Bill > SB447

This bill revises Montana's laws related to prior authorization in health insurance, making several key changes to improve patient access to healthcare services. The bill extends the length of prior authorization certifications from 3 to 12 months and introduces a special provision for chronic conditions, allowing prior authorization to remain valid for the entire duration of the condition, with only minimal documentation required annually. The legislation prohibits prior authorization for various prescription drugs, including generic drugs that have been consistently prescribed for 6 months, long-acting injectable antipsychotics, drugs for substance use disorder treatment, and specific therapeutic classes like insulin and corticosteroids. Additionally, the bill requires health insurance issuers to provide written notices with alternative treatment options if they make an adverse determination for a prescription drug during prior authorization. The bill also updates definitions related to medical necessity and chronic conditions, expanding the understanding of what constitutes medically necessary care to include minimizing symptom progression and considering the broader impact of health conditions. These changes aim to reduce administrative barriers to healthcare and provide more consistent, patient-centered care.

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https://bills.legmt.gov/#/laws/bill/2/LC3199