SB 417 would require most Montana health insurance plans to cover certain injectable medicines prescribed for glucose control or weight loss in adults diagnosed with prediabetes, gestational diabetes, or obesity. Coverage must be deemed medically necessary by a physician and requires participants to join a lifestyle management program to continue treatment. The bill applies to individual and group health insurance policies but excludes Medicare Advantage plans. It amends Montana insurance law to mandate this coverage as a standard benefit.
SB 295 would restore Montana injured workers' right to choose their own treating physician for initial treatment and ongoing care under workers' compensation, without being forced to use a managed care organization (MCO) or preferred provider organization (PPO) without consent. The bill requires insurers to allow workers to select a physician from a designated list for initial treatment and to change physicians with the insurer's approval (with mediation available if approval is denied). It also mandates that insurers provide individual written notice (not workplace postings) before referring workers to an MCO or PPO. This directly affects injured workers seeking medical treatment for work-related injuries in Montana, giving them more control over their healthcare decisions.
SB 563 would create a temporary "provisional resident license" for recent medical school graduates in Montana who have passed initial licensing exams but haven't yet secured a residency position. This license allows them to provide supervised patient care under a licensed physician's direct oversight through a formal collaborative agreement, with a maximum duration of two years total. The bill directly affects new physicians seeking their first clinical roles while awaiting residency placements. It amends Montana's medical licensing laws to establish specific qualifications, fees, and supervision requirements for this temporary license.
SB 199 revises Montana's Medicaid expansion program (the Montana HELP Act) by introducing monthly "taxpayer integrity fees" for participants meeting specific asset thresholds. It requires fees based on excess real estate value ($5,000+ above homestead limits), vehicle equity ($20,000+ combined value), or agricultural land taxable value ($1,500+ annually), with a base fee of $100 plus $4 per $1,000 over limits. The bill also updates community engagement rules, mandating 80 monthly hours of work-related activities for 19-55-year-olds (with exemptions for medical conditions, caregivers, students, and others). These changes directly affect Medicaid expansion participants owning significant assets or required to meet work participation standards.
SB 354, the "Montana Healthy SNAP Act," would require Montana's Department of Public Health to request a federal waiver prohibiting the use of SNAP benefits (formerly food stamps) to buy soft drinks and candy. The bill directly affects SNAP recipients in Montana by restricting purchases of these items, which the legislature states are the most commonly bought non-nutritious items with SNAP funds. Key provisions include mandating a federal waiver request with a public health justification, an implementation plan for retailers, and annual reporting on spending patterns and health impacts. The bill defines "candy" as non-refrigerated sweet items and "soft drinks" as nonalcoholic sweetened beverages (excluding milk-based drinks or juices with >50% fruit/veg content).
SB 438 establishes a registration system for out-of-state health care providers offering telehealth services to Montana patients. It requires these providers to register with Montana’s Department of Labor and Industry if they hold an active license in another state, have no recent disciplinary actions, and meet scope-of-practice standards. The bill mandates providers to notify Montana authorities within 5 business days of any disciplinary action against their license in another state and allows Montana to impose disciplinary actions like registration suspension for noncompliance. It also defines key terms like "asynchronous" and "synchronous" telehealth and designates patient location as the venue for legal actions. The bill directly affects out-of-state telehealth providers, not patients, by creating new administrative and compliance requirements.
SB 448, a health insurance payment reform bill, requires Montana health carriers (insurance companies) to pay "clean claims" from healthcare providers within 14 days for electronic submissions or 30 days for paper submissions. It defines a "clean claim" as one with all required documentation and no errors, and mandates that carriers notify providers of missing information within 10 days if a claim is incomplete. The bill also establishes penalties for late payments due to carrier errors and allows providers to pursue legal action if payments are delayed unlawfully. This directly affects healthcare providers (hospitals, doctors, labs), health carriers, and enrollees by streamlining payment processes and reducing billing delays.
HB 364 proposes to update laws concerning student immunizations and exemptions in K-12 schools. It would require school governing authorities to submit written reports on student immunization and exemption data to state and local health departments. These reports must only contain deidentified or aggregate information, ensuring student privacy. The Department of Public Health and Human Services would determine the specific form and schedule for these reports.
HB 758 aims to protect health benefit plan enrollees from balance billing for out-of-network ground ambulance services. It prohibits ambulance services from billing enrollees more than their in-network cost-sharing for covered transportation. The bill requires insurers to pay ambulance providers directly, caps out-of-pocket costs for these services at $100, and ensures these costs count towards deductibles. It also mandates that insurers reimburse ambulance services at established local rates or at least 400% of the Medicare rate if no contracted rate exists, and requires the state to create a public database of local ambulance rates.
HB 912 proposes creating a new secure forensic facility in Montana, overseen by the Department of Public Health and Human Services. This facility would provide care, treatment, and security for up to 70 individuals involved in the legal system due to mental illness, including those needing competency restoration or forensic evaluations. The bill allocates $60 million from the Behavioral Health System for Future Generations Fund to plan, construct, and equip this facility, while also expanding the fund's uses to support new behavioral health infrastructure.
