1. (1) A drug prior approval program approved or implemented by the board shall meet the following conditions:

   1. (a) except as provided in Subsection (2), a drug may not be placed on prior approval for other than medical reasons;
   2. (b) the board shall hold a public hearing at least 30 days prior to placing a drug on prior approval;
   3. (c) notwithstanding the provisions of Section 52-4-202, the board shall provide not less than 14 days' notice to the public before holding a public hearing under Subsection (1)(b);
   4. (d) the board shall consider written and oral comments submitted by interested parties prior to or during the hearing held in accordance with Subsection (1)(b);

   5. (e) the board shall provide evidence that placing a drug class on prior approval:

      1. (i) will not impede quality of recipient care; and
      2. (ii) that the drug class is subject to clinical abuse or misuse;

   6. (f) the board shall reconsider its decision to place a drug on prior approval:

      1. (i) no later than nine months after any drug class is placed on prior approval; and
      2. (ii) at a public hearing with notice as provided in Subsection (1)(b);

   7. (g) the program shall provide an approval or denial of a request for prior approval:

      1. (i) by either:

         1. (A) fax;
         2. (B) telephone; or
         3. (C) electronic transmission;
      2. (ii) at least Monday through Friday, except for state holidays; and
      3. (iii) within 24 hours after receipt of the prior approval request;

   8. (h) the program shall provide for the dispensing of at least a 72-hour supply of the drug on the prior approval program:

      1. (i) in an emergency situation; or
      2. (ii) on weekends or state holidays;
   9. (i) the program may be applied to allow acceptable medical use of a drug on prior approval for appropriate off-label indications; and

   10. (j) before placing a drug class on the prior approval program, the board shall:

       1. (i) determine that the requirements of Subsections (1)(a) through (i) have been met; and
       2. (ii) by majority vote, place the drug class on prior approval.

2. (2) The board may, only after complying with Subsections (1)(b) through (j), consider the cost:

   1. (a) of a drug when placing a drug on the prior approval program; and

   2. (b) associated with including, or excluding a drug from the prior approval process, including:

      1. (i) potential side effects associated with a drug; or
      2. (ii) potential hospitalizations or other complications that may occur as a result of a drug's inclusion on the prior approval process.

Renumbered and Amended by Chapter 306, 2023 General Session