Healthcare

died · Montana · Senate May 23, 2025

SB 483: Generally revise health care laws

SB 483 would revise Montana's health care laws by adding specific definitions to clarify insurance coverage processes, particularly around "step therapy" protocols. It directly affects health insurance issuers, providers, and patients by standardizing terms like "adverse determination" (denials of coverage), "clinical peer" reviews, and "step therapy" requirements. Key provisions define how insurers must review coverage requests, including requiring medical necessity justifications and establishing clearer pathways for appeals. The bill focuses on improving transparency in insurance decision-making without creating new benefits or funding. (Note: This bill died in process on May 23, 2025, and did not become law.)

Topics ✓ HealthcareSupports HealthcareStandardizes insurance definitions and mandates medical necessity justifications for coverage, protecting patients from arbitrary denials and improving access to care.95% confidence | Rep's Stance ✓ Voted Yes ✓ Supports Healthcare

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died · Montana · Senate May 23, 2025

SB 417: Generally revise laws relating to insurance coverage relating to obesity prevention

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.

Topics ✓ HealthcareSupports HealthcareBill mandates insurance coverage for obesity/diabetes treatments, expanding access to prescribed medicines and requiring medically necessary care, aligning with healthcare access expansion indicators.95% confidence | Rep's Stance ✓ Voted Yes ✓ Supports Healthcare

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died · Montana · Senate May 23, 2025

SB 295: Restoring the right for injured worker to choose their own doctor.

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.

Topics ✓ HealthcareSupports HealthcareRestores injured workers' right to choose treating physician, improving healthcare access without insurer-imposed MCO/PPO restrictions.95% confidence ✓ Labor & EmploymentSupports Labor & EmploymentRestores injured workers' right to choose physicians under workers' comp, protecting healthcare access and advancing labor rights without forced MCO/PPO use.95% confidence | Rep's Stance ✓ Voted Yes ✓ Supports Healthcare

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died · Montana · Senate May 23, 2025

SB 563: Creating the Montana Bridge to Medical Residency Act

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.

Topics ✓ HealthcareSupports HealthcareEnables provisional medical licensure for new grads awaiting residency, expanding access to healthcare services under supervision.95% confidence | Rep's Stance ✓ Voted Yes ✓ Supports Healthcare

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died · Montana · Senate May 23, 2025

SB 100: Revise funding for assisted living services

SB 100 establishes new rules for Medicaid payments in Montana's assisted living facilities. It requires the state agency to adjust room and board costs annually based on recipients' income (minus a $100 personal needs allowance) and directs the shift of Medicaid-covered assisted living services from the current "Big Sky Waiver" program to the federal "Community First Choice" program by 2026. The bill mandates quarterly reporting on service usage, waitlists, and costs for both programs. It affects Medicaid-eligible seniors receiving assisted living care, ensuring payments align with income and streamlining service delivery under federal Medicaid options.

Topics ✓ HealthcareSupports HealthcareShifts Medicaid services to federal Community First Choice program, expanding access to assisted living care while requiring cost transparency and reporting on service usage.95% confidence | Rep's Stance ✓ Voted Yes ✓ Supports Healthcare

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died · Montana · Senate May 23, 2025

SB 199: Revise the Medicaid expansion program

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.

Topics ✗ HealthcareOpposes HealthcareAdds asset-based fees to Medicaid, restricting access for participants with property/vehicle equity, effectively limiting program eligibility and coverage.95% confidence | Rep's Stance ✗ Voted No ✓ Supports Healthcare

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died · Montana · Senate May 23, 2025

SB 354: Prohibit purchase of soft drinks and candy with SNAP benefits

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).

Topics ✓ HealthcareSupports HealthcareRestricts SNAP use for unhealthy items to improve public health outcomes, aligning with public health program goals through nutrition policy.90% confidence | Rep's Stance ✓ Voted Yes ✓ Supports Healthcare

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died · Montana · Senate May 23, 2025

SB 448: Generally revise laws related to payments made by health carriers

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.

Topics ✓ HealthcareSupports HealthcareRequires timely insurance payments to providers, reduces administrative delays, and protects provider rights through penalties for late payments, improving healthcare system efficiency.90% confidence | Rep's Stance ✓ Voted Yes ✓ Supports Healthcare

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died · Montana · House May 22, 2025

HB 364: Generally revise laws related to immunizations

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.

Topics ✓ HealthcareSupports HealthcareRequires school immunization data reporting for public health oversight, strengthening disease prevention efforts under healthcare policy.90% confidence ✓ TechnologySupports TechnologyRequires deidentified health data reporting to protect student privacy, aligning with tech policy data protection standards.85% confidence | Rep's Stance ✓ Voted Yes ✓ Supports Healthcare

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died · Montana · House May 22, 2025

HB 758: Revise health care laws relating to out-of-network services

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.

Topics ✓ HealthcareSupports HealthcarePrevents balance billing for ambulance services, caps out-of-pocket costs at $100, and ensures costs count toward deductibles, strengthening patient access and financial protection in healthcare.95% confidence | Rep's Stance ✓ Voted Yes ✓ Supports Healthcare

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