Healthcare

signed · Montana · Senate May 16, 2025

SB 446: Revise laws related to healthcare utilization review

SB 446 revises laws related to health utilization review, affecting health insurance companies, utilization review organizations, and patients. It requires that only a physician licensed in the state, with a relevant specialty, can make adverse determinations (denials of coverage) or review grievances. The bill also restricts health insurance issuers from requiring prior authorization for certain prescription drugs, such as some generics, drugs for substance use disorder, and long-acting injectable antipsychotics. If an issuer or utilization review organization fails to comply with the requirements, the healthcare service under review will be automatically approved.

Topics ✓ HealthcareSupports HealthcareRestricts prior authorization for essential drugs (substance use, generics) and mandates physician oversight for coverage denials, improving patient access and protecting rights.85% confidence | Rep's Stance ✓ Voted Yes ✓ Supports Healthcare

signed · Montana · Senate May 16, 2025

SB 335: Generally revise laws related to dental insurance

Senate Bill 335, known as the "Montana Dental Insurance Transparency and Accountability Act," establishes new regulations for dental insurance companies in Montana. It requires dental insurers to annually report their "dental loss ratio" (DLR), which measures the percentage of premium dollars spent on patient care, to the state's commissioner of securities and insurance. This reported DLR information, along with other plan details, will be made publicly available online for consumers to compare plans. The bill also mandates consumer rebates from dental insurers if their aggregated dental loss ratio falls below a certain threshold over a three-year period. This act applies to individual and group dental insurance plans, but excludes health plans with embedded dental benefits already subject to federal medical loss ratio requirements, as well as Medicaid and Healthy Montana Kids plans.

Topics ✓ HealthcareSupports HealthcareRequires dental insurers to report DLR publicly, enhancing consumer transparency and accountability in healthcare insurance.95% confidence | Rep's Stance ✓ Voted Yes ✓ Supports Healthcare

signed · Montana · House May 16, 2025

HB 953: Revise medicaid laws related to direct primary care

HB 953 revises Montana's Medicaid laws to allow for the coverage of direct primary care contracts under the state's Medicaid program. This bill directly affects Medicaid enrollees by providing them the option to use these services. It also prohibits the Department of Public Health and Human Services from requiring an enrollee to participate in primary care case management if they opt for a direct primary care contract. The bill provides a definition for "direct primary care contract" and includes an appropriation to support these changes.

Topics ✓ HealthcareSupports HealthcareExpands Medicaid coverage for direct primary care, improving patient access and removing case management requirements per bill text.95% confidence | Rep's Stance ✓ Voted Yes ✓ Supports Healthcare

signed · Montana · Senate May 16, 2025

SB 524: Revise laws relating to category D assisted living facilities

SB 524 revises laws concerning Category D assisted living facilities, which cater to residents who may pose a danger to themselves or others and require assistance with daily living activities. The bill allows these facilities to be independent or co-located with others, limiting them to 15 residents, and clarifies that while not required, prior authorization is needed for any use of seclusion or restraints. It mandates the Department of Public Health and Human Services to provide technical assistance and a specialized reimbursement model. Additionally, it establishes new processes for diverting individuals from the Montana State Hospital or committing them directly to Category D facilities.

Topics ✓ HealthcareSupports HealthcareClarifies safety protocols for vulnerable residents in assisted living facilities, protecting patient rights and improving care standards under healthcare services.85% confidence | Rep's Stance ✓ Voted Yes ✓ Supports Healthcare

signed · Montana · Senate May 16, 2025

SB 535: Revise laws related to experimental treatments

SB 535 revises laws related to experimental treatments, primarily by requiring experimental treatment centers to obtain a license from the state department. These centers must adhere to operational standards and pay licensing fees. The bill also mandates that licensed centers allocate 2% of their net annual profits to support access to experimental treatments for qualifying Montana residents. This allocation can be fulfilled by providing free treatment or contributing to a new Insurance Premium Support Account. This account is established to help fund health insurance premiums for eligible Montana residents who purchase insurance on the federal marketplace and meet specific income criteria.

Topics ✓ HealthcareSupports HealthcareMandates 2% profit allocation for patient access to experimental treatments, directly expanding access and funding under healthcare services.95% confidence | Rep's Stance ✓ Voted Yes ✓ Supports Healthcare

signed · Montana · Senate May 16, 2025

SB 319: Generally revise health care laws related to doulas

This bill establishes a state licensure system for doulas, defining them as nonmedical professionals who provide continuous physical, emotional, and informational support during pregnancy and up to one year postpartum. Beginning January 1, 2027, individuals wishing to practice as state-licensed doulas must obtain a license from the Department of Labor and Industry. Licensure requires paying fees, completing specific competencies, and adhering to professional conduct standards. Additionally, the bill allows the Department of Public Health and Human Services to provide Medicaid coverage for services offered by state-licensed doulas.

Topics ✓ HealthcareSupports HealthcareEstablishes licensure standards for doulas (nonmedical healthcare support), formalizing their role in pregnancy/postpartum care and improving professional standards within healthcare services.85% confidence | Rep's Stance ✗ Voted No ✗ Opposes Healthcare

signed · Montana · Senate May 13, 2025

SB 503: Allow use of expired opioid antagonists

SB 503 allows for the use of expired opioid antagonists, such as naloxone, to treat opioid-related drug overdoses. This bill grants partial immunity from liability to school employees, eligible recipients, medical practitioners, and pharmacists who administer or distribute these expired medications in good faith. It amends existing law to explicitly permit schools to stock and use expired opioid antagonists and extends immunity to school personnel, except in cases of gross negligence or intentional misconduct. The bill's purpose is to broaden access to life-saving opioid antagonist medication by permitting the use of expired doses.

Topics ✓ HealthcareSupports HealthcareAllows expired naloxone use for overdose treatment, expands emergency access to life-saving care, and grants liability protection to providers - directly improving healthcare access for opioid emergencies.95% confidence | Rep's Stance ✓ Voted Yes ✓ Supports Healthcare

vetoed · Montana · House May 13, 2025

HB 881: Revise medicaid buy-in program to include children with disabilities

HB 881 proposed to revise the existing Medicaid buy-in program to include children with disabilities. This would expand eligibility for the program, allowing more children with disabilities to access Medicaid services. The bill also included an appropriation and extended rulemaking authority for the relevant department to implement these changes. It aimed to amend specific sections of Montana law concerning Medicaid administration and eligibility requirements.

Topics ✓ Budget & TaxesSupports Budget & TaxesBill includes specific appropriation to fund expanded Medicaid eligibility for children with disabilities, directly advancing essential public health funding under Budget & Taxes.95% confidence ✓ HealthcareSupports HealthcareExpands Medicaid eligibility for children with disabilities, increasing healthcare access through new appropriations and policy changes.95% confidence | Rep's Stance ✓ Voted Yes ✓ Supports Healthcare

Track

vetoed · Montana · House May 13, 2025

HB 880: Establish a stabilization fund for medicaid

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.

Topics ✓ Budget & TaxesSupports Budget & TaxesCreates Medicaid Stabilization Reserve Account using unused general fund appropriations to maintain benefits during revenue shortfalls, protecting essential program funding through fiscal management.95% confidence ✓ HealthcareSupports HealthcareEstablishes Medicaid Stabilization Reserve to maintain benefits during revenue shortfalls, preventing cuts to healthcare coverage and ensuring continued funding for Medicaid services.95% confidence | Rep's Stance ✗ Voted No ✗ Opposes Healthcare

Track

signed · Montana · House May 13, 2025

HB 732: Establish prompt cost report reimbursement act

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.

Topics ✓ Budget & TaxesSupports Budget & TaxesBill mandates timely Medicaid reimbursements under appropriations process, promoting fiscal responsibility in state budget execution for healthcare funding.85% confidence ✓ HealthcareSupports HealthcareBill mandates timely Medicaid reimbursements to critical access hospitals, preventing financial strain and ensuring continued healthcare service provision.90% confidence | Rep's Stance ✓ Voted Yes ✓ Supports Healthcare