Administrative Rules of Montana
Department 24 - LABOR AND INDUSTRY
Chapter 24.29 - WORKERS' COMPENSATION AND OCCUPATIONAL DISEASE
Subchapter 24.29.16 - Utilization and Treatment Guidelines
Rule 24.29.1607 - APPLICABILITY OF FORMULARY RULES TO OUT-PATIENT SERVICES

Universal Citation: MT Admin Rules 24.29.1607

Current through Register Vol. 18, September 20, 2024

(1) The provisions of these formulary rules apply to all claims arising on or after April 1, 2019, but only with respect to outpatient services.

(2) For claims arising before April 1, 2019, which are referred to as "legacy claims," the rules in this subchapter will apply to prescriptions written on or after April 1, 2020, or 90 days after the insurer gives notice as provided in ARM 24.29.1631, whichever is later.

(3) The provisions of [this subchapter], including the formulary adopted and automatically updated as provided in ARM 24.29.1616 apply as they are in effect on the date the prescription is written.

(4) Nothing in this subchapter excuses an insurer from providing medications that constitute primary medical services required to be furnished by 39-71-704, MCA.

(5) Nothing in this subchapter requires an insurer to use the services of a PBM.

AUTH: 39-71-203, 39-71-704, MCA; IMP: 39-71-704, MCA

Disclaimer: These regulations may not be the most recent version. Montana may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.