MontanaHealth plans would not require failed drug trials before cancer coverage
If enacted, Montana health plans covering advanced metastatic cancer could not require patients to fail another drug before receiving certain approved treatments.
What it does
People with advanced metastatic cancer could receive coverage for certain approved drugs without first trying another drug, if medical and research standards are met.
The proposed cancer-drug coverage rule would also be listed among the insurance requirements for health maintenance organizations and certain self-funded employer plans.
Argument forPatients may avoid delays in getting evidence-backed cancer drugs because plans could not require a failed trial of another drug first.
Argument againstInsurers may face higher drug costs because they could have less ability to require another treatment before covering an approved cancer drug.
More detail
Insurers would not be allowed to require an insured person to try and fail another drug before covering certain cancer drugs. This would cover insurers selling group or individual health plans in Montana that provide coverage for advanced metastatic cancer or related conditions. The drug must be approved by the U.S. Food and Drug Administration. The drug's use must follow cancer-treatment best practices and be supported by peer-reviewed, evidence-based research. A related condition must involve cancer symptoms or treatment side effects that a health care practitioner believes could further harm the patient if untreated. The restriction would apply before the health plan provides coverage for the qualifying prescription drug.
Health maintenance organizations and certain self-funded employer health arrangements would be subject to the proposed cancer-coverage section under their listed insurance rules. The provision lists Montana-authorized health maintenance organizations and self-funded multiple-employer welfare arrangements with an unrevoked certificate of authority. The arrangements would remain subject to the other limits and exceptions in their governing chapters. The self-funded arrangements must have a certificate of authority that has not been revoked.
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Where it stands
- Introduced
- Passed Senate
- Passed House
- To Governor
- Became Law
Looking ahead
No hearings or votes scheduled.
History
- 2025
- Jul 14(S) Veto OverrideLatest
- Jul 2(S) Veto Override Vote in Progress
- Jun 9(S) Vetoed by Governor Greg GianforteMajor
- Jun 3(S) Transmitted to GovernorTo Governor
- Jun 2(H) Signed by SpeakerPassed House
- Apr 29(S) Signed by PresidentPassed Senate
- Apr 20(S) Returned from Enrolling
- Apr 18(S) Sent to Enrolling
- Apr 17(S) 3rd Reading House Amendments
- Vote recorded Do Pass. Result: pass.Upper
- Apr 17(S) Scheduled for 3rd ReadingMinor
- Apr 16(S) Revised Fiscal Note Printed
- Vote recorded Do Pass. Result: pass.Upper
- Apr 16(S) 2nd Reading House AmendmentsMinor
- Apr 16(S) Scheduled for 2nd ReadingMinor
- Apr 16(S) Fiscal Note Unsigned
- Apr 16(S) Revised Fiscal Note ReceivedMinor
- Apr 12(H) Returned to Senate with Amendments
- Apr 12(H) 3rd Reading
- Apr 11(H) Scheduled for 3rd ReadingMinor
- Vote recorded Do Concur. Result: pass.Lower
- Vote recorded Do Concur. Result: pass.Lower
- Apr 11(H) 2nd ReadingMinor
- Apr 11(H) Scheduled for 2nd ReadingMinor
- Apr 11(H) Committee Report - (H) Appropriations
- Apr 10(S) Revised Fiscal Note Requested
- Vote recorded be_concurred_in. Result: pass.Lower
- Apr 10(H) Committee Executive Action - (H) Appropriations
- Apr 10(H) Hearing - (H) Appropriations
- Apr 10(H) Rereferred to Committee - (H) AppropriationsMinor
- Apr 9(H) Committee Report - (H) Business and Labor
- Vote recorded be_concurred_in_as_amended. Result: pass.Lower
- Apr 9(H) Committee Executive Action - (H) Business and Labor
- Mar 28(S) Revised Fiscal Note Printed
- Mar 27(S) Fiscal Note Unsigned
- Mar 26(S) Revised Fiscal Note ReceivedMinor
- Mar 21(H) Hearing - (H) Business and Labor
- Mar 13(H) Hearing - (H) Business and Labor
- Mar 6(H) 1st Reading
- Mar 5(H) Referred to Committee - (H) Business and LaborMinor
- Vote recorded Do Pass. Result: pass.Upper
- Mar 5(S) Transmitted to House
- Mar 5(S) 3rd Reading
- Mar 4(S) 2nd ReadingMinor
- Vote recorded Do Pass As Amended. Result: pass.Upper
- Vote recorded AMD-SB0422.001.002 Usher D/PASS. Result: pass.Upper
- Mar 4(S) 2nd Reading Motion to AmendMinor
- Mar 4(S) Fiscal Note Printed
- Mar 4(S) Fiscal Note Unsigned
- Mar 4(S) Fiscal Note ReceivedMinor
- Mar 3(S) Reconsidered Previous Action
- Vote recorded ReconsAction -Usher. Result: pass.Upper
- Vote recorded Do Pass. Result: pass.Upper
- Mar 3(S) 2nd ReadingMinor
- Mar 1(S) Take from Committee; Place on 2nd Reading - (S) Business, Labor and Economic AffairsMinor
- Vote recorded to_table. Result: pass.Upper
- Mar 1(S) Tabled in Committee - (S) Business, Labor and Economic AffairsMinor
- Feb 25(S) Hearing - (S) Business, Labor and Economic Affairs
- Feb 24(S) Fiscal Note Requested
- Feb 24(S) Referred to Committee - (S) Business, Labor and Economic AffairsMinor
- Feb 24(S) 1st Reading
- Feb 21(S) Introduced
- Feb 21(LC) Draft Delivered to Requester
- Feb 18(LC) Draft Ready for Delivery
- Feb 18(LC) Draft in Assembly
- Feb 18(LC) Draft in Final Drafter Review
- Feb 17(LC) Draft in Input/Proofing
- Feb 11(LC) Draft in Edit
- Feb 11(LC) Draft in Legal Review
- 2024
- Nov 23(LC) Drafter AssignedIntroduced
HealthcareMental HealthEmergency Management