Many medications require prior authorization (PA) before pharmacists can provide them to their patients. Our expert team of pharmacist reviewers check medications for medical necessity and cost effectiveness before providing authorization. Providers can view a list of medications and their coverage below and contact our drug PA team for approval at 1-800-395-7961.
Montana Healthcare Programs Preferred Drug List (PDL)
Please note: Members who have started or have been established on drug therapy through samples, patient assistance or cash pay (specifically to bypass criteria or PDL placement) will not be grandfathered into that therapy. Additionally, adverse reactions do not constitute a therapeutic failure. This reason alone will not guarantee prior authorization for a non-preferred medication.
Mountain Pacific administers a prior authorization program for several physician-administered drugs (PAD) for Montana Healthcare Programs. Our clinical pharmacy team reviews a provider’s request for these complicated, often expensive treatments. Provider requests are submitted through our provider portal and routed to our pharmacy experts who review the claim to make sure it satisfies state drug utilization board requirements. Via the portal, providers can access the claim in real-time to track its progress. They also receive an email notification when a decision is made. This process ensures streamlined communication and reduces the burden on providers and their staff.
Providers can view a list of medications and their coverage below and contact our team for approval at 1-800-219-7035.
Medscape is a free membership that provides access to lots of medical resources as well as drug monographs.