Montana legislates 12-month approval for chronic condition healthcare services

The Montana Legislature has introduced House Bill 398, aimed at reforming the prior authorization process for health care services. Introduced on February 27, 2025, the bill seeks to streamline the approval process for medical treatments, particularly for chronic conditions, by extending the validity of certifications issued by utilization review organizations.

Key provisions of the bill include a mandate that certifications for health care services must remain valid for at least six months, with a specific extension to twelve months for chronic condition treatments. This change is designed to reduce the administrative burden on both health care providers and patients, ensuring that individuals do not have to repeatedly seek approval for ongoing treatments unless safety concerns arise.

The bill has sparked notable discussions among lawmakers and health care advocates. Proponents argue that the extended certification periods will enhance patient care by allowing for more consistent treatment without the interruptions caused by frequent reauthorizations. Critics, however, express concerns about potential risks associated with longer approval times, suggesting that it may lead to inadequate oversight of treatment appropriateness.

The implications of House Bill 398 are significant, as it addresses ongoing frustrations within the health care system regarding prior authorization delays, which can hinder timely access to necessary medical care. If passed, the bill could lead to improved health outcomes for patients with chronic conditions and reduce administrative costs for health care providers.

The bill is set to take effect on January 1, 2026, pending further legislative approval. As discussions continue, stakeholders from various sectors are closely monitoring the bill's progress, recognizing its potential to reshape health care delivery in Montana.