SB 394 would have expanded Montana's workers' compensation system to cover posttraumatic stress disorder (PTSD) for eligible first responders. It defines "first responder" to include firefighters, law enforcement officers, detention center/prison staff, and emergency care providers, requiring a diagnosis per the latest DSM-5 manual that links PTSD directly to work duties. The bill amended existing laws to allow PTSD claims under workers' compensation, subject to standard procedural requirements. However, this bill was vetoed by the Governor on June 9, 2025, so it did not become law.
SB 526 establishes a grant program to fund tribal colleges in Montana developing community health aide and dental health aide training programs. The program provides up to $3 million per institution, including a $1 million startup grant and $500,000 annually for four years, to expand or create education programs qualifying graduates for federal certification. Tribal colleges receiving grants must report annually on program outcomes, including graduates, provider certifications, patient access metrics, and cost-effectiveness. The bill directly affects tribal colleges and aims to address healthcare disparities in American Indian and Alaska Native communities by increasing local provider capacity. It allocates $1.5 million from the general fund for the 2025-2027 biennium to support this initiative.
SB 136 amends Montana's criminal code (Section 45-2-211, MCA) to state that a patient's consent to physician aid in dying is not a defense to a homicide charge against the physician. The bill defines "physician aid in dying" as a physician prescribing a lethal medication for the patient to self-administer, excluding standard comfort care or withholding life-sustaining treatment. This directly affects physicians who provide such aid, making their actions prosecutable as homicide if consent is claimed as a defense. The law takes effect July 1, 2025, and does not impact existing practices of comfort care or end-of-life treatment under Montana law.
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 474 would have expanded school immunization exemptions in Montana to include religious exemptions and a new "personal medical informed consent" exemption requiring only a notarized statement. This new exemption would allow students to decline vaccines after consulting a healthcare provider (without needing a provider's signature), distinct from the existing medical exemption requiring a healthcare provider's written statement. The bill also amended school immunization laws (20-5-405 and 49-2-312) to prevent schools from being sued for injuries related to exempt students and to block overly burdensome exemption forms. The bill died in committee on May 23, 2025, and never became law.
SB 164 amends Montana's endangering the welfare of children law to prohibit specific medical treatments for children under 16. The bill bans surgical procedures, puberty blockers, and hormone therapies (like estrogen or testosterone) when used to alter a child's appearance or affirm a gender identity inconsistent with their biological sex. Violating this prohibition is classified as a felony, carrying up to five years in prison and a $10,000 fine, with harsher penalties if the child suffers serious injury. The law would take effect on January 1, 2026, directly affecting medical providers, caregivers, and children under 16 who might receive these treatments.
SB 554 (Montana) limits nonprofit hospitals (excluding critical access/rural emergency hospitals) to charging no more than 300% of the Medicare reimbursement rate for Medicare-eligible services. Hospitals exceeding this rate face an escalating excise tax (starting at 25% in 2027 and rising to 50% after 2030) and risk losing nonprofit status. The bill also requires hospitals to maintain written financial assistance and community benefit policies, submit annual reports including IRS Form 990, and comply with new reporting rules. This bill died in process in May 2025 and was never enacted.
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.
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 112 would prohibit Montana state funds (including federal funds) from purchasing opioid reversal drugs after June 30, 2025, from companies involved in opioid settlement agreements. It allows existing contracts for these drugs to continue until fulfillment but bans renewal after the deadline, and requires continued supply under settlement agreements signed before September 1, 2024. The bill directly affects state agencies purchasing opioid reversal medications and pharmaceutical companies that settled opioid-related lawsuits. The bill died in committee in May 2025 and did not become law.
