House Bill No. [insert bill number] aims to revise health utilization review laws in Montana by introducing new provisions that prohibit retroactive denials of health insurance claims under specific circumstances. If prior approval for a covered service is obtained and the service is rendered, the health insurance issuer cannot rescind that approval, except in cases of fraud, misrepresentation, or other specified exceptions. Additionally, the bill allows for the prescription of biologic therapies for minors under 18, provided these therapies are FDA-approved for adults and deemed medically necessary based on peer-reviewed literature.

The bill also amends Section 2-18-704 of the Montana Code Annotated to include new provisions related to health insurance contracts, ensuring coverage for various medical needs, including well-child care and mental health services. The act is set to take effect on January 1, 2026, and will apply to health insurance policies issued or renewed on or after that date. The new sections introduced in the bill are intended to be codified as part of Title 33, chapter 32 of the Montana Code.

Statutes affected:
LC Text: 2-18-704
HB0544_1(1): 2-18-704
HB0544_1(2): 2-18-704
HB0544_1(3): 2-18-704
HB0544_1(4): 2-18-704
HB0544_1: 2-18-704