The bill aims to revise prior authorization laws by prohibiting health insurance issuers from requiring prior authorization for specific categories of prescription drugs. These include oral and inhaled generic prescription drugs, inhaled prescription drugs used for treating asthma, chronic obstructive pulmonary disease, or chronic lung disease, and insulin for diabetes patients. Additionally, the bill mandates that if an insurer makes an adverse determination regarding a prescription drug, they must provide a list of reasonable therapeutic alternatives that are covered under the insurer's formulary.

To implement these changes, the bill amends Section 33-32-221 of the Montana Code Annotated (MCA). Key insertions include the prohibition of prior authorization for formulary oral or inhaled nonbiologic generic prescription drugs, formulary nonspecialty inhaled prescription drugs for specific respiratory conditions, and formulary generic or brand name insulin. The bill also stipulates that any adverse determination must be made by a physician specializing in the relevant condition and requires that a written notice of adverse determination includes a list of therapeutic alternatives.

Statutes affected:
LC Text: 33-32-221
HB0399_1(1): 33-32-221
HB0399_1(2): 33-32-221
HB0399_1(3): 33-32-221
HB0399_1(4): 33-32-221
HB0399_1(5): 33-32-221
HB0399_1(6): 33-32-221
HB0399_1: 33-32-221
HB0399_2(1): 33-32-221
HB0399_2(10): 33-32-221
HB0399_2(2): 33-32-221
HB0399_2(3): 33-32-221
HB0399_2(4): 33-32-221
HB0399_2(5): 33-32-221
HB0399_2(6): 33-32-221
HB0399_2(7): 33-32-221
HB0399_2(8): 33-32-221
HB0399_2(9): 33-32-221
HB0399_2: 33-32-221
HB0399_X(1): 33-32-221
HB0399_X(2): 33-32-221
HB0399_X(3): 33-32-221
HB0399_X(4): 33-32-221
HB0399_X(5): 33-32-221
HB0399_X: 33-32-221