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.
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.
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.
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 825 revises laws related to healthcare decision-makers for adult patients. It allows patients to designate a "trusted decisionmaker" to make medical choices on their behalf if they lose the ability to make their own, with healthcare providers required to document this designation. The bill establishes a legal hierarchy for selecting a decision-maker for incapacitated patients, placing the patient-designated trusted decisionmaker high on that list. This ensures a patient's chosen individual has authority to make healthcare decisions if they cannot.
Senate Bill 95 allocates $300,000 to the Department of Public Health and Human Services for the biennium beginning July 1, 2025. This funding is dedicated to suicide prevention efforts specifically for service members, veterans, and their families. The bill outlines several key uses for the money, including implementing prevention strategies and establishing screening standards for suicide risk. It also aims to improve care transitions and increase lethal means safety through initiatives such as a statewide safe storage campaign and training events. The act is effective July 1, 2025, and terminates on June 30, 2027.
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.