MAC appeal with a 14-business-day resolution window, and a spread-pricing ban. None of these tie reimbursement to NADAC or acquisition cost, so Utah is tracked here as regulated, not floored.

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