UtahUtah directs PEHP to offer members a GLP-1 treatment path
Beginning with the 2026 plan year, PEHP must run the pilot within its adjusted annual budget and offer medically qualified members a choice of treatment paths.
What it does
Starting with the 2026 plan year, PEHP is directed to run a weight management pilot with surgery and an alternative GLP-1 treatment path. The program must stay within its adjusted annual budget.
The GLP-1 path must use reimbursement, with members paying 50% of costs and PEHP’s allowed pharmacy expenses capped at $300 per month. Coverage is limited to 24 months, and surgery-path participation rules also apply.
Members entering the pilot may choose surgery or the GLP-1 path once. Those who stop GLP-1 treatment within six months may participate in the surgery path. PEHP must report results each year through 2028.
Argument forMedically qualified members could choose a GLP-1 treatment path instead of surgery, and may join the surgery path if they stop GLP-1 treatment within six months.
Argument againstMembers may have to pay half of the allowed costs for GLP-1 treatment, which could make this option hard to afford.
More detail
PEHP is directed to run a weight management pilot with a surgery path and an alternative GLP-1 treatment path, beginning with the 2026 plan year. The program is for medically qualified members of the state health plan. PEHP must keep the program within its adjusted annual budget. The direction applies beginning with the 2026 plan year.
PEHP must set the GLP-1 path up for reimbursement, require 50% member cost sharing, cap its allowed pharmacy expenses at $300 per member each month, and limit coverage to 24 months. These requirements apply to medically qualified members using the GLP-1 path. The coaching and other participation requirements for the surgery path must also apply to the GLP-1 path. GLP-1 coverage is limited to 24 months.
PEHP must allow members entering the pilot to make a one-time choice between surgery and the GLP-1 path, and report program results to the Health and Human Services Interim Committee. The one-time choice applies to members who enter the pilot. A member who stops GLP-1 treatment within six months may participate in the surgery path. PEHP must report before December 1, 2026, and each year after that until 2028.
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Where it stands
- Introduced
- Passed 1st Chamber
- Passed 2nd Chamber
- To Governor
- Became Law
Looking ahead
No hearings or votes scheduled.
History
- 2026
- Mar 25Governor Spencer Cox SignedBecame Law
- Mar 17House/ to GovernorTo Governor
- Mar 17House/ received enrolled bill from PrintingMinor
- Mar 12House/ enrolled bill to Printing
- Mar 12Enrolled Bill Returned to House or SenateMinor
- Mar 7Draft of Enrolled Bill Prepared
- Mar 7Bill Received from House for EnrollingMinor
- Mar 6House/ signed by Speaker/ sent for enrollingMajor
- Vote recorded Senate/ passed 3rd reading. Result: pass.Upper
- Mar 6House/ received from SenateMinor
- Mar 6Senate/ to House
- Mar 6Senate/ signed by President/ returned to HouseMajor
- Mar 6Senate/ passed 3rd readingPassed 2nd Chamber
- Mar 6Senate/ 3rd readingMinor
- Mar 3Senate/ 2nd readingMinor
- Mar 3Senate/ comm rpt/ placed on Consent Calendar [Senate Health and Human Services Committee]
- Mar 2Senate Comm - Consent Calendar Recommendation [Senate Health and Human Services Committee]
- Mar 2Senate Comm - Favorable Recommendation [Senate Health and Human Services Committee]Minor
- Feb 25Senate/ to standing committee [Senate Health and Human Services Committee]Minor
- Feb 23Senate/ 1st reading (Introduced)Minor
- Vote recorded House/ passed 3rd reading. Result: pass.Lower
- Feb 23Senate/ received from HouseMinor
- Feb 23House/ to Senate
- Feb 23House/ passed 3rd readingPassed 1st Chamber
- Feb 23House/ substituted
- Feb 23House/ 3rd readingMinor
- Feb 21LFA/ fiscal note publicly available for HCR008S01
- Feb 21LFA/ fiscal note sent to sponsor for HCR008S01
- Feb 20LFA/ bill sent to agencies for fiscal input for HCR008S01
- Feb 20LFA/ bill assigned to staff for fiscal analysis for HCR008S01
- Feb 13House/ 2nd readingMinor
- Feb 13House/ committee report favorable [House Health and Human Services Committee]Minor
- Feb 12House Comm - Favorable Recommendation [House Health and Human Services Committee]Minor
- Feb 11House/ to standing committee [House Health and Human Services Committee]Minor
- Feb 2House/ received fiscal note from Fiscal AnalystMinor
- Jan 30LFA/ fiscal note publicly available for HCR008
- Jan 30LFA/ fiscal note sent to sponsor for HCR008
- Jan 28House/ 1st reading (Introduced)Minor
- Jan 28House/ received bill from Legislative ResearchMinor
- Jan 28LFA/ bill sent to agencies for fiscal input for HCR008
- Jan 28LFA/ bill assigned to staff for fiscal analysis for HCR008
- Jan 28Numbered Bill Publicly Distributed
- Jan 28Bill Numbered but not DistributedIntroduced
Healthcare