Montana bill would bar retroactive denials, set standards for off‑label biologic use in minors

Representative Ed Buttrell introduced House Bill 544 in the House Business and Labor Committee, saying the bill would stop most retroactive denials by insurers and set standards for when insurers may require prior authorization for biologic therapies used in minors.

The bill disallows retroactive denials except in the case of fraud, misrepresentation, nonpayment of premium or exhaustion of benefits. It also requires that off‑label use of biologic therapies for minors be supported by medical literature in at least two peer‑reviewed journals and that insurers respond to properly documented prior‑authorization requests within the timelines already established in Title 33, chapter 32 of Montana law. Section 3 would extend similar requirements to…