HB 273, the "Montana Medical Debt Patient Protection Act," aimed to limit how health care providers and third-party collectors pursue medical debt from patients in Montana. The bill would have prohibited certain collection actions, including wage garnishment, placing liens on a patient's primary residence, and reporting adverse information to credit agencies. It also mandated a 180-day waiting period after the first bill before "extraordinary collection actions," such as filing lawsuits or selling debt, could begin, along with requiring a 30-day notice to the patient. Additionally, it sought to provide patients with an opportunity to appeal insurance decisions before a bill went to collections.
HB 947 requires most individual health insurance policies in Montana to cover continuous glucose monitors (CGMs) and their supplies for people diagnosed with type I or type II diabetes when medically necessary, as prescribed by a healthcare provider. The bill prohibits insurers from denying coverage based on diabetes severity or insulin dependence, and bans special deductibles or limits specifically for CGMs - though standard deductibles may still apply. This affects diabetes patients covered by individual disability, health, or membership insurance plans (excluding Medicare supplements, hospital indemnity, or long-term care policies). The law aims to ensure consistent access to these critical blood sugar monitoring tools without discriminatory coverage barriers.
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.
HB 794 revises general pharmacy laws, impacting pharmacies, pharmacy technicians, and clinical pharmacist practitioners. The bill updates and clarifies definitions, removes the utilization plan requirement for in-state and mail-order pharmacies, and mandates an endorsement for clinical pharmacist practitioners. It also eliminates outdated notification practices for biosimilar drug selection and generic drug signage requirements. Additionally, the bill clarifies pharmacy wholesale distribution licenses and the powers of the Board of Pharmacy, and adjusts provisions for insurance plans regarding out-of-state mail-order pharmacies.
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.
HB 198 revises laws that prohibit contracts restricting the practice of specific healthcare providers. The bill prevents employment or professional relationship contracts from limiting a healthcare provider's right to practice their licensed profession in any area or for any period after their relationship ends. It also prohibits contracts from restricting their ability to treat or solicit current patients of their former employer or partner. This applies to a range of providers, including psychiatrists, psychologists, various counselors, nurses, and physician assistants, but does not apply to contracts for the sale of a practice.
HB 885 aims to improve customer service for Medicaid applicants and recipients in Montana. It requires the Department of Public Health and Human Services (DPHHS) to implement mobile-first technology for online applications and renewals, utilize text and email for communications, and ensure written notices are in plain language and translated. The bill also mandates the DPHHS to provide expected wait times and callback options for hotline callers and to reopen 10 local public assistance offices by June 30, 2026. Additionally, it establishes quarterly reporting requirements to the legislature on various Medicaid client service metrics.
HB 459 would amend Montana law to increase the number of physician assistants on the Board of Medical Examiners from one to two. This change directly affects the composition of the 13-member board, which oversees medical licensing and regulation in Montana. The bill specifically revises Section 2-15-1731 of the Montana Code to add a second physician assistant position to the existing board structure. The bill was introduced in the 2025 legislative session but was withdrawn on February 14, 2025.
House Bill 556 regulates how health insurance issuers use artificial intelligence (AI) for reviewing and managing healthcare services. It prohibits AI, algorithms, or other software tools from solely determining medical necessity or denying, delaying, or modifying healthcare services. Instead, medical necessity determinations must be made by licensed healthcare professionals, considering individual patient history and circumstances, not just group data. The bill also requires AI tools to be applied fairly, avoid discrimination, and be open to audit, making non-compliance an unfair claim settlement practice.
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.
