House Bill No. [insert bill number] seeks to reform regulations governing pharmacies and pharmacy benefit managers (PBMs) in Montana by introducing new standards for fund recoupment, defining key terms, and updating provisions related to maximum allowable costs and reference pricing. The bill prohibits certain fees that PBMs and third-party payers can impose on pharmacies, such as fees for claim submissions and retroactive charges. It also establishes minimum reimbursement standards for independent pharmacies, including a professional dispensing fee that adjusts annually for inflation. Additionally, the bill prohibits effective rate contracting, ensuring that reimbursement rates are fixed rather than based on aggregated claims.

The legislation further enhances pharmacy rights by preventing discrimination against newly opened pharmacies and ensuring timely credentialing application processing. It mandates regular updates to maximum allowable cost lists and reference pricing to promote transparency. The bill also restricts PBMs from reimbursing network pharmacies below contracted prices and from pressuring patients to use affiliated pharmacies. It removes previous limitations on insurers' liabilities for generic versus brand-name drugs and specifies that the new regulations will take effect on October 1, 2025, with a termination date of June 30, 2029. Overall, the bill aims to create a fairer and more transparent framework for pharmacy operations and patient access to medications.

Statutes affected:
LC Text: 33-2-2005, 33-22-170, 33-22-171, 33-22-172, 33-22-175, 33-22-177, 39-71-727
HB0740_1(1): 33-2-2005, 33-22-170, 33-22-171, 33-22-172, 33-22-175, 33-22-177, 39-71-727
HB0740_1(2): 33-2-2005, 33-22-170, 33-22-171, 33-22-172, 33-22-175, 33-22-177, 39-71-727
HB0740_1(3): 33-2-2005, 33-22-170, 33-22-171, 33-22-172, 33-22-175, 33-22-177, 39-71-727
HB0740_1(4): 33-2-2005, 33-22-170, 33-22-171, 33-22-172, 33-22-175, 33-22-177, 39-71-727
HB0740_1(5): 33-2-2005, 33-22-170, 33-22-171, 33-22-172, 33-22-175, 33-22-177, 39-71-727
HB0740_1: 33-2-2005, 33-22-170, 33-22-171, 33-22-172, 33-22-175, 33-22-177, 39-71-727
HB0740_2(1): 33-2-2005, 33-22-170, 33-22-171, 33-22-172, 33-22-175, 33-22-177, 39-71-727
HB0740_2(2): 33-2-2005, 33-22-170, 33-22-171, 33-22-172, 33-22-175, 33-22-177, 39-71-727
HB0740_2(3): 33-2-2005, 33-22-170, 33-22-171, 33-22-172, 33-22-175, 33-22-177, 39-71-727
HB0740_2(4): 33-2-2005, 33-22-170, 33-22-171, 33-22-172, 33-22-175, 33-22-177, 39-71-727
HB0740_2(5): 33-2-2005, 33-22-170, 33-22-171, 33-22-172, 33-22-175, 33-22-177, 39-71-727
HB0740_2(6): 33-2-2005, 33-22-170, 33-22-171, 33-22-172, 33-22-175, 33-22-177, 39-71-727
HB0740_2(7): 33-2-2005, 33-22-170, 33-22-171, 33-22-172, 33-22-175, 33-22-177, 39-71-727
HB0740_2(8): 33-2-2005, 33-22-170, 33-22-171, 33-22-172, 33-22-175, 33-22-177, 39-71-727
HB0740_2(9): 33-2-2005, 33-22-170, 33-22-171, 33-22-172, 33-22-175, 33-22-177, 39-71-727
HB0740_2: 33-2-2005, 33-22-170, 33-22-171, 33-22-172, 33-22-175, 33-22-177, 39-71-727
HB0740_3(1): 33-2-2005, 33-22-170, 33-22-171, 33-22-172, 33-22-175, 33-22-177, 39-71-727
HB0740_3(10): 33-2-2005, 33-22-170, 33-22-171, 33-22-172, 33-22-175, 33-22-177, 39-71-727
HB0740_3(11): 33-2-2005, 33-22-170, 33-22-171, 33-22-172, 33-22-175, 33-22-177, 39-71-727
HB0740_3(12): 33-2-2005, 33-22-170, 33-22-171, 33-22-172, 33-22-175, 33-22-177, 39-71-727
HB0740_3(13): 33-2-2005, 33-22-170, 33-22-171, 33-22-172, 33-22-175, 33-22-177, 39-71-727
HB0740_3(14): 33-2-2005, 33-22-170, 33-22-171, 33-22-172, 33-22-175, 33-22-177, 39-71-727
HB0740_3(15): 33-2-2005, 33-22-170, 33-22-171, 33-22-172, 33-22-175, 33-22-177, 39-71-727
HB0740_3(16): 33-2-2005, 33-22-170, 33-22-171, 33-22-172, 33-22-175, 33-22-177, 39-71-727
HB0740_3(2): 33-2-2005, 33-22-170, 33-22-171, 33-22-172, 33-22-175, 33-22-177, 39-71-727
HB0740_3(3): 33-2-2005, 33-22-170, 33-22-171, 33-22-172, 33-22-175, 33-22-177, 39-71-727
HB0740_3(4): 33-2-2005, 33-22-170, 33-22-171, 33-22-172, 33-22-175, 33-22-177, 39-71-727
HB0740_3(5): 33-2-2005, 33-22-170, 33-22-171, 33-22-172, 33-22-175, 33-22-177, 39-71-727
HB0740_3(6): 33-2-2005, 33-22-170, 33-22-171, 33-22-172, 33-22-175, 33-22-177, 39-71-727
HB0740_3(7): 33-2-2005, 33-22-170, 33-22-171, 33-22-172, 33-22-175, 33-22-177, 39-71-727
HB0740_3(8): 33-2-2005, 33-22-170, 33-22-171, 33-22-172, 33-22-175, 33-22-177, 39-71-727
HB0740_3(9): 33-2-2005, 33-22-170, 33-22-171, 33-22-172, 33-22-175, 33-22-177, 39-71-727
HB0740_3: 33-2-2005, 33-22-170, 33-22-171, 33-22-172, 33-22-175, 33-22-177, 39-71-727
HB0740_4(1): 33-2-2005, 33-22-170, 33-22-171, 33-22-172, 33-22-175, 33-22-177, 39-71-727
HB0740_4(2): 33-2-2005, 33-22-170, 33-22-171, 33-22-172, 33-22-175, 33-22-177, 39-71-727
HB0740_4(3): 33-2-2005, 33-22-170, 33-22-171, 33-22-172, 33-22-175, 33-22-177, 39-71-727
HB0740_4(4): 33-2-2005, 33-22-170, 33-22-171, 33-22-172, 33-22-175, 33-22-177, 39-71-727
HB0740_4(5): 33-2-2005, 33-22-170, 33-22-171, 33-22-172, 33-22-175, 33-22-177, 39-71-727
HB0740_4: 33-2-2005, 33-22-170, 33-22-171, 33-22-172, 33-22-175, 33-22-177, 39-71-727
HB0740_5(1): 33-2-2005, 33-22-170, 33-22-171, 33-22-172, 33-22-175, 33-22-177, 39-71-727
HB0740_5: 33-2-2005, 33-22-170, 33-22-171, 33-22-172, 33-22-175, 33-22-177, 39-71-727