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MontanaHB 39969th Legislature, Regular Session (2025)HouseWALLET

Revise prior authorization laws

Sponsored By: Jonathan Karlen (Democrat)

Signed by Governor

Health Care ServicesInsurance

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Bill Overview

Analyzed Economic Effects

2 provisions identified: 2 benefits, 0 costs, 0 mixed.

Fewer prior authorizations for common medicines

The law prohibits prior authorization for several drugs and situations. No prior authorization applies to formulary insulin for people with diabetes and to long-acting injectable antipsychotics. Insurers cannot require it for formulary nonspecialty inhaled drugs for asthma, COPD, or chronic lung disease. They also cannot require it for formulary oral or inhaled nonbiologic generics that are not Medicare Part D specialty drugs and are not controlled substances. After you have taken the same generic (not a controlled substance) at the same quantity for 6 months without a break, prior authorization no longer applies. Prior authorization cannot be triggered only because your prescriber adjusts the dose within FDA or clinical ranges, or to re-check “therapeutic duplication” after the same dosage was already approved.

Fairer drug denial reviews and notices

If an insurer denies a drug during prior authorization, a physician who treats that condition must make the denial. The insurer must send a written denial that lists reasonable, covered alternatives on the plan’s formulary. Approvals do not need a specialist’s sign-off.

Sponsors & Cosponsors

Sponsor

  • Jonathan Karlen

    Democrat • House

Cosponsors

  • Willis Curdy

    Democrat • Senate

Roll Call Votes

All Roll Calls

Yes: 259 • No: 38

Senate vote • 4/3/2025

Do Concur

Yes: 38 • No: 12

Senate vote • 4/2/2025

Do Concur

Yes: 43 • No: 7

House vote • 3/4/2025

Do Pass

Yes: 86 • No: 13

House vote • 3/3/2025

Do Pass

Yes: 92 • No: 6

Actions Timeline

  1. Chapter Number Assigned

    4/17/2025House

  2. Signed by Governor

    4/16/2025House

  3. Transmitted to Governor

    4/9/2025House

  4. Signed by President

    4/9/2025Senate

  5. Signed by Speaker

    4/7/2025House

  6. Returned from Enrolling

    4/4/2025House

  7. Sent to Enrolling

    4/3/2025House

  8. 3rd Reading

    4/3/2025Senate

  9. 2nd Reading

    4/2/2025Senate

  10. Committee Report

    3/24/2025Senate

  11. Committee Executive Action

    3/24/2025Senate

  12. Hearing

    3/19/2025Senate

  13. Referred to Committee

    3/5/2025Senate

  14. Transmitted to Senate

    3/4/2025House

  15. 3rd Reading

    3/4/2025House

  16. 2nd Reading

    3/3/2025House

  17. Committee Report

    2/27/2025House

  18. Committee Executive Action

    2/27/2025House

  19. Fiscal Note Printed

    2/27/2025House

  20. Fiscal Note Signed

    2/26/2025House

  21. Fiscal Note Received

    2/26/2025House

  22. Hearing

    2/20/2025House

  23. Fiscal Note Requested

    2/19/2025House

  24. Rereferred to Committee

    2/10/2025House

  25. Hearing Canceled

    2/7/2025House

Bill Text

  • Enrolled

    4/15/2025

    PDF

  • As Amended (Version 2)

    2/27/2025

    PDF

  • Introduced

    2/5/2025

    PDF

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