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.