HB 880 establishes the Medicaid Stabilization Reserve Account, a state special revenue fund designed to help maintain Medicaid benefits during state revenue shortfalls. The account would be primarily funded by transferring any unused state general fund appropriations for Medicaid at the end of a fiscal year. Funds from this account could only be appropriated by the legislature for state Medicaid matching funds after the budget director certifies a projected general fund deficit. This mechanism aims to mitigate expenditure reductions in the Medicaid program, directly affecting the stability of services for beneficiaries. The bill also includes an initial appropriation of $50,000 for state Medicaid matching funds.
HB 732, the "Prompt Cost Report Reimbursement Act," revises how the Montana Department of Public Health and Human Services reimburses critical access hospitals participating in the state's Medicaid program. The bill requires the department to perform a tentative settlement and make interim payments to these hospitals within 240 days of a cost report being submitted to the Medicare administrative contractor. A final settlement and adjustment will occur after the Medicare administrative contractor completes its full review or audit. This process aims to align Montana Medicaid's reimbursement with Medicare's, ensuring more timely payments to critical access hospitals for services rendered.
HB 576 revises the funding for Medicaid and health and support services for children and adults who are aged, blind, or disabled. The bill allows a portion of the state's annual tobacco settlement proceeds to be used as matching funds for federal programs, including the Children's Health Insurance Program (CHIP), home visiting services, and specific Medicaid waivers. It also expands the uses of an existing state special revenue account, enabling its funds to similarly provide matching funds for these same services. These changes are designed to help secure federal funding for a range of health and support programs.
HB 543 repeals the termination date for laws requiring the reporting and disclosure of violence against healthcare employees. Previously, these reporting requirements were set to expire on a specific date. By repealing that sunset clause, this bill makes the reporting and disclosure obligations permanent. This ensures that information about violence affecting healthcare workers will continue to be collected and shared indefinitely.
HB 574 authorizes the Department of Public Health and Human Services to establish a program for Certified Community Behavioral Health Clinics (CCBHCs) by October 1, 2026. These clinics will provide comprehensive behavioral health services, including targeted case management, peer support, and outreach to emergency rooms and law enforcement. The bill also outlines specific requirements for CCBHCs, such as providing urgent care within one business day, offering a sliding fee scale, and not refusing services due to inability to pay. Additionally, it directs the department to establish reimbursement rates, monitor clinic performance, and develop an incentive program for clinics that achieve exceptional outcomes.
HB 806 generally revises the laws governing dietitians and nutritionists in Montana. The bill updates definitions related to the practice of nutrition and dietetics, and establishes new licensure requirements, including mandatory criminal background checks. It also outlines provisions for qualified supervisors, permits, and transitional licensure for these professionals. Additionally, the bill integrates licensed dietitians and nutritionists into the state's "quality educator" payment framework, affecting their recognition in public schools, special education cooperatives, and correctional facilities.
SB 449 generally revises health utilization review laws, affecting health insurance enrollees, health insurance issuers, and healthcare providers. It requires health insurers to honor existing prior authorizations for at least 90 days when an enrollee changes health plans and prevents requiring repeat step therapy protocols if already completed. The bill prohibits prior authorization for certain prescriptions written at discharge from inpatient care for at least three days. Additionally, it generally prevents health insurers from retroactively denying covered services that received prior authorization and mandates that insurers accept and respond electronically to prior authorization requests from healthcare providers.
SB 317 prohibits health insurance companies from requiring prior authorization for psychiatric prescription drugs that are officially designated as being in shortage. The list of these drugs will be updated quarterly, based on the U.S. Food and Drug Administration's official shortage list. This aims to ensure covered persons can access necessary psychiatric medications without delays due to prior authorization when supplies are limited. Additionally, the bill prevents manufacturers of these shortage drugs from engaging in predatory pricing or marketing practices.
HB 740 revises laws affecting pharmacies, pharmacy benefit managers (PBMs), and other entities involved in prescription drug dispensing and reimbursement. The bill establishes new restrictions on how PBMs can audit pharmacies and recoup funds, such as prohibiting recoupment for clerical errors without actual financial harm and banning the use of extrapolation in calculations. It also updates regulations for Maximum Allowable Cost (MAC) lists and reference pricing, requiring PBMs to ensure drugs on MAC lists are available and to frequently update and disclose pricing information to pharmacies.
HB 601 establishes an online portal by May 1, 2026, to assist Medicaid applicants and enrollees. This portal allows designated "community assisters" to help individuals apply for Medicaid coverage and submit required documents. Key functions include enabling assisters to review application status, view department notices, report eligibility changes, and update contact information for their clients. The portal also allows, but does not require, assisters to submit initial applications or redeterminations and upload verification documents. This aims to streamline the application process for individuals seeking Medicaid assistance through community organizations.
