Healthcare (Insurance)

introduced · Montana · Legislature Feb 17, 2025

LC 1894: Revise laws relating to health insurance claims submitted to the department of public health and human insurances

This bill requires health insurance providers and related entities in Montana to accept claims submitted by the Department of Public Health and Human Services for Medicaid services, even if the claim lacks prior authorization or proper documentation at the time of service. The law mandates that these entities cannot deny such claims solely based on submission date, claim format, or missing paperwork, provided the claim is filed within three years of the service and enforcement actions begin within six years. Additionally, the bill clarifies that these requirements do not force insurers to pay for non-covered services or create new financial obligations beyond what they already owe under existing contracts.

Topics ✓ HealthcareSupports HealthcareBill protects patient access to Medicaid services by preventing denial of claims due to administrative issues, strengthening healthcare coverage and rights.90% confidence

Sub-Topics Insurance Public Health

Track

introduced · Montana · Legislature Jan 29, 2025

LC 4030: Revise laws related to health insurance coverage of behavioral health screening

This bill requires health insurance policies issued or renewed in Montana to cover behavioral health screening assessments using standardized, evidence-based tools at no cost to the insured. It specifically applies to individual disability policies, state employee group benefit plans, disability insurance offered in the state, and self-funded multiple welfare employment arrangements. The legislation amends existing state laws to mandate this coverage while also updating provisions related to continued group plan membership for retirees, surviving spouses, judges, and legislators.

Topics ✓ HealthcareSupports HealthcareBill mandates insurance coverage for behavioral health screenings at no cost to insured, expanding access to mental health services and protecting patient rights.95% confidence ✓ VeteransSupports VeteransBill mandates coverage for behavioral health screening, which supports veteran mental health services and healthcare access.75% confidence

Sub-Topics Insurance Mental Health Public Health

Track

introduced · Montana · Legislature Feb 18, 2025

LC 1388: Require health insurance companies doing business in Montana to cover IVF treatment

This bill requires health insurance companies operating in Montana to cover infertility diagnosis and treatment, including in vitro fertilization, for individuals, spouses, and dependents. It mandates that all health plans offering medical coverage provide at least $40,000 in lifetime benefits for fertilization services and prohibits insurers from applying different restrictions to fertility medications or services than those applied to other prescription drugs and medical treatments. The legislation defines infertility based on specific timeframes for attempting pregnancy and includes coverage for cases involving life-threatening genetic diseases, while excluding individuals who have undergone voluntary sterilization.

Topics ✓ HealthcareSupports HealthcareBill mandates insurance coverage for IVF and infertility treatment, expanding healthcare access and benefits for patients.95% confidence

Sub-Topics Insurance

Track

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

Sub-Topics Insurance Medicaid

introduced · Montana · Legislature Mar 30, 2025

LC 2363: Revise insurance laws relating to continuous glucose monitors and supplies

This bill 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, if prescribed by a healthcare provider as medically necessary. Insurers cannot deny coverage based on the stage of diabetes or insulin dependency. The coverage must include standard deductibles and coinsurance but cannot impose special cost limits unique to CGM use. This applies to individual disability, health, and membership plans, excluding Medicare supplements, hospital indemnity, and long-term care policies.

Topics ✓ HealthcareSupports HealthcareMandates insurance coverage for CGMs, preventing denials based on diabetes type/stage, expanding access to essential diabetes management tools.95% confidence

Sub-Topics Hospitals Insurance Prescription Drugs

Track

died · Montana · Legislature May 20, 2025

LC 860: Require coverage for continuous glucose monitors and supplies

This bill requires most health insurance policies in Montana to cover continuous glucose monitors (CGMs) and their supplies for people diagnosed with type I or II diabetes when a medical provider deems them medically necessary. Insurers cannot deny coverage based on the stage of diabetes or insulin dependence, though standard deductibles and copays may apply. The law applies to individual disability, health, and group insurance policies but excludes Medicare supplements, hospital indemnity, and long-term care plans. It ensures consistent coverage for CGMs without special restrictions unique to this treatment.

Topics ✓ HealthcareSupports HealthcareMandates insurance coverage for CGMs, expanding access to essential diabetes care for patients with type I/II diabetes without restrictive denial criteria.95% confidence

Sub-Topics Hospitals Insurance Prescription Drugs

Track

died · Montana · Legislature May 23, 2025

LC 1019: Generally revise laws related to healthcare insurance risk pools

This bill (LC 1019) aimed to revise laws governing healthcare insurance risk pools, which help stabilize premiums for high-risk individuals. However, the bill died in the drafting process on May 23, 2025, and never advanced to a committee or floor vote. As a result, no concrete policy changes were enacted, and the bill did not affect any specific groups or insurers. It remains a proposed measure that was not enacted into law.

Topics ✓ HealthcareSupports HealthcareBill aimed to stabilize premiums for high-risk individuals via risk pool revisions, directly supporting healthcare access and affordability for vulnerable groups.90% confidence

Sub-Topics Insurance

Track

died · Montana · Legislature May 23, 2025

LC 1054: Provide for mandatory coverage of infertility services by health plans

This bill (LC 1054) proposed requiring health insurance plans to cover infertility services, directly affecting individuals seeking treatment for infertility and the health plans that provide coverage. It would have mandated that health plans include specific infertility treatments - such as in vitro fertilization (IVF) or fertility drugs - as part of standard coverage, rather than treating them as optional or excluded services. The bill was introduced but never advanced beyond the drafting stage, as it was marked "Draft Died in Process" on May 23, 2025, meaning it did not become law. No further legislative action or committee hearings are reflected in the provided records.

Topics ✓ HealthcareSupports HealthcareMandates health plans to cover infertility services (IVF, fertility drugs), expanding insurance coverage and improving patient access to reproductive healthcare.95% confidence

Sub-Topics Insurance

Track

vetoed · Montana · House May 1, 2025

HB 607: Provide for the hearing aid coverage act

HB 607, known as the "Hearing Aid Coverage Act," proposes to expand health insurance coverage for hearing loss. The bill revises current law that mandates coverage only for children, extending this requirement to include individuals of all ages. It achieves this by amending sections 2-18-704 and 33-22-128 of the Montana Code Annotated, which govern mandatory provisions in insurance contracts. This change would require state insurance plans to cover treatment for hearing loss for both children and adults.

Topics ✓ HealthcareSupports HealthcareExpands mandatory hearing aid coverage from children to all ages, requiring state insurance plans to cover hearing loss treatment for all individuals.95% confidence

Sub-Topics Insurance

Track

died · Montana · House May 20, 2025

HB 783: Generally revise health insurance laws relating to certain conditions

HB 783 aimed to revise health insurance laws by requiring coverage for specific conditions and treatments. It would have mandated individual health insurance policies to cover glucagon-like peptide-1 receptor agonists and treatments for polycystic ovary syndrome when medically necessary, including for diagnoses of diabetes or class 3 obesity. While allowing standard cost-sharing and cost containment measures, the bill prohibited special limitations on glucagon-like peptide-1 receptor agonists. Additionally, it sought to add other mandatory coverages, such as fertility preservation services and therapies for Down syndrome, to state group health plans. The bill would have affected individuals with these conditions and those covered by applicable health insurance policies in the state.

Topics ✓ HealthcareSupports HealthcareMandates coverage for specific treatments (GLP-1 agonists, PCOS) when medically necessary, prohibiting special limitations and expanding access to essential healthcare services.95% confidence

Sub-Topics Insurance

Track