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SB 447 would extend prior-authorization durations for chronic conditions; insurers caution against indefinite approvals
Summary
Senate Bill 447 defines 'chronic condition' and proposes longer prior-authorization durations (including provisions that could make approvals valid for the duration of a chronic disease); clinicians argued the change reduces redundant administrative work, while insurers warned it removes negotiated safety exceptions and could prevent necessary periodic review. Committee amended coordination language and concurred the bill to the floor after prioritizing previously negotiated House language in conflicting sections.
Sen. Vince Ricci opened the hearing on Senate Bill 447 by saying it was part of a package addressing prior authorizations; proponents told the committee the bill focuses on chronic conditions and continuity of care. Amy Grimoljez (Billings Clinic counsel) noted the bill adds a chronic-condition definition and extends certification validity “for the duration of the condition” in some sections, rather than short, repeat prior-authorizations.
Clinicians, including pediatric specialists and addiction-medicine physicians, testified repeatedly that repeated short prior-authorizations for conditions that do not change (feeding supplies for some neurologically impaired children, maintenance medications for cystic fibrosis or autoimmune disease) impose large burdens on staff and patients. “This bill does that,” testified Jean Branscum (Montana Medical Association), describing studies that show frequent prior-authorizations increase costs and disrupt care for chronic patients.
Opponents including Blue Cross Blue Shield and PBM representatives argued the bill conflicts with earlier negotiated bills (HB 398) that established compromise durations (e.g., six months or 12 months in different sections) and included patient-safety exceptions (FDA warnings, evolving standards of care). Drew Cziok said indefinite durations with no explicit safety exceptions were a nonstarter during previous negotiations and could prevent necessary reassessments when standards or patient circumstances change.
Committee staff and sponsors proposed and adopted coordination instructions to harmonize SB 447 with HB 398 and other related bills to avoid statutory conflicts. The committee concurred SB 447 with amendments prioritizing negotiated House language where sections conflict and moved the bill to the House floor.
