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.
HB 56 establishes an assessment fee program for ground ambulance providers licensed in the state. These providers will pay a uniform fee of 5.75% of their net operating revenues annually to the Department of Revenue. The revenues generated from this assessment are specifically designated to supplement Medicaid payments for ambulance services. The bill also outlines procedures for reporting, collection, auditing, and penalties for non-compliance.
Senate Bill 191 establishes a new licensing system for residential treatment centers in Montana. It grants the Department of Public Health and Human Services the authority to create administrative rules for these centers, covering areas such as staff qualifications, treatment services, insurance, and background checks. The bill requires these centers to obtain accreditation from an entity approved by the U.S. Centers for Medicare and Medicaid Services, with provisional licenses available during the accreditation process. Finally, it extends eligibility for appropriate educational opportunities to children placed in these newly defined residential treatment centers.
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 600 authorizes public and nonpublic schools to maintain a supply of "stock albuterol," a quick-relief asthma medication, for emergency use. This medication can be administered by a school nurse or other authorized school personnel to any individual, student or non-student, experiencing respiratory distress on school grounds or at school-related activities. Schools choosing to keep stock albuterol must develop a protocol for staff training, medication maintenance, and post-administration follow-up, including determining when to make a 9-1-1 emergency call. The bill requires a prescription for the stock albuterol, with the school designated as the patient.
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 544 revises health insurance laws, affecting health insurance issuers, covered individuals, and state employees/retirees. It prohibits health insurance issuers from retroactively denying coverage for services that received prior approval, with exceptions for fraud or misrepresentation. The bill also allows biologic therapies to be prescribed to minors under 18, even if FDA-approved only for adults, provided the treatment is medically necessary and supported by peer-reviewed medical literature. Furthermore, it amends provisions for state insurance contracts, detailing conditions under which certain state employees, retirees, and their families, as well as legislators and judges, can continue membership in state group health plans.
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.
Senate Bill 495 eliminates the Tobacco Prevention Advisory Board. The bill repeals the specific section of law that established this board. It also amends existing statute to remove the board from the list of entities funded by state special revenue accounts, which are primarily used for tobacco disease prevention programs and the Children's Health Insurance Program. The direct effect is the dissolution of the advisory board, which previously provided guidance for these programs.
HB 399 revises prior authorization laws for health insurance issuers, aiming to simplify access to certain prescription drugs for covered individuals. The bill prohibits prior authorization for oral and inhaled generic prescription drugs, inhaled medications for asthma or chronic lung diseases, and insulin for diabetes patients. It also restricts prior authorization for generic drugs used consistently for six months and for dosage adjustments within approved limits. If an insurer makes an adverse determination for a prescription drug, the decision must be made by a specialist physician, and the insurer must provide a list of covered therapeutic alternatives.
