Healthcare

died · Montana · House Mar 1, 2025

HB 774: Generally revise laws relating to pharmacies

HB 774 would require Montana Medicaid and commercial health insurance plans to provide equal coverage for FDA-approved nonopioid pain medications compared to opioid medications. The bill prohibits insurers from disadvantaging nonopioid drugs through formulary placement (like higher cost-sharing tiers) or more restrictive prior authorization requirements than for opioids. It also mandates that healthcare providers can request exceptions to coverage restrictions for nonopioid drugs when they determine such drugs are appropriate for a patient. This law aims to ensure patients have full access to pain management options without insurance barriers.

Topics ✓ HealthcareSupports HealthcareRequires equal coverage for nonopioid pain meds vs opioids, removing cost/access barriers and improving patient access to safer alternatives.95% confidence

Sub-Topics Substance Abuse

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died · Montana · House May 22, 2025

HB 912: Generally revise behavioral health laws to create a secure forensic facility

HB 912 proposes creating a new secure forensic facility in Montana, overseen by the Department of Public Health and Human Services. This facility would provide care, treatment, and security for up to 70 individuals involved in the legal system due to mental illness, including those needing competency restoration or forensic evaluations. The bill allocates $60 million from the Behavioral Health System for Future Generations Fund to plan, construct, and equip this facility, while also expanding the fund's uses to support new behavioral health infrastructure.

Topics ✓ Criminal JusticeSupports Criminal JusticeCreates secure forensic facility for mental health treatment in legal system, advancing rehabilitation and competency restoration within criminal justice framework.95% confidence ✓ HealthcareSupports HealthcareAllocates $60M from behavioral health fund to create facility providing mental health care/treatment for forensic patients, directly advancing mental health services under healthcare topic.95% confidence

Sub-Topics Mental Health Public Health

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vetoed · Montana · Senate Jun 18, 2025

SB 244: Revise laws related to health insurance coverage of behavioral health screening

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.

Topics ✓ HealthcareSupports HealthcareMandates no-cost behavioral health screenings in all insurance plans, expanding access to mental health services without cost-sharing.95% confidence

Sub-Topics Public Health

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signed · Montana · Senate May 13, 2025

SB 449: Generally revise health utilization review laws

SB 449 generally revises health utilization review laws, affecting health insurance enrollees, health insurance issuers, and healthcare providers. It requires health insurers to honor existing prior authorizations for at least 90 days when an enrollee changes health plans and prevents requiring repeat step therapy protocols if already completed. The bill prohibits prior authorization for certain prescriptions written at discharge from inpatient care for at least three days. Additionally, it generally prevents health insurers from retroactively denying covered services that received prior authorization and mandates that insurers accept and respond electronically to prior authorization requests from healthcare providers.

Topics ✓ HealthcareSupports HealthcarePrevents redundant prior authorizations and extends coverage during plan changes, improving patient access to care without added delays.95% confidence

Sub-Topics Hospitals

died · Montana · Senate May 23, 2025

SB 554: Generally revise laws related to hospitals operating as nonprofit care facilities

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.

Topics ✓ Budget & TaxesSupports Budget & TaxesImposes escalating excise tax (25-50%) on hospitals exceeding Medicare rate, generating state revenue through new tax mechanism.95% confidence ✓ HealthcareSupports HealthcareCaps hospital charges for Medicare services at 300% of Medicare rate, reducing patient costs and enforcing community benefit requirements to improve access.95% confidence

Sub-Topics Sales Tax Hospitals Medicare

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died · Montana · Senate May 23, 2025

SB 563: Creating the Montana Bridge to Medical Residency Act

SB 563 would create a temporary "provisional resident license" for recent medical school graduates in Montana who have passed initial licensing exams but haven't yet secured a residency position. This license allows them to provide supervised patient care under a licensed physician's direct oversight through a formal collaborative agreement, with a maximum duration of two years total. The bill directly affects new physicians seeking their first clinical roles while awaiting residency placements. It amends Montana's medical licensing laws to establish specific qualifications, fees, and supervision requirements for this temporary license.

Topics ✓ HealthcareSupports HealthcareEnables provisional medical licensure for new grads awaiting residency, expanding access to healthcare services under supervision.95% confidence

Sub-Topics Medical Licensing

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signed · Montana · Senate May 13, 2025

SB 317: Prohibit health insurers from performing prior authorization on psychiatric drugs in shortage or discontinued

SB 317 prohibits health insurance companies from requiring prior authorization for psychiatric prescription drugs that are officially designated as being in shortage. The list of these drugs will be updated quarterly, based on the U.S. Food and Drug Administration's official shortage list. This aims to ensure covered persons can access necessary psychiatric medications without delays due to prior authorization when supplies are limited. Additionally, the bill prevents manufacturers of these shortage drugs from engaging in predatory pricing or marketing practices.

Topics ✓ HealthcareSupports HealthcareRemoves prior authorization barriers for psychiatric drugs in shortage, improving patient access to mental health care per FDA shortage list.95% confidence

Sub-Topics Mental Health Prescription Drugs

passed both · Montana · Senate May 6, 2025

SJ 49: Interim study of youth and family behavioral health prevention

SJ 49 requests an interim study of youth and family behavioral health prevention programs across Montana. An interim committee will be designated to comprehensively review these programs, focusing on their funding, workforce, and delivery settings for youth under 18. The study aims to identify gaps in the state's behavioral health system and assess how prevention efforts divert youth and families from crises, with findings to be reported to the 70th Legislature.

Topics ✓ HealthcareSupports HealthcareBill initiates study to identify gaps in youth mental health prevention programs, aiming to strengthen system through comprehensive review of funding, workforce, and delivery settings.90% confidence

Sub-Topics Mental Health

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died · Montana · Senate May 23, 2025

SB 100: Revise funding for assisted living services

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.

Topics ✓ HealthcareSupports HealthcareShifts Medicaid services to federal Community First Choice program, expanding access to assisted living care while requiring cost transparency and reporting on service usage.95% confidence

Sub-Topics Long-Term Care Medicaid

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died · Montana · Senate May 23, 2025

SB 199: Revise the Medicaid expansion program

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.

Topics ✗ HealthcareOpposes HealthcareAdds asset-based fees to Medicaid, restricting access for participants with property/vehicle equity, effectively limiting program eligibility and coverage.95% confidence

Sub-Topics Medicaid

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