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 527, the "Building Families Act," would require most health insurance plans in Montana to cover infertility diagnosis and treatment, including in vitro fertilization (IVF), up to a $25,000 lifetime limit. It directly affects insured Montanans seeking infertility care by mandating coverage for these services without extra deductibles, copays, or restrictions that differ from standard medical coverage. The bill defines infertility based on medical guidelines and prohibits insurers from imposing unique limitations on fertility treatments compared to other prescription drugs or services. It applies to all small group, large group, and individual health plans sold in Montana that cover medical expenses.
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 216 creates Montana's Physicians' Workforce Investment Act, establishing a task force to administer grants for health sector facilities (like hospitals) to launch or expand residency and fellowship programs. The grant program provides up to $2 million per facility to support new graduate medical education programs, requiring applicants to submit accreditation plans, 2-year financial projections, and 5-year sustainability strategies. This directly affects Montana hospitals seeking to train medical graduates (those with medical degrees but without residency completion) and aims to address physician shortages by increasing training opportunities. The task force must report annually on grant usage, program locations, specialty fields, and accreditation status to the legislature.
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.