HB 869, titled "Provide for the sudden cardiac arrest prevention in youth sports," establishes measures to prevent sudden cardiac arrest in youth athletes. It requires the Superintendent of Public Instruction to develop informational resources on cardiac arrest symptoms and risks. Beginning in the 2026-2027 school year, schools with athletic programs must implement cardiac emergency response plans, including accessible automated external defibrillators (AEDs) and staff training in CPR and AED use. Coaches will be required to be certified in CPR, first aid, and AED use, and hold informational meetings for parents and athletes. The bill also allows coaches or officials to remove athletes exhibiting cardiac arrest symptoms, who then require written medical clearance to return to play, and clarifies that AED purchases are an allowable expenditure for school safety.
HB 891 grants the Office of Inspector General (OIG) within the Department of Public Health and Human Services (DPHHS) new authority. This bill allows the OIG to issue subpoenas to compel the production of financial records, documents, and data. These subpoenas are specifically for investigations into waste, fraud, or abuse within health care services and public assistance programs administered by the DPHHS. The measure specifies that both the DPHHS director and the inspector general must sign these subpoenas. It also appropriates $5,000 to the DPHHS for the biennium beginning July 1, 2025, to implement these provisions.
SB 560 requires nonprofit hospitals to report their annual charity care and community benefit spending to the state. The bill mandates that a nonprofit hospital's total community benefit must exceed the amount of property taxes it would have paid if it were not tax-exempt. If a hospital's reported community benefit does not meet this threshold, a fee equal to the difference will be assessed. These collected fees are then deposited into a new Critical Access Health Care Special Revenue Account, which provides funding to critical access hospitals not affiliated with other hospitals.
SB 260 establishes procedures for altering the boundaries of hospital and school service districts. It allows real property owners to petition for these changes if they have difficulty accessing public services or to improve public safety services like law enforcement, firefighting, or emergency medical services. The process involves petitions, public hearings, and election procedures to transfer property between existing districts or create new divisions. The bill also provides for sharing tax collections and making reconciliation payments between districts when boundaries are altered.
SB 447 revises state laws related to prior authorization for health care services, affecting individuals with health insurance and health insurance issuers. The bill extends the length of a prior authorization certification. For treatment of chronic conditions, a prior authorization would be valid for the duration of that condition. Additionally, this bill prohibits prior authorization for certain prescriptions.
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.
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.
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.
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.
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.
