Healthcare

signed · Montana · Senate May 16, 2025

SB 447: Revise laws related to prior authorization

SB 447 revises state laws related to prior authorization for health care services, affecting individuals with health insurance and health insurance issuers. The bill extends the length of a prior authorization certification. For treatment of chronic conditions, a prior authorization would be valid for the duration of that condition. Additionally, this bill prohibits prior authorization for certain prescriptions.

Topics ✓ HealthcareSupports HealthcareExtends prior auth validity for chronic conditions and prohibits auth for certain prescriptions, improving patient access to care without restricting coverage.95% confidence | Rep's Stance ✓ Voted Yes ✓ Supports Healthcare

signed · Montana · Senate May 16, 2025

SB 446: Revise laws related to healthcare utilization review

SB 446 revises laws related to health utilization review, affecting health insurance companies, utilization review organizations, and patients. It requires that only a physician licensed in the state, with a relevant specialty, can make adverse determinations (denials of coverage) or review grievances. The bill also restricts health insurance issuers from requiring prior authorization for certain prescription drugs, such as some generics, drugs for substance use disorder, and long-acting injectable antipsychotics. If an issuer or utilization review organization fails to comply with the requirements, the healthcare service under review will be automatically approved.

Topics ✓ HealthcareSupports HealthcareRestricts prior authorization for essential drugs (substance use, generics) and mandates physician oversight for coverage denials, improving patient access and protecting rights.85% confidence | Rep's Stance ✓ Voted Yes ✓ Supports Healthcare

signed · Montana · Senate May 16, 2025

SB 335: Generally revise laws related to dental insurance

Senate Bill 335, known as the "Montana Dental Insurance Transparency and Accountability Act," establishes new regulations for dental insurance companies in Montana. It requires dental insurers to annually report their "dental loss ratio" (DLR), which measures the percentage of premium dollars spent on patient care, to the state's commissioner of securities and insurance. This reported DLR information, along with other plan details, will be made publicly available online for consumers to compare plans. The bill also mandates consumer rebates from dental insurers if their aggregated dental loss ratio falls below a certain threshold over a three-year period. This act applies to individual and group dental insurance plans, but excludes health plans with embedded dental benefits already subject to federal medical loss ratio requirements, as well as Medicaid and Healthy Montana Kids plans.

Topics ✓ HealthcareSupports HealthcareRequires dental insurers to report DLR publicly, enhancing consumer transparency and accountability in healthcare insurance.95% confidence | Rep's Stance ✓ Voted Yes ✓ Supports Healthcare

signed · Montana · Senate May 16, 2025

SB 524: Revise laws relating to category D assisted living facilities

SB 524 revises laws concerning Category D assisted living facilities, which cater to residents who may pose a danger to themselves or others and require assistance with daily living activities. The bill allows these facilities to be independent or co-located with others, limiting them to 15 residents, and clarifies that while not required, prior authorization is needed for any use of seclusion or restraints. It mandates the Department of Public Health and Human Services to provide technical assistance and a specialized reimbursement model. Additionally, it establishes new processes for diverting individuals from the Montana State Hospital or committing them directly to Category D facilities.

Topics ✓ HealthcareSupports HealthcareClarifies safety protocols for vulnerable residents in assisted living facilities, protecting patient rights and improving care standards under healthcare services.85% confidence | Rep's Stance ✓ Voted Yes ✓ Supports Healthcare

signed · Montana · Senate May 16, 2025

SB 535: Revise laws related to experimental treatments

SB 535 revises laws related to experimental treatments, primarily by requiring experimental treatment centers to obtain a license from the state department. These centers must adhere to operational standards and pay licensing fees. The bill also mandates that licensed centers allocate 2% of their net annual profits to support access to experimental treatments for qualifying Montana residents. This allocation can be fulfilled by providing free treatment or contributing to a new Insurance Premium Support Account. This account is established to help fund health insurance premiums for eligible Montana residents who purchase insurance on the federal marketplace and meet specific income criteria.

Topics ✓ HealthcareSupports HealthcareMandates 2% profit allocation for patient access to experimental treatments, directly expanding access and funding under healthcare services.95% confidence | Rep's Stance ✓ Voted Yes ✓ Supports Healthcare

vetoed · Montana · House May 13, 2025

HB 880: Establish a stabilization fund for medicaid

HB 880 establishes the Medicaid Stabilization Reserve Account, a state special revenue fund designed to help maintain Medicaid benefits during state revenue shortfalls. The account would be primarily funded by transferring any unused state general fund appropriations for Medicaid at the end of a fiscal year. Funds from this account could only be appropriated by the legislature for state Medicaid matching funds after the budget director certifies a projected general fund deficit. This mechanism aims to mitigate expenditure reductions in the Medicaid program, directly affecting the stability of services for beneficiaries. The bill also includes an initial appropriation of $50,000 for state Medicaid matching funds.

Topics ✓ Budget & TaxesSupports Budget & TaxesCreates Medicaid Stabilization Reserve Account using unused general fund appropriations to maintain benefits during revenue shortfalls, protecting essential program funding through fiscal management.95% confidence ✓ HealthcareSupports HealthcareEstablishes Medicaid Stabilization Reserve to maintain benefits during revenue shortfalls, preventing cuts to healthcare coverage and ensuring continued funding for Medicaid services.95% confidence | Rep's Stance ✓ Voted Yes ✓ Supports Healthcare

Track

signed · Montana · House May 13, 2025

HB 732: Establish prompt cost report reimbursement act

HB 732, the "Prompt Cost Report Reimbursement Act," revises how the Montana Department of Public Health and Human Services reimburses critical access hospitals participating in the state's Medicaid program. The bill requires the department to perform a tentative settlement and make interim payments to these hospitals within 240 days of a cost report being submitted to the Medicare administrative contractor. A final settlement and adjustment will occur after the Medicare administrative contractor completes its full review or audit. This process aims to align Montana Medicaid's reimbursement with Medicare's, ensuring more timely payments to critical access hospitals for services rendered.

Topics ✓ Budget & TaxesSupports Budget & TaxesBill mandates timely Medicaid reimbursements under appropriations process, promoting fiscal responsibility in state budget execution for healthcare funding.85% confidence ✓ HealthcareSupports HealthcareBill mandates timely Medicaid reimbursements to critical access hospitals, preventing financial strain and ensuring continued healthcare service provision.90% confidence | Rep's Stance ✓ Voted Yes ✓ Supports Healthcare

signed · Montana · House May 13, 2025

HB 576: Revise funding for medicaid and health and support services to children and to adults who are aged, blind, and disabled

HB 576 revises the funding for Medicaid and health and support services for children and adults who are aged, blind, or disabled. The bill allows a portion of the state's annual tobacco settlement proceeds to be used as matching funds for federal programs, including the Children's Health Insurance Program (CHIP), home visiting services, and specific Medicaid waivers. It also expands the uses of an existing state special revenue account, enabling its funds to similarly provide matching funds for these same services. These changes are designed to help secure federal funding for a range of health and support programs.

Topics ✓ Budget & TaxesSupports Budget & TaxesUses tobacco settlement proceeds as matching funds for Medicaid/CHIP, directly funding essential health services without new taxes or cuts.95% confidence ✓ HealthcareSupports HealthcareBill allocates tobacco settlement funds to expand Medicaid/CHIP funding and health services for vulnerable populations, strengthening coverage and access.95% confidence | Rep's Stance ✓ Voted Yes ✓ Supports Healthcare

signed · Montana · House May 13, 2025

HB 574: Authorizing implementation of the certified community behavioral health clinic model

HB 574 authorizes the Department of Public Health and Human Services to establish a program for Certified Community Behavioral Health Clinics (CCBHCs) by October 1, 2026. These clinics will provide comprehensive behavioral health services, including targeted case management, peer support, and outreach to emergency rooms and law enforcement. The bill also outlines specific requirements for CCBHCs, such as providing urgent care within one business day, offering a sliding fee scale, and not refusing services due to inability to pay. Additionally, it directs the department to establish reimbursement rates, monitor clinic performance, and develop an incentive program for clinics that achieve exceptional outcomes.

Topics ✓ HealthcareSupports HealthcareAuthorizes CCBHCs to expand mental health services with urgent care access, sliding fees, and outreach - directly advancing behavioral health care access and coverage.95% confidence | Rep's Stance ✓ Voted Yes ✓ Supports Healthcare

signed · Montana · House May 13, 2025

HB 806: Generally revising laws related to dietitians and nutritionists

HB 806 generally revises the laws governing dietitians and nutritionists in Montana. The bill updates definitions related to the practice of nutrition and dietetics, and establishes new licensure requirements, including mandatory criminal background checks. It also outlines provisions for qualified supervisors, permits, and transitional licensure for these professionals. Additionally, the bill integrates licensed dietitians and nutritionists into the state's "quality educator" payment framework, affecting their recognition in public schools, special education cooperatives, and correctional facilities.

Topics ✓ HealthcareSupports HealthcareBill establishes licensure requirements and integrates dietitians/nutritionists into state payment framework, enhancing professional access to healthcare services.85% confidence | Rep's Stance ✓ Voted Yes ✓ Supports Healthcare