SB 422 requires Montana health insurers to cover FDA-approved drugs for advanced or metastatic cancer without forcing patients to first fail other treatments. It prohibits insurers from demanding that patients prove they've tried and failed alternative drugs before approving coverage for new treatments that align with national cancer guidelines. This directly affects patients diagnosed with advanced or metastatic cancer in Montana, ensuring faster access to potentially life-saving medications without unnecessary bureaucratic hurdles. The law applies only to drugs approved by the FDA and consistent with evidence-based cancer treatment protocols.
SB 72 creates a "presumptive eligibility" process for Montana Medicaid, allowing people with physical disabilities or who are elderly to immediately access home and community-based services like personal care, meal delivery, medical equipment, and emergency response systems while awaiting full Medicaid approval. It requires a screening process by trained staff (including tribal entities, hospitals, or aging agencies) to verify income, residency, and need, with applicants having 30 days to apply for ongoing Medicaid coverage. The program aims to prevent hospitalizations or institutional care by providing temporary coverage during the application period, ending after 30 days or when full eligibility is determined. The bill requires state approval from CMS before implementation and was vetoed by the governor in May 2025, with a legislative override attempt failing.
SB 394 would have expanded Montana's workers' compensation system to cover posttraumatic stress disorder (PTSD) for eligible first responders. It defines "first responder" to include firefighters, law enforcement officers, detention center/prison staff, and emergency care providers, requiring a diagnosis per the latest DSM-5 manual that links PTSD directly to work duties. The bill amended existing laws to allow PTSD claims under workers' compensation, subject to standard procedural requirements. However, this bill was vetoed by the Governor on June 9, 2025, so it did not become law.
SB 474 would have expanded school immunization exemptions in Montana to include religious exemptions and a new "personal medical informed consent" exemption requiring only a notarized statement. This new exemption would allow students to decline vaccines after consulting a healthcare provider (without needing a provider's signature), distinct from the existing medical exemption requiring a healthcare provider's written statement. The bill also amended school immunization laws (20-5-405 and 49-2-312) to prevent schools from being sued for injuries related to exempt students and to block overly burdensome exemption forms. The bill died in committee on May 23, 2025, and never became law.
SB 164 amends Montana's endangering the welfare of children law to prohibit specific medical treatments for children under 16. The bill bans surgical procedures, puberty blockers, and hormone therapies (like estrogen or testosterone) when used to alter a child's appearance or affirm a gender identity inconsistent with their biological sex. Violating this prohibition is classified as a felony, carrying up to five years in prison and a $10,000 fine, with harsher penalties if the child suffers serious injury. The law would take effect on January 1, 2026, directly affecting medical providers, caregivers, and children under 16 who might receive these treatments.
HB 185 directs the Department of Public Health and Human Services (DPHHS) to implement continuous eligibility for children under six years old in the Healthy Montana Kids plan. This means eligible children would remain enrolled in the program until their sixth birthday, regardless of changes in family income or other circumstances that might otherwise make them ineligible. DPHHS is required to apply for the necessary federal waivers and state plan amendments by July 1, 2025, and implement the continuous eligibility within six months of federal approval. The bill aims to provide consistent health coverage for young children enrolled in Medicaid and the Children's Health Insurance Program.
HB 364 proposes to update laws concerning student immunizations and exemptions in K-12 schools. It would require school governing authorities to submit written reports on student immunization and exemption data to state and local health departments. These reports must only contain deidentified or aggregate information, ensuring student privacy. The Department of Public Health and Human Services would determine the specific form and schedule for these reports.
HB 274 sought to establish a medical respite care program in Montana for homeless individuals who are eligible for Medicaid. This program would have provided short-term housing in residential facilities with supportive medical services for those recovering from illness or injury but not requiring hospitalization. Services would have included treatment plan monitoring, medication management, immunizations, discharge planning, and transportation for medical appointments. The bill directed the Department of Public Health and Human Services to seek federal approval for the program and to report annually on its costs and the number of individuals served.
HB 783 aimed to revise health insurance laws by requiring coverage for specific conditions and treatments. It would have mandated individual health insurance policies to cover glucagon-like peptide-1 receptor agonists and treatments for polycystic ovary syndrome when medically necessary, including for diagnoses of diabetes or class 3 obesity. While allowing standard cost-sharing and cost containment measures, the bill prohibited special limitations on glucagon-like peptide-1 receptor agonists. Additionally, it sought to add other mandatory coverages, such as fertility preservation services and therapies for Down syndrome, to state group health plans. The bill would have affected individuals with these conditions and those covered by applicable health insurance policies in the state.
HB 386 directs the Department of Public Health and Human Services to apply for the reinstatement of 12-month continuous Medicaid eligibility for specific groups. This would affect parents, caretaker relatives, and adults covered under Medicaid expansion. The department is required to submit amendments to existing federal waivers by September 30, 2025, to restore this continuous eligibility, which was previously allowed before certain waiver changes in 2021 and 2022. The bill would take effect immediately upon passage and approval.