Prior Authorization in Montana
Montana enacted HB 183 (2021) requiring step therapy exception protections. Insurers must provide exceptions when the required drug is contraindicated, has been tried, or is expected to be ineffective. Montana follows standard PA response timelines and provides external review.
Key Facts About PA in Montana
- ✓ Step therapy exception protections enacted in 2021
- ✓ External review available through the Montana Commissioner of Securities and Insurance
- ✓ PA decisions must be communicated timely
- ✓ BCBS of Montana (HCSC) is the dominant carrier
Quick Stats
- Typical Appeal Filing Window: 30 days
- External Review Available: Yes
- Major Payers: 4
Top Payers in Montana
RxCheckUp generates payer-specific Letters of Medical Necessity for each of these Montana carriers:
BCBS of MontanaPacificSourceUnitedHealthcareAllegiance