HB 585 would have revised Montana's Medicaid reimbursement rates for physical therapists, speech-language pathologists, and occupational therapists. It set a 2026 Medicaid payment rate of $39.56 per service unit and required annual rate increases tied to the medical care component of the U.S. Consumer Price Index. This directly affected these healthcare providers who bill Medicaid for services, ensuring their payments adjusted with inflation. The bill was introduced in 2025 but was vetoed by the governor and later failed to override in the legislature.
SB 422 requires Montana health insurers to cover FDA-approved drugs for advanced or metastatic cancer without forcing patients to first fail other treatments. It prohibits insurers from demanding that patients prove they've tried and failed alternative drugs before approving coverage for new treatments that align with national cancer guidelines. This directly affects patients diagnosed with advanced or metastatic cancer in Montana, ensuring faster access to potentially life-saving medications without unnecessary bureaucratic hurdles. The law applies only to drugs approved by the FDA and consistent with evidence-based cancer treatment protocols.
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.
SB 244 requires all health insurance plans sold in Montana to cover behavioral health screenings and assessments at no cost to the insured. This applies to state employee health plans, disability insurance, health maintenance organizations (HMOs), and self-funded workplace plans. Screenings must use standardized, evidence-based tools, but are optional - insured individuals must actively request them. The bill amends Montana insurance codes to include these coverage requirements, ensuring people can access mental health screenings without out-of-pocket costs when they choose to participate.
HB 832 creates a Montana state grant program to fund training for healthcare providers in nonmedication therapies for treating posttraumatic stress disorder (PTSD). The program, administered by the Department of Labor and Industry, awards grants to entities developing 2-year projects that train licensed providers (including Veterans Affairs-certified professionals) in these therapies, develop treatment protocols, and engage in community planning. It appropriates $600,000 from the state general fund for the 2025-2027 biennium as a one-time allocation, requiring grantees to report outcomes like providers trained, patients served, and treatment impact by 2026. The law takes effect July 1, 2025.
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 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.
