Pharmacists for Fair Reimbursement What your state's PBM laws actually mean for community pharmacies
State Tracker Updated June 15, 2026

Montana: what the PBM reimbursement law requires

Montana requires PBMs and payers to reimburse independent pharmacies at no less than the national average drug acquisition cost (NADAC) plus a professional dispensing fee of at least $15 (adjusted annually for inflation), for claims billed on or after October 1, 2025. The law applies to independent pharmacies and sunsets June 30, 2029.

Status Enacted
Law House Bill 740 (2025), Ch. 474 — MCA § 33-22-172(5)
Effective date Applies to conduct on or after October 1, 2025 (sunsets June 30, 2029)
Reimbursement basis No less than NADAC (the price in effect the day the claim was billed) plus a professional dispensing fee; if no NADAC is published, 100% of WAC plus the fee
Professional dispensing fee Statutory minimum $15, increased each January for inflation (CPI-U)
Appeal route No fixed appeal-filing window; MAC and reference-price lists must be updated at least every 10 days, and the law carries a private right of action to enforce it

Montana is part of the wave of states that moved from regulating MAC lists to setting an explicit reimbursement floor. Under HB 740 (2025), a plan sponsor, PBM, or third-party payer must reimburse independent pharmacies at no less than NADAC plus a professional dispensing fee, with the NADAC price being the one in effect on the day the claim was billed.

What the statute actually says — and what the summaries get wrong

The enrolled bill sets the floor at “not less than the national average drug acquisition cost” — that is, 100% of NADAC — plus a dispensing fee with a statutory minimum of $15, increased annually for inflation.

This is a case where widely-circulated summaries disagree with the law. Several secondary sources report Montana’s floor as “106% of NADAC” and the fee as “$12–$18.” Neither figure appears in the enrolled bill: the operative text is “not less than NADAC” (100%) and a flat $15 minimum fee. The 106% and $12–$18 figures appear to come from an earlier draft or from Montana’s separate Medicaid program. Where this site differs from a secondary summary, the enrolled statute is the source we follow.

Scope and enforcement

The floor applies to independent pharmacies — the law excludes pharmacies owned by a chain of more than 10 locations, a PBM, or a publicly traded company — and excludes workers’-compensation reimbursement. There is no Arkansas-style fixed appeal window; instead, price lists must be updated at least every 10 days, and the law provides a private right of action to enforce it.

Sources

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