Revise provider rate laws for physical therapists, speech-language pathologists, and occupational therapists
HB 585 would have revised Montana's Medicaid reimbursement rates for physical therapists, speech-language pathologists, and occupational therapists. It set a 2026 Medicaid payment rate of $39.56 per service unit and required annual rate increases tied to the medical care component of the U.S. Consumer Price Index. This directly affected these healthcare providers who bill Medicaid for services, ensuring their payments adjusted with inflation. The bill was introduced in 2025 but was vetoed by the governor and later failed to override in the legislature.
This bill updates the Medicaid reimbursement formula for physical therapists, speech-language pathologists, and occupational therapists in Montana. The primary change is a clarification in the conversion factor adjustment rule, ensuring that future rate increases must match the Consumer Price Index for medical care to maintain consistent funding levels. Additionally, the bill reorganizes the bill's internal structure and renumbers the definitions section to improve clarity and codification.
Scope change
The scope of the bill remains focused on Medicaid reimbursement for the same three therapy disciplines, but the mechanism for calculating future payment increases has been clarified to prevent administrative discretion from altering the intended funding growth.
FISCAL
The rule for adjusting the Medicaid conversion factor in future years was modified to explicitly require that increases match the Consumer Price Index for medical care, removing ambiguity about how the Department may adjust rates.
TECHNICAL
The bill's title and introductory text were renumbered and reorganized to align with standard legislative formatting and codification requirements.
DEFINITION
The definitions section was renumbered and restructured to ensure proper integration into the state code, though the actual definitions of terms like 'Department' and 'Medicaid' remain unchanged.
HB0585_2(16).pdf→HB0585_X(17).pdf·1 edit
MINOR
The bill was transitioned from a draft version to an enrolled, final version ready for signing. The substantive policy content regarding Medicaid reimbursement rates and definitions remains identical, though the text was reorganized to match standard legislative formatting.
Scope change
No change in scope or applicability; the bill affects the same healthcare providers and services as before.
TECHNICAL
The bill text was renumbered and restructured to conform to the official enrolled format, removing draft markers and adding certification signatures.
HB0585_2(15).pdf→HB0585_X(16).pdf·3 edits
MINOR
The bill was finalized and enrolled for signature, moving it from a draft version to an official legislative document. The core policy content regarding Medicaid reimbursement rates for therapists remains unchanged, but the text was reorganized to align with standard enrolled bill formatting.
Scope change
The bill's scope and applicability remain unchanged; it continues to define Medicaid reimbursement rates for physical therapists, speech-language pathologists, and occupational therapists in Montana.
TECHNICAL
Added certification signatures and official enrollment markings indicating the bill has passed both the House and Senate and is ready for the Governor's signature.
Reformatted the header and title to match the standard 'Enrolled Bill' style, removing draft identifiers like 'HB0585.2' and replacing them with the final 'HB 585' designation.
Removed draft-specific line numbers and internal markup symbols used during the legislative drafting process.
HB0585_X(15).pdf→HB0585_2(15).pdf·3 edits
MINOR
This bill updates the Medicaid reimbursement rules for physical, speech-language, and occupational therapists in Montana. It sets a specific dollar amount for 2026 and changes how future payment increases are calculated to match medical inflation rather than allowing department discretion. The bill also renumbers and reorganizes the definitions section to clarify how these terms apply to the law.
Scope change
The scope of the bill remains focused on Medicaid reimbursement for the same three types of therapists, but the mechanism for determining payment amounts has shifted from discretionary departmental adjustment to a mandatory formula based on consumer price index data.
FISCAL
The method for adjusting reimbursement rates in future years was changed from a discretionary department decision to a mandatory increase based on the Consumer Price Index for medical care.
TIMELINE
The specific reimbursement conversion factor for state fiscal year 2026 was established at $39.56.
TECHNICAL
The bill text was renumbered and reorganized, shifting the definitions section to follow the reimbursement calculation rules and updating internal section references.
HB0585_X(4).pdf→HB0585_X(5).pdf·2 edits
MINOR
The bill text was cleaned up by removing unnecessary quotation marks and extra blank lines, while the effective date for the new rules remains July 1, 2025. These are purely technical formatting adjustments that do not alter the bill's legal meaning or policy impact.
TECHNICAL
Removed stray quotation marks and extra blank lines from the bill header and footer.
Adjusted the effective date line to remove a period, ensuring consistent formatting.
HB0585_1(8).pdf→HB0585_X(3).pdf·1 edit
MINOR
The bill text was updated from a draft version to the final enrolled version, incorporating minor formatting adjustments and adding standard certification signatures required for legislative passage. No substantive policy changes, funding amounts, or effective dates were altered.
TECHNICAL
The bill header was updated to reflect the final 'ENROLLED BILL' status and included certification signatures from the House and Senate officers, replacing the initial draft header.
HB0585_X(2).pdf→HB0585_1(8).pdf·3 edits
MINOR
The bill was revised to clarify the annual adjustment mechanism for Medicaid reimbursement rates, changing the language from allowing the department to 'adjust' the factor to requiring a 'minimum increase' based on the Consumer Price Index for Medical Care. This ensures providers receive at least the inflation rate in subsequent years, preventing potential rate reductions. The bill also reorganized the document structure, removing redundant headers and consolidating definitions into a single section.
Scope change
The scope of applicability remains unchanged; the bill still applies to physical therapists, speech-language pathologists, and occupational therapists under the Montana Medicaid program.
FISCAL
Changed the reimbursement adjustment rule from discretionary ('may adjust') to mandatory minimum ('must be increased, at a minimum') based on the Consumer Price Index for Medical Care.
TECHNICAL
Reorganized the bill's layout by removing duplicate headers and consolidating the definitions section for clarity.
TIMELINE
Maintained the effective date of July 1, 2025, and the 2026 conversion factor of $39.56.
HB0585_2(14).pdf→HB0585_X(2).pdf·4 edits
MODERATE
This bill establishes a standardized method for calculating Medicaid reimbursement rates for physical therapists, speech-language pathologists, and occupational therapists. It defines the conversion factor for 2026 and mandates annual adjustments based on the Consumer Price Index for Medical Care to ensure providers receive fair compensation. The bill also clarifies legal definitions for key terms and sets the effective date for these new rules.
Scope change
The bill applies to all covered services provided by physical therapists, speech-language pathologists, and occupational therapists under the Montana Medicaid program.
FISCAL
Sets the initial Medicaid reimbursement conversion factor at $39.56 for state fiscal year 2026.
REQUIREMENT
Changes the rule for future rate adjustments from a mandatory minimum increase to a discretionary adjustment by the department, allowing flexibility to match the Consumer Price Index for Medical Care.
DEFINITION
Adds specific legal definitions for 'Department', 'Medicaid', 'Occupational therapist', 'Physical therapist', 'Physician', 'Policy adjuster', 'Relative value unit', 'Resource-based relative value scale', and 'Speech-language pathologist'.
TIMELINE
Establishes July 1, 2025, as the effective date for the new reimbursement and definition provisions.
HB0585_X(1).pdf→HB0585_2(11).pdf·1 edit
MINOR
The bill text was reformatted to align with standard legislative numbering conventions, changing the bill identifier from HB 585 to HB0585.2. The substantive policy content regarding Medicaid reimbursement rates and definitions remains unchanged.
TECHNICAL
The bill title and section headers were updated to include the version number (HB0585.2) and adjusted line numbering to match the new format.
HB0585_2(10).pdf→HB0585_X.pdf·5 edits
MODERATE
The bill text was updated to reflect its final passage as an enrolled bill, including the addition of certification signatures and the removal of draft formatting. Substantively, the reimbursement conversion factor for physical therapists, speech-language pathologists, and occupational therapists was set at $39.56 for fiscal year 2026, with a mandate for future increases to match the consumer price index for medical care.
Scope change
The bill's scope remains focused on Medicaid reimbursement rates for specific therapy services; no changes were made to the applicability or eligibility criteria.
TECHNICAL
The document format changed from a draft version to an enrolled bill, adding certification signatures and removing draft headers.
DEFINITION
The definition of 'Department' was added to clarify it refers to the department of public health and human services.
The definition of 'Policy adjuster' was added to explain factors that increase Medicaid fees for specific service categories.
REQUIREMENT
The conversion factor for fiscal year 2026 was set at $39.56, and future adjustments are now required to match the consumer price index for medical care.
TIMELINE
The effective date for the act was set to July 1, 2025.
HB0585_1(7).pdf→HB0585_2.pdf·3 edits
MINOR
The bill underwent significant formatting reorganization, shifting the header information and reordering the sections. The most substantive policy change is in Section 1, where the automatic annual increase for the conversion factor was modified to allow the Department of Public Health and Human Services discretion to adjust the factor upward to achieve a specific expenditure target, rather than strictly following the consumer price index. Additionally, the codification instruction was altered to clarify that the new section is intended to be an integral part of the existing Title 53, chapter 6, part 1.
Scope change
The bill's scope regarding provider reimbursement rates was modified to introduce departmental discretion in setting conversion factors, while the scope of codification was clarified to integrate the new section into existing statutes.
FISCAL
Changed the mechanism for increasing the conversion factor from a mandatory CPI-based increase to a discretionary adjustment by the Department to meet expenditure targets.
TECHNICAL
Reordered the bill structure, moving the header and codification instruction to different positions and updating the codification language to reference the existing Title 53 chapter.
Adjusted the bill numbering and formatting, including changes to the bill identifier and page headers.
LC1850.pdf→HB0585_1.pdf·3 edits
MINOR
The bill was renumbered from LC 1850 to HB 585.1 and updated with new sponsors. The scope of services covered by Medicaid reimbursement calculations was narrowed by removing 'physical therapists' from the list of providers, now including only speech-language pathologists and occupational therapists. The formatting of the definitions section was adjusted to correct numbering errors, and the document header was updated to reflect the new bill number.
Scope change
The bill's scope was narrowed by excluding physical therapists from the specific Medicaid reimbursement calculation rules previously outlined.
DEFINITION
Removed 'physical therapist' from the list of providers whose fees are calculated using the conversion factor and relative value units.
TECHNICAL
Corrected numbering errors in the definitions section, changing sequential numbers like '(4) (6)' to '(4)(6)'.
Updated the bill header and page footers to reflect the new bill number HB 585.1 and new sponsors.
