Healthcare

signed · Montana · Senate May 16, 2025

SB 446: Revise laws related to healthcare utilization review

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.

Topics ✓ HealthcareSupports HealthcareRestricts prior authorization for essential drugs (substance use, generics) and mandates physician oversight for coverage denials, improving patient access and protecting rights.85% confidence | Rep's Stance ✓ Voted Yes ✓ Supports Healthcare

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 | Rep's Stance ✓ Voted Yes ✓ Supports Healthcare

signed · Montana · House May 16, 2025

HB 953: Revise medicaid laws related to direct primary care

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.

Topics ✓ HealthcareSupports HealthcareExpands Medicaid coverage for direct primary care, improving patient access and removing case management requirements per bill text.95% confidence | Rep's Stance ✓ Voted Yes ✓ Supports Healthcare

signed · Montana · Senate May 16, 2025

SB 524: Revise laws relating to category D assisted living facilities

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.

Topics ✓ HealthcareSupports HealthcareClarifies safety protocols for vulnerable residents in assisted living facilities, protecting patient rights and improving care standards under healthcare services.85% confidence | Rep's Stance ✓ Voted Yes ✓ Supports Healthcare

signed · Montana · Senate May 16, 2025

SB 535: Revise laws related to experimental treatments

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.

Topics ✓ HealthcareSupports HealthcareMandates 2% profit allocation for patient access to experimental treatments, directly expanding access and funding under healthcare services.95% confidence | Rep's Stance ✓ Voted Yes ✓ Supports Healthcare

signed · Montana · Senate May 13, 2025

SB 503: Allow use of expired opioid antagonists

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.

Topics ✓ HealthcareSupports HealthcareAllows expired naloxone use for overdose treatment, expands emergency access to life-saving care, and grants liability protection to providers - directly improving healthcare access for opioid emergencies.95% confidence | Rep's Stance ✓ Voted Yes ✓ Supports Healthcare

signed · Montana · House May 13, 2025

HB 732: Establish prompt cost report reimbursement act

HB 732, the "Prompt Cost Report Reimbursement Act," revises how the Montana Department of Public Health and Human Services reimburses critical access hospitals participating in the state's Medicaid program. The bill requires the department to perform a tentative settlement and make interim payments to these hospitals within 240 days of a cost report being submitted to the Medicare administrative contractor. A final settlement and adjustment will occur after the Medicare administrative contractor completes its full review or audit. This process aims to align Montana Medicaid's reimbursement with Medicare's, ensuring more timely payments to critical access hospitals for services rendered.

Topics ✓ Budget & TaxesSupports Budget & TaxesBill mandates timely Medicaid reimbursements under appropriations process, promoting fiscal responsibility in state budget execution for healthcare funding.85% confidence ✓ HealthcareSupports HealthcareBill mandates timely Medicaid reimbursements to critical access hospitals, preventing financial strain and ensuring continued healthcare service provision.90% confidence | Rep's Stance ✓ Voted Yes ✓ Supports Healthcare

signed · Montana · House May 13, 2025

HB 825: Generally revise laws related to health care proxy decisionmakers

HB 825 revises laws related to healthcare decision-makers for adult patients. It allows patients to designate a "trusted decisionmaker" to make medical choices on their behalf if they lose the ability to make their own, with healthcare providers required to document this designation. The bill establishes a legal hierarchy for selecting a decision-maker for incapacitated patients, placing the patient-designated trusted decisionmaker high on that list. This ensures a patient's chosen individual has authority to make healthcare decisions if they cannot.

Topics ✓ HealthcareSupports HealthcareEnables patient designation of trusted decisionmakers, prioritizing patient autonomy in medical choices, protecting rights under healthcare decision-making laws.95% confidence | Rep's Stance ✓ Voted Yes ✓ Supports Healthcare

signed · Montana · Senate May 13, 2025

SB 95: Provide funding for suicide prevention

Senate Bill 95 allocates $300,000 to the Department of Public Health and Human Services for the biennium beginning July 1, 2025. This funding is dedicated to suicide prevention efforts specifically for service members, veterans, and their families. The bill outlines several key uses for the money, including implementing prevention strategies and establishing screening standards for suicide risk. It also aims to improve care transitions and increase lethal means safety through initiatives such as a statewide safe storage campaign and training events. The act is effective July 1, 2025, and terminates on June 30, 2027.

Topics ✓ HealthcareSupports HealthcareAllocates $300,000 for suicide prevention mental health services targeting veterans, directly advancing mental healthcare access and prevention programs.95% confidence ✓ VeteransSupports VeteransExplicitly funds suicide prevention for veterans with $300k allocation, directly addressing mental healthcare needs as stated in bill summary.95% confidence | Rep's Stance ✓ Voted Yes ✓ Supports Healthcare

signed · Montana · House May 13, 2025

HB 576: Revise funding for medicaid and health and support services to children and to adults who are aged, blind, and disabled

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.

Topics ✓ Budget & TaxesSupports Budget & TaxesUses tobacco settlement proceeds as matching funds for Medicaid/CHIP, directly funding essential health services without new taxes or cuts.95% confidence ✓ HealthcareSupports HealthcareBill allocates tobacco settlement funds to expand Medicaid/CHIP funding and health services for vulnerable populations, strengthening coverage and access.95% confidence | Rep's Stance ✓ Voted Yes ✓ Supports Healthcare