MT SB483

Establishes requirements for step therapy protocols (policies requiring patients to try certain prescription drugs in a specific sequence before coverage of alternative drugs), mandating they be based on clinical practice guidelines developed by multidisciplinary expert panels with conflict-of-interest safeguards

Requires insurers and utilization review organizations to grant step therapy exceptions when a patient is already stabilized on a medication, when required drugs are contraindicated or likely ineffective, or when continuing the protocol would not serve the patient's best interest based on medical necessity

Mandates insurers make step therapy exception determinations within 72 hours (24 hours for exigent circumstances), with exceptions automatically granted if no determination is made within the deadline

Requires annual certification to the Commissioner of Securities and Insurance that protocols meet statutory requirements, with any proposed changes needing commissioner approval before implementation

Adds new definitions to Montana health care law including "step therapy protocol," "clinical practice guidelines," "AB-rated generic equivalent drug," "interchangeable biological product," and "medically appropriate"