HB 599

Enrolled Copy  H.B. 599
1Social Services Funding Amendments
                                       2026 GENERAL SESSION
                                            STATE OF UTAH
                                 Chief Sponsor: Raymond P. Ward
                                   Senate Sponsor: Keven J. Stratton
2
3  LONG TITLE
4  General Description:
5      This bill addresses social services funding.
6  Highlighted Provisions:
7      This bill:
8      ▸ provides that interest earned on money in the Medicaid ACA Fund shall be deposited into
9  the General Fund;
10      ▸ requires immunosuppressive drugs to be added to the Medicaid preferred drug list;
11      ▸ requires the Department of Health and Human Services (department) to:
12●   transition the state's Children's Health Insurance Program from a separate program, to
13  providing benefits under the state's Medicaid program; and
14●   after the transition, to the extent possible, provide dental services to individuals
15  covered by the Children's Health Insurance Program through the University of Utah
16  School of Dentistry;
17      ▸ requires certain funds to be distributed from the Electronic Cigarette Substance and
18  Nicotine Product Proceeds Restricted Account for substance use treatment and
19  prevention services; and
20      ▸ makes technical and conforming changes.
21  Money Appropriated in this Bill:
22      This bill appropriates ($759,700) in operating and capital budgets for fiscal year 2026, all
23  of which is from the General Fund.
24      This bill appropriates ($759,700) in operating and capital budgets for fiscal year 2027, all of
25  which is from the General Fund.
26  Other Special Clauses:
27      This bill provides a special effective date.
H.B. 599  Enrolled Copy
28   Utah Code Sections Affected:
29   AMENDS:
3026B-1-315 (Effective 05/06/26) (Superseded 07/01/26), as last amended by Laws of Utah
312025, Chapter 135
3226B-1-315 (Effective 07/01/26) (Repealed 07/01/34), as last amended by Laws of Utah
332025, Chapter 285
3426B-3-105 (Effective 05/06/26), as last amended by Laws of Utah 2025, Chapter 135
3526B-3-902 (Effective 05/06/26), as renumbered and amended by Laws of Utah 2023,
36Chapter 306
3759-14-807 (Effective 05/06/26) (Partially Repealed 07/01/30), as last amended by Laws
38of Utah 2025, Chapters 173, 366
39
40   Be it enacted by the Legislature of the state of Utah:
41Section 1. Section 26B-1-315 is amended to read:
4226B-1-315 (Effective 05/06/26) (Superseded 07/01/26). Medicaid ACA Fund.
43   (1) There is created an expendable special revenue fund known as the "Medicaid ACA
44Fund."
45   (2) The fund consists of:
46(a) assessments collected under Chapter 3, Part 5, Inpatient Hospital Assessment;
47(b) intergovernmental transfers under Section 26B-3-508;
48(c) savings attributable to the health coverage improvement program, as defined in
49Section 26B-3-501, as determined by the department;
50(d) savings attributable to the enhancement waiver program, as defined in Section
5126B-3-501, as determined by the department;
52(e) savings attributable to the Medicaid waiver expansion, as defined in Section
5326B-3-501, as determined by the department;
54(f) revenues collected from the sales tax described in Subsection 59-12-103(11);
55(g) gifts, grants, donations, or any other conveyance of money that may be made to the
56fund from private sources; and
57[(h) interest earned on money in the fund; and]
58[(i)] (h) additional amounts as appropriated by the Legislature.
59   (3)(a) The fund shall earn interest.
60(b) All interest earned on fund money in a fiscal year beginning on or after July 1, 2025,
61shall be deposited into the [fund] General Fund.
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62  (4)(a) A state agency administering the provisions of Chapter 3, Part 5, Inpatient
63      Hospital Assessment, may use money from the fund to pay the costs, not otherwise
64      paid for with federal funds or other revenue sources, of:
65(i) the health coverage improvement program as defined in Section 26B-3-501;
66(ii) the enhancement waiver program as defined in Section 26B-3-501;
67(iii) a Medicaid waiver expansion as defined in Section 26B-3-501; and
68(iv) the outpatient upper payment limit supplemental payments under Section
6926B-3-511.
70      (b) A state agency administering the provisions of Chapter 3, Part 5, Inpatient Hospital
71Assessment, may not use:
72(i) funds described in Subsection (2)(b) to pay the cost of private outpatient upper
73payment limit supplemental payments; or
74(ii) money in the fund for any purpose not described in Subsection (4)(a).
75Section 2. Section 26B-1-315 is amended to read:
7626B-1-315 (Effective 07/01/26) (Repealed 07/01/34). Medicaid ACA Fund.
77  (1) There is created an expendable special revenue fund known as the "Medicaid ACA
78      Fund."
79  (2) The fund consists of:
80      (a) assessments collected under Chapter 3, Part 5, Inpatient Hospital Assessment;
81      (b) intergovernmental transfers under Section 26B-3-508;
82      (c) savings attributable to the health coverage improvement program, as defined in
83Section 26B-3-501, as determined by the department;
84      (d) savings attributable to the enhancement waiver program, as defined in Section
8526B-3-501, as determined by the department;
86      (e) savings attributable to the Medicaid waiver expansion, as defined in Section
8726B-3-501, as determined by the department;
88      (f) revenues collected from the sales tax described in Subsection 59-12-103(6);
89      (g) gifts, grants, donations, or any other conveyance of money that may be made to the
90fund from private sources; and
91      [(h) interest earned on money in the fund; and]
92      [(i)] (h) additional amounts as appropriated by the Legislature.
93  (3)(a) The fund shall earn interest.
94      (b) All interest earned on fund money in a fiscal year beginning on or after July 1, 2025,
95shall be deposited into the [fund] General Fund.
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96   (4)(a) A state agency administering the provisions of Chapter 3, Part 5, Inpatient
97Hospital Assessment, may use money from the fund to pay the costs, not otherwise
98paid for with federal funds or other revenue sources, of:
99(i) the health coverage improvement program as defined in Section 26B-3-501;
100(ii) the enhancement waiver program as defined in Section 26B-3-501;
101(iii) a Medicaid waiver expansion as defined in Section 26B-3-501; and
102(iv) the outpatient upper payment limit supplemental payments under Section
10326B-3-511.
104(b) A state agency administering the provisions of Chapter 3, Part 5, Inpatient Hospital
105Assessment, may not use:
106(i) funds described in Subsection (2)(b) to pay the cost of private outpatient upper
107payment limit supplemental payments; or
108(ii) money in the fund for any purpose not described in Subsection (4)(a).
109Section 3. Section 26B-3-105 is amended to read:
11026B-3-105 (Effective 05/06/26). Medicaid drug program -- Preferred drug list.
111   (1) As used in this section:
112(a) "Immunosuppressive drug" means a drug that:
113(i) is used in immunosuppressive therapy to inhibit or prevent activity of the immune
114system to aid the body in preventing the rejection of transplanted organs and
115tissue; and
116(ii) does not include drugs used for the treatment of autoimmune disease or diseases
117that are most likely of autoimmune origin.
118(b) "Psychotropic drug" means the following classes of drugs:
119(i) anti-depressant;
120(ii) anti-convulsant/mood stabilizer;
121(iii) anti-anxiety; and
122(iv) attention deficit hyperactivity disorder stimulant.
123(c) "Stabilized" means a health care provider has documented in the patient's medical
124chart that a patient has achieved a stable or steadfast medical state within the past 90
125days.
126   (2) A Medicaid drug program developed by the department under Subsection
12726B-3-104(2)(f):
128(a) shall, notwithstanding Subsection 26B-3-104(1)(b), be based on clinical and
129cost-related factors which include medical necessity as determined by a provider in
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130accordance with administrative rules established by the Drug Utilization Review
131Board;
132      (b) may include therapeutic categories of drugs that may be exempted from the drug
133program;
134      (c) notwithstanding Section 58-17b-606, may include placing some drugs on a preferred
135drug list:
136(i) to the extent determined appropriate by the department; and
137(ii) in the manner described in Subsection (4) for atypical anti-psychotic drugs;
138      (d) notwithstanding the requirements of Sections 26B-3-302 through 26B-3-309
139regarding the Drug Utilization Review Board, and except as provided in Subsection
140(4), shall immediately implement the prior authorization requirements for a
141nonpreferred drug that is in the same therapeutic class as a drug that is:
142(i) on the preferred drug list on the date that this act takes effect; or
143(ii) added to the preferred drug list after this act takes effect; and
144      (e) except as prohibited by Subsections 58-17b-606(4) and (5), shall establish the prior
145authorization requirements which shall permit a health care provider or the health
146care provider's agent to obtain a prior authorization override of the preferred drug list
147through the department's pharmacy prior authorization review process, and which
148shall:
149(i) provide either telephone or fax approval or denial of the request within 24 hours of
150the receipt of a request that is submitted during normal business hours of Monday
151through Friday from 8 a.m. to 5 p.m.;
152(ii) provide for the dispensing of a limited supply of a requested drug as determined
153appropriate by the department in an emergency situation, if the request for an
154override is received outside of the department's normal business hours; and
155(iii) require the health care provider to provide the department with documentation of
156the medical need for the preferred drug list override in accordance with criteria
157established by the department in consultation with the Pharmacy and Therapeutics
158Committee.
159  (3)(a)(i) [A] Except as provided in Subsection (3)(a)(ii), a preferred drug list
160      developed under the provisions of this section may not include an
161      immunosuppressive drug.
162(ii) Beginning on March 1, 2027, the department shall include immunosuppressive
163drugs on the preferred drug list.
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164[(i)] (b) The state Medicaid program shall reimburse for a prescription for an
165immunosuppressive drug as written by the health care provider for a patient who has
166undergone an organ transplant.
167[(ii)] (c) For purposes of Subsection 58-17b-606(4), and with respect to patients who
168have undergone an organ transplant, the prescription for a particular
169immunosuppressive drug as written by a health care provider meets the criteria of
170demonstrating to the department a medical necessity for dispensing the prescribed
171immunosuppressive drug.
172[(iii)] (d) Notwithstanding the requirements of Sections 26B-3-302 through 26B-3-309
173regarding the Drug Utilization Review Board, the state Medicaid drug program may
174not require the use of step therapy for immunosuppressive drugs without the written
175or oral consent of the health care provider and the patient.
176   (4)(a)(i) The department shall include atypical anti-psychotic drugs on the preferred
177drug list.
178(ii) The department shall allow a health care provider to override the preferred drug
179list for an atypical anti-psychotic drug by writing "dispense as written" on the
180prescription for the atypical anti-psychotic drug.
181(iii) A health care provider may not override Section 58-17b-606 by writing
182"dispense as written" on a prescription.
183(b) The department, and a Medicaid accountable care organization that is responsible for
184providing behavioral health, shall establish a system to:
185(i) track health care provider prescribing patterns for atypical anti-psychotic drugs;
186(ii) educate health care providers who are not complying with the preferred drug list;
187and
188(iii) implement peer to peer education for health care providers whose prescribing
189practices continue to not comply with the preferred drug list.
190   (5) For enrollees that begin a psychotropic drug treatment on or after July 1, 2025, the
191department shall pay for a psychotropic drug that is not on the preferred drug list if the
192department, based on patient claims history or health care provider attestation, has
193evidence of:
194(a) an enrollee's trial and failure of a psychotropic drug on the preferred drug list that is
195equivalent or similar to the drug that is not on the preferred drug list in the last 365
196days; or
197(b) the enrollee being stabilized on the psychotropic drug that is not on the preferred
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198drug list at the time of enrollment.
199Section 4. Section 26B-3-902 is amended to read:
20026B-3-902 (Effective 05/06/26). Creation and administration of the Utah
201  Children's Health Insurance Program.
202  (1) There is created the Utah Children's Health Insurance Program to be administered by
203      the department in accordance with the provisions of:
204      (a) this part; and
205      (b) the State Children's Health Insurance Program, 42 U.S.C. Sec. 1397aa et seq.
206  (2) The department shall:
207      (a) prepare and submit the state's children's health insurance plan before May 1, 1998,
208and any amendments to the United States Department of Health and Human Services
209in accordance with 42 U.S.C. Sec. 1397ff; and
210      (b) make rules in accordance with Title 63G, Chapter 3, Utah Administrative
211Rulemaking Act, regarding:
212(i) eligibility requirements consistent with Section 26B-3-108;
213(ii) program benefits;
214(iii) the level of coverage for each program benefit;
215(iv) cost-sharing requirements for members, which may not:
216(A) exceed the guidelines set forth in 42 U.S.C. Sec. 1397ee; or
217(B) impose deductible, copayment, or coinsurance requirements on a member for
218well-child, well-baby, and immunizations;
219(v) the administration of the program; and
220(vi) a requirement that:
221(A) members in the program shall participate in the electronic exchange of clinical
222health records established in accordance with Section 26B-8-411 unless the
223member opts out of participation;
224(B) prior to enrollment in the electronic exchange of clinical health records the
225member shall receive notice of the enrollment in the electronic exchange of
226clinical health records and the right to opt out of participation at any time; and
227(C) beginning July 1, 2012, when the program sends enrollment or renewal
228information to the member and when the member logs onto the program's
229website, the member shall receive notice of the right to opt out of the electronic
230exchange of clinical health records.
231  (3)(a) Before July 1, 2026, the department shall apply for a state plan amendment to
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232transition the state's Children's Health Insurance Program from a separate program
233under 42 U.S.C. Sec. 1397aa(a)(1), to providing benefits under the state's Medicaid
234program under 42 U.S.C. Sec. 1397aa(1)(2).
235(b) If the application described in Subsection (3)(a) is approved, and the state's
236Children's Health Insurance Program transitions as described in Subsection (3)(a), to
237the extent possible, dental services for individuals covered by the state's Children's
238Health Insurance Program shall be provided through the University of Utah School of
239Dentistry and the University of Utah School of Dentistry's associated statewide
240network.
241Section 5. Section 59-14-807 is amended to read:
24259-14-807 (Effective 05/06/26) (Partially Repealed 07/01/30). Electronic
243   Cigarette Substance and Nicotine Product Proceeds Restricted Account.
244   (1) There is created within the General Fund a restricted account known as the "Electronic
245Cigarette Substance and Nicotine Product Proceeds Restricted Account."
246   (2) The Electronic Cigarette Substance and Nicotine Product Proceeds Restricted Account
247consists of:
248(a) revenue collected from the tax imposed by Section 59-14-804;
249(b) fees and penalties collected under Section 59-14-810;
250(c) all money received by the attorney general or the Department of Commerce as a
251result of any judgment, settlement, or compromise of claims pertaining to alleged
252violations of law related to the manufacture, marketing, distribution, or sale of
253electronic cigarette products, as defined in Section 76-9-1101:
254(i) if the total amount of the judgment, settlement, or compromise received by the
255state exceeds $1,000,000; and
256(ii) after reimbursement to the attorney general and the Department of Commerce for
257expenses related to the matters described in this Subsection (2)(c); and
258(d) amounts appropriated by the Legislature.
259   (3)(a) Subject to Subsections (3)(b) and (c), for each fiscal year and subject to
260appropriation by the Legislature, the Division of Finance shall distribute from the
261Electronic Cigarette Substance and Nicotine Product Proceeds Restricted Account:
262(i) $2,000,000 to the Department of Health and Human Services for enforcement
263services aimed at disrupting organizations and networks that provide tobacco
264products, electronic cigarette products, nicotine products, or other illegal
265controlled substances to minors, which the Department of Health and Human
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266Services shall allocate to the local health departments using the formula created in
267accordance with Section 26A-1-116;
268(ii) $1,180,000 to the Department of Public Safety for law enforcement officers
269aimed at disrupting organizations and networks that provide tobacco products,
270electronic cigarette products, nicotine products, and other illegal controlled
271substances to minors;
272(iii) $1,000,000 to the Department of Health and Human Services for enforcement
273services aimed at disrupting organizations and networks that provide tobacco
274products, electronic cigarette products, nicotine products, and other illegal
275controlled substances to minors;
276(iv) $3,000,000 to the Department of Health and Human Services for community
277partner prevention programs, which the Department of Health and Human
278Services shall allocate to the local health departments using the formula created in
279accordance with Section 26A-1-116;
280(v) $1,000,000 to the Department of Health and Human Services for statewide
281cessation programs and prevention education;
282(vi) $2,000,000 to the Department of Health and Human Services for alcohol,
283tobacco, and other drug prevention, reduction, cessation, and control programs
284that promote unified messages and make use of media outlets, including radio,
285newspaper, billboards, and television; [and]
286(vii) $759,700 to the Department of Health and Human Services for the Office of
287Substance Use and Mental Health to provide substance use treatment and
288prevention services, including Medicaid matching funds for substance use
289treatment services; and
290[(vii)] (viii) $5,084,200 to the State Board of Education for school-based prevention
291programs.
292      (b) If the amount in the Electronic Cigarette Substance and Nicotine Product Proceeds
293Restricted Account is insufficient to cover the distributions described in Subsection
294(3)(a), the Division of Finance shall make the distributions under Subsection (3)(a):
295(i) sequentially in the order of priority the distributions are listed under Subsection
296(3)(a);
297(ii) in full or, if insufficient funds are available to satisfy the next distribution in the
298sequence, in part; and
299(iii) until the available funds in the Electronic Cigarette Substance and Nicotine
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300Product Proceeds Restricted Account are exhausted.
301(c) For each fiscal year and subject to appropriation by the Legislature, the Division of
302Finance shall distribute from the funds deposited under Section 59-14-810 into the
303Electronic Cigarette Substance and Nicotine Product Proceeds Restricted Account:
304(i) to the commission, in an amount equal to the amount necessary to create and
305maintain the registry described in Section 59-14-810;
306(ii) to the Department of Health and Human Services, in an amount necessary for
307completing duties described in Section 59-14-810; and
308(iii) to the Department of Health and Human Services, the remainder to be divided
309among the local health departments for inspection and enforcement described in
310Sections 26A-1-131 and 59-14-810.
311   (4)(a) The local health departments shall use the money received in accordance with
312Subsection (3)(a) for enforcing:
313(i) the regulation provisions described in Section 26B-7-505;
314(ii) the labeling requirement described in Section 26B-7-505; and
315(iii) the penalty provisions described in Section 26B-7-518.
316(b) The Department of Health and Human Services shall use the money received in
317accordance with Subsection (3)(a)(v) for the Youth Electronic Cigarette, Marijuana,
318and Other Drug Prevention Program created in Section 26B-1-428.
319(c) The local health departments shall use the money received in accordance with
320Subsection (3)(a)(iv) to issue grants under the Electronic Cigarette, Marijuana, and
321Other Drug Prevention Grant Program created in Section 26A-1-129.
322(d) The State Board of Education shall use the money received in accordance with
323Subsection (3)(a)(vii) to distribute to local education agencies to pay for:
324(i)(A) stipends for positive behaviors specialists as described in Subsection
32553G-10-407(4)(a)(i);
326(B) the cost of administering the positive behaviors plan as described in
327Subsection 53G-10-407(4)(a)(ii); and
328(C) the cost of implementing an Underage Drinking and Substance Abuse
329Prevention Program in grade 4 or 5, as described in Subsection
33053G-10-406(3)(b); or
331(ii) a comprehensive prevention plan, as that term is defined in Section 53F-2-525.
332   (5)(a) The fund shall earn interest.
333(b) All interest earned on fund money shall be deposited into the fund.
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334  (6) Subject to legislative appropriations, funds remaining in the Electronic Cigarette
335      Substance and Nicotine Product Proceeds Restricted Account after the distribution
336      described in Subsection (3) may only be used for:
337      (a) funding commission personnel to enforce compliance with the tax collection
338requirements of this part; and
339      (b) programs and activities related to the prevention and cessation of electronic cigarette,
340nicotine products, marijuana, and other drug use.
341Section 6. FY 2026 Appropriations.
342The following sums of money are appropriated for the fiscal year beginning July 1,
343  2025, and ending June 30, 2026. These are additions to amounts previously appropriated for
344  fiscal year 2026.
345Subsection 6(a). Operating and Capital Budgets
346Under the terms and conditions of Title 63J, Chapter 1, Budgetary Procedures Act, the
347  Legislature appropriates the following sums of money from the funds or accounts indicated for
348  the use and support of the government of the state of Utah.
349  ITEM 1      To Department of Health and Human Services - Integrated Health Care Services
350From General Fund, One-time  (759,700)
351Schedule of Programs:
352Non-Medicaid Behavioral Health Treatment and
353Crisis Response  (759,700)
354Section 7. FY 2027 Appropriations.
355The following sums of money are appropriated for the fiscal year beginning July 1,
356  2026, and ending June 30, 2027. These are additions to amounts previously appropriated for
357  fiscal year 2027.
358Subsection 7(a). Operating and Capital Budgets
359Under the terms and conditions of Title 63J, Chapter 1, Budgetary Procedures Act, the
360  Legislature appropriates the following sums of money from the funds or accounts indicated for
361  the use and support of the government of the state of Utah.
362  ITEM 2      To Department of Health and Human Services - Integrated Health Care Services
363From General Fund  (759,700)
364Schedule of Programs:
365Non-Medicaid Behavioral Health Treatment and
366Crisis Response  (759,700)
367Section 8. Effective Date.
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368   (1) Except as provided in Subsection (2), this bill takes effect May 6, 2026.
369   (2) The actions affecting Section 26B-1-315 (Effective 07/01/26) (Repealed 07/01/34) take
370effect on July 1, 2026.
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