Montanans could face fewer hurdles getting their insurance to cover medications and treatments.
Prior authorization is when an insurance company makes a doctor justify why a patient needs a certain medication or treatment. Providers and patients argue the practice is overused and delays or blocks life-saving care.
Meghan Zawacki works in addiction medicine at St. Peter’s Health in Helena. She told lawmakers one of her patients must get prior authorization every year for medications that have helped her stay sober for a decade.
“She has to ration her medications, which puts her at risk. The insurance company asks that she try and fail other medications. With addiction, that would mean a relapse and a potential death," Zawacki said.
One bill would prohibit insurance companies from asking doctors to repeatedly justify treatments for patients with chronic illnesses like addiction. Three other bills would limit insurance companies’ use of prior authorization for psychiatric meds that are in short supply. That would also apply to generic medications, including insulin and asthma inhalers.
Insurance companies and pharmacy benefit managers opposed the bills, saying prior authorization saves patients money and keeps overall health care costs down.
All four bills are moving through the Legislature with bipartisan support.
