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Legislators hear bill to curb retroactive denials, speed approval of biologics for children
Summary
Representative Ed Buttrey told lawmakers House Bill 544 would bar retroactive denials for previously authorized care except in narrow cases and require insurers to approve off‑label biologic therapies for minors when peer‑reviewed evidence supports their use.
Representative Ed Buttrey opened the hearing on House Bill 544, which has two central components: prohibiting retroactive denials of approved services except for fraud, misrepresentation, nonpayment of premium or exhaustion of benefits; and requiring insurers to approve prior authorization requests for certain biologic therapies for minors when the off‑label use is supported by peer‑reviewed medical literature.
Medical providers and parents described the human impact of delays and denials. Julie Campbell, Montana’s only pediatric rheumatologist, said many rare pediatric autoimmune conditions lack FDA‑approved drug trials…
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