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.
HB 880 establishes the Medicaid Stabilization Reserve Account, a state special revenue fund designed to help maintain Medicaid benefits during state revenue shortfalls. The account would be primarily funded by transferring any unused state general fund appropriations for Medicaid at the end of a fiscal year. Funds from this account could only be appropriated by the legislature for state Medicaid matching funds after the budget director certifies a projected general fund deficit. This mechanism aims to mitigate expenditure reductions in the Medicaid program, directly affecting the stability of services for beneficiaries. The bill also includes an initial appropriation of $50,000 for state Medicaid matching funds.
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.
HB 687 revises the age range for expanded Medicaid participants who are required to engage in community engagement activities. Previously, participants aged 19 to 55 were subject to this requirement. This bill extends that upper age limit, now requiring individuals from 19 to 62 years old to participate. Affected participants must complete 80 hours per month in activities such as employment, education, work training, or community service, unless they qualify for an exemption. This change directly impacts expanded Medicaid recipients between the ages of 56 and 62.
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.
HB 398 revises health insurance laws regarding utilization review, impacting patients and health insurance companies. The bill requires health plans to honor previously approved health care services for at least three months when a patient changes plans, ensuring continuity of care. It mandates that only licensed physicians, specializing in the relevant condition, can make or review decisions to deny or reduce health care services (adverse determinations). Additionally, it clarifies the definition of "adverse determination" and other related terms within insurance law.
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.