SB 537 revises Montana's marijuana tax revenue distribution, directing funds from the marijuana state special revenue account to new and existing state accounts. It requires transferring excess funds annually to specific accounts, including 12% to the HEART account for addiction treatment and mental health programs, 20% to wildlife habitat projects, and 14% to behavioral health initiatives. The bill also allocates funds for law enforcement canine training, sexual assault evidence kits, and homeless shelter support, while modifying existing transfer rules for agencies like the Department of Fish, Wildlife, and Parks. These changes apply to all state agencies receiving marijuana tax revenue under Montana law.
SB 72 creates a "presumptive eligibility" process for Montana Medicaid, allowing people with physical disabilities or who are elderly to immediately access home and community-based services like personal care, meal delivery, medical equipment, and emergency response systems while awaiting full Medicaid approval. It requires a screening process by trained staff (including tribal entities, hospitals, or aging agencies) to verify income, residency, and need, with applicants having 30 days to apply for ongoing Medicaid coverage. The program aims to prevent hospitalizations or institutional care by providing temporary coverage during the application period, ending after 30 days or when full eligibility is determined. The bill requires state approval from CMS before implementation and was vetoed by the governor in May 2025, with a legislative override attempt failing.
HB 610 would have removed a requirement for prior approval (preauthorization) under Montana's Medicaid program for specific FDA-approved antipsychotic drugs. These drugs must be recognized in the latest DSM-5 as effective for certain mental health conditions. The bill would have directly affected Medicaid patients needing these medications and their healthcare providers, who would no longer need to seek pre-approval for covered antipsychotics. The law would have applied to claims for services provided after its effective date. (Note: The bill was vetoed by the governor and the veto override failed, so this policy change did not take effect.)
SB 521 directs Montana's Department of Public Health and Human Services and Office of Public Instruction to create a plan expanding mental health education to all public schools. The plan must include specific elements like curriculum design, funding support strategies, data collection methods, and cost estimates for addressing issues like bullying, suicide, and substance use. All public schools in Montana would be directly affected if the plan is implemented. The bill requires progress reports by September 2025 and a final plan by May 2026. It mandates the development of a roadmap but does not provide immediate funding or require schools to adopt the program.
SB 523, introduced by Senator C. Pope, proposed requiring Medicaid contracts with non-physician providers (like clinics or therapists) to include annual cost-of-living adjustments tied to the U.S. Bureau of Labor Statistics' medical care CPI. This would have mandated that reimbursement rates for these providers increase each year by the same percentage as the medical care inflation rate, rather than relying on fixed formulas. The bill would have applied specifically to non-physician Medicaid service providers, aiming to keep their payments aligned with inflation. However, the bill "died in process" on May 23, 2025, and did not become law.
SB 353 would have expanded Montana's "right to try" law to allow minors with terminal illnesses access to investigational drugs, biological products, or devices. Currently, the law excluded minors from this pathway; this bill would permit eligibility if a minor's treating health care provider attests that the minor has a terminal illness. The bill did not change other existing requirements, such as exhausting approved treatments or obtaining written consent. This change would directly affect minors diagnosed with terminal illnesses seeking experimental treatments not yet approved by the FDA. (Note: The bill died in committee in May 2025 and was never enacted.)
SB 62 would end Montana's Medicaid expansion program for able-bodied adults by prohibiting new enrollments after August 31, 2025, while requiring the Department of Public Health and Human Services to seek a federal waiver to maintain funding for current participants. The bill directly affects individuals enrolled in Montana's Medicaid expansion program who are able-bodied adults, preventing them from joining after the 2025 deadline. Key mechanisms include a strict enrollment cutoff date, a requirement for the department to apply for federal funding continuity, and authorization to implement program integrity measures like biannual eligibility reviews. The bill does not change coverage for individuals with specific health needs or those already enrolled continuously before September 1, 2025.
SB 372 establishes minimum nurse-to-patient ratios for Montana hospitals, requiring specific limits in key units (e.g., 1 nurse per critical ER patient, 2 per ICU patient, 4 per medical-surgical unit). It mandates hospitals to create annual staffing plans with input from direct-care nurses, form committees where at least half the members are frontline nurses, and publicly post these plans. Hospitals must track and report actual nurse-to-patient ratios for each shift and unit, ensuring transparency for staff, patients, and the public. The bill directly affects all Montana hospitals licensed by the Department of Public Health, requiring concrete changes to staffing practices and reporting.
SB 478 would require Montana's public universities to cover medical costs for students who develop specific vaccine-related health conditions after receiving mandated COVID-19 vaccinations. Students would need to submit proof of vaccination (to comply with school attendance rules), a medical diagnosis of one of five listed conditions (like heart inflammation or blood clotting disorders), and cost records to their institution for reimbursement. The bill covers diagnosis, treatment, and lost wages related to those conditions, as defined by the Board of Regents. The bill died in committee in May 2025 and did not become law.
SB 469 would revise Montana's mental health service structure by updating rules for local "service area authorities" that manage community mental health programs. It requires the state Department of Mental Health to provide each service area authority with an annual contract covering administrative costs, crisis services, and community events, while also supporting at least three such authorities. The bill mandates that service area boards be led by majority consumer/family members, establishes new reporting requirements, and removes unfunded mandates requiring local governments to cover costs without state funding. This directly affects local mental health providers, county governments, and communities receiving mental health services across Montana.
