All Roll Calls
Yes: 553 • No: 86
MontanaHB 74069th Legislature, Regular Session (2025)HouseWALLET
Revise laws relating to pharmacies, pharmacy benefit managers, and other entities
Sponsored By: Mark Reinschmidt (Republican)
Became Law
Contracts
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Bill Overview
Analyzed Economic Effects
9 provisions identified: 7 benefits, 0 costs, 2 mixed.
Pharmacist cost talks and copay cap
Your pharmacist can explain drug costs and cheaper options. Plans and PBMs cannot punish a pharmacy for these talks or for selling a lower-cost alternative. A plan cannot require a copay higher than the amount the pharmacy billed. Pharmacists may mail or deliver prescriptions when state law allows and may join class actions. Sharing reimbursement info with you or your plan is allowed if HIPAA is followed. Any shipping fee is allowed only when state law permits.
Same rules at any in-network pharmacy
Your plan must use the same rules and costs at any in-network pharmacy, including mail and PBM-owned stores. If a mail-order drug is more than one day late or arrives unusable, you may get it filled at a local network pharmacy. If USPS does not deliver to your physical address, your plan cannot require mail order.
Clearer PBM contracts and faster access
PBMs cannot use effective-rate contracts, pay less than the contract price, or steer patients to PBM-owned pharmacies. Pharmacies get renewal offers at least every 3 years and may end a contract with 90 days' notice. PBMs must finish credentialing within 45 days and process ownership changes within 30 days after all documents are in. PSAO pharmacies can see the PSAO’s contracts and must get the BIN/PCN/group IDs. Any contract addendum takes effect only when both parties sign, and pharmacies or PSAOs can sue to enforce these protections. PBMs cannot demand extra accreditation or exclude new or moving pharmacies unless there is a fraud, waste, or abuse investigation.
Fairer drug pricing lists and updates
PBMs can use MAC pricing only for drugs with proper FDA or reference ratings that are in stock from national or regional wholesalers. Lists must remove obsolete, unavailable, or shortage drugs. MAC prices are reviewed and updated at least every 10 calendar days, and increases post as fast as decreases. Reference prices are reviewed at least every 10 business days. Pharmacies get searchable, plan-specific pricing access and the sources used to set prices.
Higher pay floor for independent pharmacies
Independent pharmacies get a payment floor. Plans and PBMs must pay at least the NADAC price plus a professional dispensing fee. If no NADAC exists, payment is 100% of WAC plus the fee. The fee is at least $15 and rises each Jan. 1 with CPI-U. These rules do not apply to reimbursements under Title 39, chapter 71.
Stops hidden PBM fees and clawbacks
PBMs and payers cannot add claim submission fees, enrollment or credentialing fees, hidden or retroactive fees, or other claim-related charges to pharmacies. They cannot cut payment later through reconciliations like GER/BER or DIR fees. Performance fees are allowed only if a pharmacy fails approved measures and may come only from the dispensing fee, not the drug cost. Reimbursements must use payment methods without processing fees, and checks must be valid for 180 days.
Stronger limits on pharmacy audits
Auditors face tight limits on clawbacks. They cannot recoup dispensing fees except for no-dispense, denied authorization, true dispensing errors, or extra fees. They cannot take money for clerical errors unless there is real financial harm. No early collections before appeals finish unless fraud is shown, no extrapolation, no timing-based recoupments, no interest, and no contingency pay for auditors. Pharmacies may use lawful purchase records from any date to prove dispensing.
Workers' comp drugs: generics and limits
For workers' compensation, insurers pay for a generic when a therapeutic equivalent is available. You may choose a brand and pay the difference; the pharmacist bills the insurer only the generic amount and must certify when a generic is unavailable. The Department sets a drug fee schedule. Pharmacists generally dispense no more than a 30-day supply at once. Insurers may allow up to 90 days from an in-state mail pharmacy and cannot require out-of-state mail service.
When these pharmacy rules apply
These pharmacy rules are in effect now. They apply to conduct on or after October 1, 2025 and end June 30, 2029.
Sponsors & Cosponsors
Sponsor
Mark Reinschmidt
Republican • House
Cosponsors
Steve Fitzpatrick
Republican • House
Roll Call Votes
House vote • 4/18/2025
Do Concur
Yes: 63 • No: 35
House vote • 4/17/2025
Do Concur
Yes: 92 • No: 7
House vote • 4/12/2025
Do Concur
Yes: 39 • No: 11
House vote • 4/10/2025
Do Concur As Amended
Yes: 27 • No: 22
House vote • 4/10/2025
AMD-HB0740.004.001 Usher D/PASS
Yes: 49 • No: 0
House vote • 3/7/2025
Do Pass
Yes: 98 • No: 1
House vote • 3/5/2025
AMD-HB0740.002.001 Bertoglio DO PASS
Yes: 88 • No: 9
House vote • 3/5/2025
Do Pass As Amended
Yes: 97 • No: 1
Actions Timeline
Chapter Number Assigned
5/8/2025HouseSigned by Governor
5/5/2025HouseTransmitted to Governor
4/28/2025HouseSigned by President
4/28/2025SenateSigned by Speaker
4/25/2025HouseRevised Fiscal Note Printed
4/22/2025HouseFiscal Note Unsigned
4/22/2025HouseReturned from Enrolling
4/21/2025HouseSent to Enrolling
4/18/2025House3rd Reading Passed as Amended by Senate
4/18/2025HouseRevised Fiscal Note Received
4/18/2025House2nd Reading Senate Amendments Concurred
4/17/2025HouseReturned to House with Amendments
4/12/2025Senate3rd Reading Concurred
4/12/2025SenateCommittee Report--Bill Concurred
4/11/2025SenateCommittee Executive Action--Bill Concurred
4/11/2025SenateHearing
4/10/2025SenateRereferred to Committee
4/10/2025Senate2nd Reading Concurred as Amended
4/10/2025Senate2nd Reading Motion to Amend Carried
4/10/2025SenateRevised Fiscal Note Requested
4/10/2025HouseCommittee Report--Bill Concurred as Amended
4/8/2025SenateCommittee Executive Action--Bill Concurred as Amended
4/8/2025SenateHearing
3/27/2025SenateFiscal Note Unsigned
3/27/2025House
Bill Text
Enrolled
4/21/2025
As Amended (Version 5)
4/10/2025
As Amended (Version 4)
4/8/2025
As Amended (Version 3)
3/5/2025
As Amended (Version 2)
3/3/2025
Introduced
2/25/2025