In Review: There are currently 10 active prior authorization bills progressing through the Montana legislature. Among them, HB 398 and HB 399 are central to ongoing discussions. HB 399, which reflects a negotiated compromise between the Montana Medical Association (MMA) and health plans, was heard on March 21. While PCMA has flagged a minor clarification issue, at the request of the health plans and the Commissioner of Securities and Insurance (CSI), the bill is not being actively opposed. Both HB 398 and HB 399 are strategically pivotal, as plans and CSI believe that their passage could block additional prior authorization-related bills from advancing further. Additionally, HB 544 (Prior Authorization Retroactive Denials) also received a hearing on March 21 before the Senate Business, Labor, and Economic Affairs Committee.

Separately, HB 740 (omnibus), a high-priority bill, aims to broadly revise laws with direct consequences for ERISA-governed health plans. The bill proposes amending pharmacy audits, dispensing fees, clawback prohibitions, NADAC-based pricing, mail order restrictions, and generic substitution mandates. HB 740 is scheduled for a Senate Judiciary Committee hearing on April 1 and is currently facing strong opposition from a wide coalition of stakeholders, including the Chamber of Commerce, the Frontier Institute, organized labor, and the health plans.

Up Next: Several hearings are scheduled, including SB 422 (Prior Authorization Metastatic Cancer) and SB 317 (Prior Authorization Psychiatric) are scheduled for a hearing in House Business and Labor; SBHB 398 is scheduled for a Senate Business and Labor committee hearing on March 26 and HB 740 is scheduled for a hearing in the Senate Judiciary Committee on April 1.

If you have any questions, please contact Tonia Sorrell-Neal at tsorrell-neal@pcmanet.org.