SB 435 revises laws related to individuals experiencing mental illness by establishing a new 72-hour mental health hold. This provision allows a mental health professional to place an individual in a facility for up to 72 hours if, due to a mental disorder, they cannot meet basic needs, cause injury, or pose an imminent threat to themselves or others. During this hold, the individual receives an evaluation, and options upon release include further voluntary care or a petition for commitment. Additionally, the bill allows for the waiver of an individual's physical presence at mental health hearings under specific conditions, such as if their presence would seriously adversely affect their mental health condition.
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.
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.
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.
HB 953 revises Montana's Medicaid laws to allow for the coverage of direct primary care contracts under the state's Medicaid program. This bill directly affects Medicaid enrollees by providing them the option to use these services. It also prohibits the Department of Public Health and Human Services from requiring an enrollee to participate in primary care case management if they opt for a direct primary care contract. The bill provides a definition for "direct primary care contract" and includes an appropriation to support these changes.
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.
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.
This bill establishes a state licensure system for doulas, defining them as nonmedical professionals who provide continuous physical, emotional, and informational support during pregnancy and up to one year postpartum. Beginning January 1, 2027, individuals wishing to practice as state-licensed doulas must obtain a license from the Department of Labor and Industry. Licensure requires paying fees, completing specific competencies, and adhering to professional conduct standards. Additionally, the bill allows the Department of Public Health and Human Services to provide Medicaid coverage for services offered by state-licensed doulas.
SB 503 allows for the use of expired opioid antagonists, such as naloxone, to treat opioid-related drug overdoses. This bill grants partial immunity from liability to school employees, eligible recipients, medical practitioners, and pharmacists who administer or distribute these expired medications in good faith. It amends existing law to explicitly permit schools to stock and use expired opioid antagonists and extends immunity to school personnel, except in cases of gross negligence or intentional misconduct. The bill's purpose is to broaden access to life-saving opioid antagonist medication by permitting the use of expired doses.
HB 881 proposed to revise the existing Medicaid buy-in program to include children with disabilities. This would expand eligibility for the program, allowing more children with disabilities to access Medicaid services. The bill also included an appropriation and extended rulemaking authority for the relevant department to implement these changes. It aimed to amend specific sections of Montana law concerning Medicaid administration and eligibility requirements.
