State Overview: Montana

State law or statute prohibits or limits the use of prior authorization for buprenorphine containing products by either the state Medicaid plan or private insurance companies.

Health plans may not impose prior authorization on "an oral therapy prescription used to treat opioid use disorder." Mont. Code Ann. §33-32-215(8)

Montana credentials one type of addiction counselor. A Licensed Addiction Counselor requires, at minimum, an associate degree, 300 hours of relevant education courses and 1,000 hours of supervised practice. Mont. Admin. Rules § 24.219.9 and Montana Board of Behavioral Health

Licensed clinical professional counselors conduct assessments and diagnoses for the purpose of establishing treatment goals and objectives. They may also plan, implement, and evaluate treatment plans that use treatment interventions to facilitate human development and to identify and remediate mental, emotional, or behavioral disorders and associated distresses that interfere with mental health. Mont. Admin. Rules § 24.219.1002

The certification requirements for behavioral health peer support specialists were recently proposed by the state's Board of Behavioral Health. The proposed certification standards include minimum qualifications, training, continuing education, and employment requirements. Mont. Admin. Rules § 24.219.50

Full independent practice and prescriptive authority.

Advanced practice registered nursing practice, including NMs, is an independent and/or collaborative practice and may include establishing medical and nursing diagnoses, treating, and managing patients with acute and chronic illnesses and diseases as well as providing initial, ongoing and comprehensive care. Mont. Admin. Rules §24.159.1406

Drugs, devices and Schedules III-V controlled substances may be prescribed. Schedule II controlled substances may be phoned into a pharmacist in an emergency situation. Mont. Admin. Rules §24-159-1464

Full independent practice and prescriptive authority.

NP practice means the independent and/or collaborative management of primary and/or acute health care of individuals, families and communities across settings. Mont. Admin. Rules §24.159.1470

Drugs, devices and Schedules III-V controlled substances may be prescribed. Schedule II controlled substances may be phoned into a pharmacist in an emergency situation. Mont. Admin. Rules §24-159.1463 and Mont. Admin. Rules §24-159-1464

NPs are authorized to sign POLST forms. Mont. Admin. Code §37.10.101

NPs are recognized in state policy as primary care providers. NP practice means the independent and/or collaborative management of primary and/or acute health care of individuals, families and communities across settings. The NP is certified in acute or primary care and in the population focus of adult/geriatric, pediatric, neonatal, family/individual health across the life span, women's/gender-related, and/or psychiatric/mental health. Mont. Admin. Rules §24.159.1470

Optometrists may only perform procedures related to foreign body removal and the examination, evaluation, diagnosis and treatment of the human eye. Additional allowable procedures may be authorized by statute and/or rule. Mont. Code Ann. §37-10-101 and Mont. Admin. Rules §24.168.421

Optometrists may administer all pharmaceutical agents for the diagnosis and treatment of eye diseases, including epinephrine auto-injections to counter anaphylaxis. Mont. Code Ann. §37-10-101

Optometrists may prescribe Schedule III-V controlled substances and also Schedule II hydrocodone or hydrocodone combination medications. Mont. Code Ann. §37-10-101 and Mont. Code Ann. §37-10-304

A dental hygienist may obtain a limited access permit under public health supervision in a variety of settings. The dental hygienist may provide services without the authorization of a dentist provided they follow protocols established by the board and refers any patients needing further dental treatment and must meet experience requirements. Mont. Code Ann. §37-4-405

Dental health aide therapists assist with dental education and primary or preventive dental care in a practice setting operated by the Indian health service or a tribal health program. Mont. Code Ann. §53-6-101

Montana allows for private payer reimbursement of dental services provided through telehealth. Mont. Code Ann. §33-22-138 and Mont. Code Ann. §37-4

Montana has not enacted legislation allowing pharmacists to administer the COVID-19 vaccine. However, the federal PREP Act allowed pharmacists to administer the COVID-19 vaccine through the duration of the public health emergency.

Montana does not allow pharmacists to modify prescriptions.

Montana does not allow pharmacists to prescribe hormonal contraceptives.

Montana does not allow pharmacists to prescribe tobacco cessation aids.

Supervision or collaboration not required for practice or prescriptive authority.

A PA with fewer than 8,000 hours of post graduate clinical experience shall practice medicine with a collaborative agreement between the PA and one or more collaborating providers who may be a licensed physician; or licensed PA with more than 8,000 hours of postgraduate clinical experience. A licensed PA actively practicing for 8,000 is exempt from the collaborative agreement. The PA shall continue to collaborate and consult with other members of the healthcare team as appropriate. Mont. Code Ann. §37-20-203

A PA may prescribe, dispense and administer drugs. The prescribing and dispensing authority may include the following: Prescribing, dispensing and administration of Schedule III drugs, Schedule IV and Schedule V drugs. Schedule II may be authorized for limited periods not to exceed 34 days. Mont. Code Ann. §37-20-404

Supervision is no longer required for physician assistants with 8,000 or more hours of clinical practice. Statute does not address how many PAs a physician may enter into a collaborative practice agreement with. Mont. Code Ann. §37-20-301

Chart co-signatures may be determined at the practice level.

A physician assistant with less than 8,000 hours of clinical experience shall have a collaborative agreement which describes how collaboration will occur and describe methods for evaluating the physician assistant's competency, knowledge and skills. After 8,000 hours the PA will be exempt from the collaborative agreement requirement. Mont. Code Ann. §37-20-203

Statute allows adaptable proximity. Mont. Code Ann. §37-20-403(2)

A physician assistant with less than 8,000 hours of clinical experience shall have a collaborative agreement which describes how collaboration will occur and describe methods for evaluating the physician assistant's competency, knowledge and skills. After 8,000 hours the PA will be exempt from the collaborative agreement requirement. Mont. Code Ann. §37-20-203