The bill aims to revise health utilization review laws in Montana by introducing several key provisions. It mandates that health insurance issuers must honor prior authorizations for at least 90 days when enrollees switch health plans, ensuring continuity of care. Additionally, it prohibits prior authorization requirements for prescriptions written at discharge from inpatient care, provided the medication cost does not exceed $5,000 per day. The bill also establishes that once prior authorization is granted for a covered service, it cannot be rescinded after the service has been provided, except in cases of fraud or nonpayment.
Furthermore, the bill outlines requirements for health insurance issuers to accept and respond to prior authorization requests electronically, using a specified standard for electronic transactions. Notably, the bill deletes references to the "SCRIPT" standard for electronic prior authorization transactions, indicating a shift in the procedural framework. The provisions of this act will apply to policies issued or renewed after its effective date, ensuring that the new regulations are implemented promptly.