All Roll Calls
Yes: 396 • No: 0
MontanaSB 44969th Legislature, Regular Session (2025)SenateWALLET
Generally revise health utilization review laws
Sponsored By: Vince Ricci (Republican)
Became Law
Health Care ServicesInsurance
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Bill Overview
Analyzed Economic Effects
6 provisions identified: 5 benefits, 1 costs, 0 mixed.
No take-backs after prior authorization
When prior authorization was required and obtained, the approval cannot be taken back after the covered service is given. Insurers can still rescind for fraud, misrepresentation, unpaid premiums, exhausted benefits, or no coverage at the time of service.
Fast approval for discharge prescriptions
A prescription written at hospital or observation discharge is approved right away for at least 3 days. This applies if the drug costs $5,000 or less per day and the doctor notes or tells the pharmacy it is a discharge prescription. After 3 days, normal prior authorization rules apply.
Keep prior approvals when switching plans
If you change to a new health plan, your new insurer honors your prior authorization for at least 90 days after your new coverage starts once you or your provider send proof. If you move to another product from the same insurer, it must keep any prior certification for services that the new product covers. If approval rules change after you got an authorization, your approval stays good for the rest of your plan year. During the first 90 days, the new insurer can run its own review under its plan rules.
No forced repeat step therapy
You do not have to repeat a step-therapy drug trial if you already used the required drug or a similar one and stopped it due to poor effect, a bad reaction, or a contraindication. Your prescriber must provide clinical proof and records if the plan asks.
Standard electronic prior authorization rules
Insurers must accept and answer prior authorization requests sent through a secure electronic method they support. When a drug prior authorization uses the NCPDP SCRIPT standard, the insurer must reply using the same standard. Providers do not have to submit requests electronically.
No coverage for fully excluded services
This law does not make plans cover care that your policy fully excludes. If a service is fully excluded, you may still pay out of pocket even if it is medically necessary.
Sponsors & Cosponsors
Sponsor
Vince Ricci
Republican • Senate
Cosponsors
Bob Carter
Democrat • House
Roll Call Votes
Senate vote • 4/15/2025
Do Pass
Yes: 50 • No: 0
Senate vote • 4/14/2025
Do Pass
Yes: 49 • No: 0
Senate vote • 4/11/2025
Do Concur
Yes: 99 • No: 0
Senate vote • 4/11/2025
Do Concur
Yes: 99 • No: 0
Senate vote • 3/6/2025
Do Pass
Yes: 50 • No: 0
Senate vote • 3/6/2025
Do Pass
Yes: 49 • No: 0
Actions Timeline
Chapter Number Assigned
5/13/2025SenateSigned by Governor
5/8/2025SenateTransmitted to Governor
5/1/2025SenateSigned by Speaker
5/1/2025HouseSigned by President
4/22/2025SenateReturned from Enrolling
4/16/2025SenateSent to Enrolling
4/15/2025Senate3rd Reading Passed as Amended by House
4/15/2025Senate2nd Reading House Amendments Concurred
4/14/2025SenateReturned to Senate with Amendments
4/11/2025House3rd Reading Concurred
4/11/2025House2nd Reading Concurred
4/11/2025HouseCommittee Report--Bill Concurred as Amended
4/9/2025HouseCommittee Executive Action--Bill Concurred as Amended
4/9/2025HouseHearing
4/8/2025HouseHearing
4/3/2025HouseHearing Canceled
4/3/2025HouseHearing
4/2/2025HouseHearing
3/31/2025HouseFirst Reading
3/17/2025HouseReferred to Committee
3/17/2025HouseTransmitted to House
3/7/2025Senate3rd Reading Passed
3/6/2025Senate2nd Reading Passed
3/6/2025SenateCommittee Report--Bill Passed
3/1/2025Senate
Bill Text
Enrolled
4/15/2025
As Amended (Version 2)
4/9/2025
Introduced
2/24/2025