MontanaSB 31769th Legislature, Regular Session (2025)SenateWALLET

Prohibit health insurers from performing prior authorization on psychiatric drugs in shortage or discontinued

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Bill Overview

Analyzed Economic Effects

3 provisions identified: 3 benefits, 0 costs, 0 mixed.

No prior authorization for key psych meds

Insurers cannot require prior authorization for several psychiatric medications. This includes long-acting injectable antipsychotics and psychiatry drugs on the FDA shortage list. The shortage list is set on Jan 1, Apr 1, Jul 1, and Oct 1, and stays until the next date. No prior authorization is allowed just because your prescriber adjusts the dose within FDA-approved or clinically accepted ranges. No repeat prior authorization is allowed for the same drug and dose when a prior “therapeutic duplication” request was already approved. After you have used the same amount of a generic, non-controlled drug for six straight months, insurers cannot require prior authorization for it.

Specialist must review drug denials

If your prior authorization is denied, a physician who treats your condition must make that decision. Approvals do not need physician review.

No price gouging in drug shortages

Drug makers cannot use predatory pricing or marketing when a drug is on the shortage list. The state can enforce penalties under consumer-protection law.

Sponsors & Cosponsors

Sponsor

Dennis Lenz
Republican • Senate

Cosponsors

Kerri Seekins-Crowe
Republican • House
Wylie Galt
Republican • Senate

Roll Call Votes

All Roll Calls

Yes: 296 • No: 3

House vote • 4/11/2025

Do Concur

Yes: 98 • No: 1

House vote • 4/10/2025

Do Concur

Yes: 100 • No: 0

Senate vote • 3/5/2025

Do Pass

Yes: 49 • No: 1

Senate vote • 3/4/2025