- 2025
69th Legislature 2025 SB 317
- 1 - Authorized Print Version – SB 317
ENROLLED BILL
AN ACT PROHIBITING HEALTH INSURANCE ISSUERS FROM PERFORMING PRIOR AUTHORIZATION
ON PSYCHIATRIC DRUGS THAT ARE IN SHORTAGE OR DISCONTINUED; AND AMENDING SECTION 33-
32-221, MCA.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MONTANA:
Section 1. Section 33-32-221, MCA, is amended to read:
"33-32-221. (1) A health insurance issuer may not perform prior
authorization on benefits for:
(a) any generic prescription drug that is not listed within any of the schedules of controlled
substances found at 21 CFR 1308.11 through 21 CFR 1308.15 or the schedules of controlled substances found
in Title 50, chapter 32, after a covered person has been prescribed the covered drug at the same quantity
without interruption for 6 months;
(b) any prescription drug or drugs, generic or brand name, on the grounds of therapeutic
duplication for the same drug if the covered person has already been subject to prior authorization on the
grounds of therapeutic duplication for the same dosage of the prescription drug or drugs and coverage of the
prescription drug or drugs was approved;
(c) any prescription drug, generic or brand name, solely because the dosage of the medication for
the covered person has been adjusted by the prescriber of the prescription drug, as long as the dosage is
within the dosage approved by the food and drug administration or is consistent with clinical dosing for the
medication; or
(d) any prescription drug, generic or brand name, that is a long-acting injectable antipsychotic; or.
(e) any prescription drug, generic or brand name, that is designated as in shortage pursuant to
subsection (3). - 2025
69th Legislature 2025 SB 317
- 2 - Authorized Print Version – SB 317
ENROLLED BILL
(2) Any adverse determination for a prescription drug made during prior authorization by a health
insurance issuer must be made by a physician whose specialty focuses on the diagnosis and treatment of the
condition for which the prescription drug was prescribed to treat, provided that prior authorization that does not
result in an adverse determination does not require the involvement of a physician on the part of a health
insurance issuer.
(3) (a) For the purposes of subsection (1)(e), the list of prescription drugs within the therapeutic
category of psychiatry that are in shortage on April 1, July 1, October 1, or January 1 must be determined
directly from the official shortage list published by the United States food and drug administration on those
dates. The quarterly static list remains in effect until the next quarterly date.
(b) A manufacturer of a prescription drug subject to subsection (1)(e) may not engage in predatory
pricing or marketing related to any shortage described in this section. A violation of this subsection (3)(b) is
subject to enforcement and penalty under Title 30, chapter 14, part 1."
- END - I hereby certify that the within bill,
SB 317, originated in the Senate.
___________________________________________
Secretary of the Senate
___________________________________________
President of the Senate
Signed this _______________________________day
of____________________________________, 2025.
___________________________________________
Speaker of the House
Signed this _______________________________day
of____________________________________, 2025. SENATE BILL NO. 317
INTRODUCED BY D. LENZ
AN ACT PROHIBITING HEALTH INSURANCE ISSUERS FROM PERFORMING PRIOR AUTHORIZATION ON
PSYCHIATRIC DRUGS THAT ARE IN SHORTAGE OR DISCONTINUED; AND AMENDING SECTION 33-32-
221, MCA.