Senate Bill No. [insert bill number] seeks to reform prior authorization laws for health care services in Montana by extending the validity of prior authorization certifications from a minimum of three months to twelve months. It allows certifications for chronic conditions to remain valid for the duration of the condition without the need for reauthorization. The bill also prohibits prior authorization for certain prescription drugs, specifically generic medications that have been consistently prescribed for six months, and ensures that dosage adjustments within FDA-approved limits do not require prior authorization. Additionally, it amends definitions related to medical necessity and mandates that health insurance issuers provide written notice of reasonable therapeutic alternatives if an adverse determination is made during the prior authorization process.

The bill introduces a new coordination section that clarifies the amendment process for existing laws related to health insurance. It specifies that if both House Bill No. 398 and the current act are passed and contain sections that amend 33-22-102, those sections will be void, and 33-22-102 must be amended according to the provisions of this bill. Furthermore, it includes a definition for "chronic condition" and establishes additional coordination instructions for amendments to sections 33-22-107 and 33-22-221, ensuring that clarity and consistency are maintained in the legislative process regarding health insurance and the management of chronic conditions.

Statutes affected:
LC Text: 33-32-102, 33-32-107, 33-32-221
SB0447_1(1): 33-32-102, 33-32-107, 33-32-221
SB0447_1(2): 33-32-102, 33-32-107, 33-32-221
SB0447_1(3): 33-32-102, 33-32-107, 33-32-221
SB0447_1(4): 33-32-102, 33-32-107, 33-32-221
SB0447_1(5): 33-32-102, 33-32-107, 33-32-221
SB0447_1: 33-32-102, 33-32-107, 33-32-221
SB0447_2(1): 33-32-102, 33-32-107, 33-32-221
SB0447_2(10): 33-32-102, 33-32-107, 33-32-221
SB0447_2(11): 33-32-102, 33-32-107, 33-32-221
SB0447_2(12): 33-32-102, 33-32-107, 33-32-221
SB0447_2(13): 33-32-102, 33-32-107, 33-32-221
SB0447_2(14): 33-32-102, 33-32-107, 33-32-221
SB0447_2(15): 33-32-102, 33-32-107, 33-32-221
SB0447_2(16): 33-32-102, 33-32-107, 33-32-221
SB0447_2(2): 33-32-102, 33-32-107, 33-32-221
SB0447_2(3): 33-32-102, 33-32-107, 33-32-221
SB0447_2(4): 33-32-102, 33-32-107, 33-32-221
SB0447_2(5): 33-32-102, 33-32-107, 33-32-221
SB0447_2(6): 33-32-102, 33-32-107, 33-32-221
SB0447_2(7): 33-32-102, 33-32-107, 33-32-221
SB0447_2(8): 33-32-102, 33-32-107, 33-32-221
SB0447_2(9): 33-32-102, 33-32-107, 33-32-221
SB0447_2: 33-32-102, 33-32-107, 33-32-221
SB0447_3(1): 33-32-102, 33-32-107, 33-32-221
SB0447_3(2): 33-32-102, 33-32-107, 33-32-221
SB0447_3(3): 33-32-102, 33-32-107, 33-32-221
SB0447_3(4): 33-32-102, 33-32-107, 33-32-221
SB0447_3(5): 33-32-102, 33-32-107, 33-32-221
SB0447_3: 33-32-102, 33-32-107, 33-32-221