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MontanaSB 44769th Legislature, Regular Session (2025)SenateWALLET

Revise laws related to prior authorization

Sponsored By: Vince Ricci (Republican)

Signed by Governor

Health Care ServicesHealthInsurance

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Bill Overview

Analyzed Economic Effects

5 provisions identified: 3 benefits, 0 costs, 2 mixed.

Fewer drug prior authorizations and re-checks

No prior authorization is needed after six months of uninterrupted use of the same non‑controlled generic at the same amount. Dose changes within the FDA label or standard clinical dosing do not trigger a new prior authorization. Insurers cannot require prior authorization for long‑acting injectable antipsychotics. At least one child option and one adult option in these classes must be on the formulary without prior authorization: inhaled corticosteroids, short‑acting rescue inhalers, inhaled steroid + LABA combos, short‑acting insulin, and long‑acting insulin. If you already had approval for therapeutic duplication at the same dose, you cannot be forced to re‑apply. Certain formulary oral or inhaled nonbiologic generics that are not Medicare Part D specialty‑tier and not controlled substances are also exempt. Medicines for substance use disorder do not need prior authorization when the dose stays within the FDA label.

Longer prior approvals, especially for chronic care

Prior authorization approvals now last at least 12 months from when your provider gets the approval. They can end sooner only if you lose your health plan coverage. For a chronic condition, the approval lasts for the life of the condition. Insurers cannot require a new approval for the same service more than once every 12 months, and can ask for proof the condition still exists no more than once a year. A chronic condition means it lasts one year or more and needs ongoing care or limits daily activities.

Stronger rules for drug denial reviews

If your prescription prior authorization is denied, a doctor who treats your condition must make that decision. The denial notice must list reasonable covered alternatives on the plan’s formulary. Approvals that are not denials do not require a physician reviewer.

Updated definitions for prior authorization rules

The law updates key terms used in prior authorization, like adverse determination, utilization review, chronic condition, and medical necessity. Clearer definitions guide how insurers and reviewers apply the rules to your care.

Coordination with other bills on overlaps

If another new law (HB 398) also changes section 33‑22‑107, this law’s change to that section does not take effect. If another new law (HB 399) also changes section 33‑22‑221, this law’s change to that section does not take effect. This avoids conflicting wording and decides which bill controls.

Sponsors & Cosponsors

Sponsor

  • Vince Ricci

    Republican • Senate

Cosponsors

There are no cosponsors for this bill.

Roll Call Votes

All Roll Calls

Yes: 473 • No: 23

Senate vote • 4/18/2025

Do Pass

Yes: 50 • No: 0

Senate vote • 4/17/2025

Do Pass

Yes: 48 • No: 0

House vote • 4/11/2025

Do Concur

Yes: 99 • No: 0

House vote • 4/11/2025

Do Concur

Yes: 100 • No: 0

Senate vote • 3/6/2025

Do Pass

Yes: 41 • No: 8

Senate vote • 3/5/2025

AMD-SB0447.001.002 Ricci D/PASS

Yes: 50 • No: 0

Senate vote • 3/5/2025

Do Pass As Amended

Yes: 41 • No: 9

Senate vote • 3/4/2025

Take SB 447 from Comm-Ricci

Yes: 44 • No: 6

Actions Timeline

  1. Chapter Number Assigned

    5/16/2025Senate

  2. Signed by Governor

    5/13/2025Senate

  3. Transmitted to Governor

    5/5/2025Senate

  4. Signed by Speaker

    5/5/2025House

  5. Signed by President

    4/29/2025Senate

  6. Returned from Enrolling

    4/24/2025Senate

  7. Sent to Enrolling

    4/22/2025Senate

  8. 3rd Reading House Amendments

    4/18/2025Senate

  9. 2nd Reading House Amendments

    4/17/2025Senate

  10. Returned to Senate with Amendments

    4/11/2025House

  11. 3rd Reading

    4/11/2025House

  12. 2nd Reading

    4/11/2025House

  13. Committee Report

    4/9/2025House

  14. Committee Executive Action

    4/9/2025House

  15. Hearing

    4/8/2025House

  16. Fiscal Note Printed

    3/28/2025Senate

  17. Fiscal Note Unsigned

    3/27/2025Senate

  18. Fiscal Note Received

    3/26/2025Senate

  19. 1st Reading

    3/17/2025House

  20. Referred to Committee

    3/17/2025House

  21. Transmitted to House

    3/7/2025Senate

  22. 3rd Reading

    3/6/2025Senate

  23. 2nd Reading

    3/5/2025Senate

  24. 2nd Reading Motion to Amend

    3/5/2025Senate

  25. Take from Committee; Place on 2nd Reading

    3/4/2025Senate

Bill Text

  • Enrolled

    4/22/2025

    PDF

  • As Amended (Version 3)

    4/9/2025

    PDF

  • As Amended (Version 2)

    3/5/2025

    PDF

  • Introduced

    2/24/2025

    PDF

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