Healthcare

signed · Montana · Senate May 13, 2025

SB 449: Generally revise health utilization review laws

SB 449 generally revises health utilization review laws, affecting health insurance enrollees, health insurance issuers, and healthcare providers. It requires health insurers to honor existing prior authorizations for at least 90 days when an enrollee changes health plans and prevents requiring repeat step therapy protocols if already completed. The bill prohibits prior authorization for certain prescriptions written at discharge from inpatient care for at least three days. Additionally, it generally prevents health insurers from retroactively denying covered services that received prior authorization and mandates that insurers accept and respond electronically to prior authorization requests from healthcare providers.

Topics ✓ HealthcareSupports HealthcarePrevents redundant prior authorizations and extends coverage during plan changes, improving patient access to care without added delays.95% confidence | Rep's Stance ✓ Voted Yes ✓ Supports Healthcare

signed · Montana · Senate May 13, 2025

SB 317: Prohibit health insurers from performing prior authorization on psychiatric drugs in shortage or discontinued

SB 317 prohibits health insurance companies from requiring prior authorization for psychiatric prescription drugs that are officially designated as being in shortage. The list of these drugs will be updated quarterly, based on the U.S. Food and Drug Administration's official shortage list. This aims to ensure covered persons can access necessary psychiatric medications without delays due to prior authorization when supplies are limited. Additionally, the bill prevents manufacturers of these shortage drugs from engaging in predatory pricing or marketing practices.

Topics ✓ HealthcareSupports HealthcareRemoves prior authorization barriers for psychiatric drugs in shortage, improving patient access to mental health care per FDA shortage list.95% confidence | Rep's Stance ✓ Voted Yes ✓ Supports Healthcare

signed · Montana · House May 8, 2025

HB 740: Revise laws relating to pharmacies, pharmacy benefit managers, and other entities

HB 740 revises laws affecting pharmacies, pharmacy benefit managers (PBMs), and other entities involved in prescription drug dispensing and reimbursement. The bill establishes new restrictions on how PBMs can audit pharmacies and recoup funds, such as prohibiting recoupment for clerical errors without actual financial harm and banning the use of extrapolation in calculations. It also updates regulations for Maximum Allowable Cost (MAC) lists and reference pricing, requiring PBMs to ensure drugs on MAC lists are available and to frequently update and disclose pricing information to pharmacies.

Topics ✓ HealthcareSupports HealthcareRestricts PBMs from unfair recoupment (e.g., clerical errors without harm) and mandates fair MAC/reference pricing, protecting pharmacies and improving patient access to medications.85% confidence | Rep's Stance ✓ Voted Yes ✓ Supports Healthcare

signed · Montana · House May 8, 2025

HB 601: Create online portal for community assisters related to Medicaid

HB 601 establishes an online portal by May 1, 2026, to assist Medicaid applicants and enrollees. This portal allows designated "community assisters" to help individuals apply for Medicaid coverage and submit required documents. Key functions include enabling assisters to review application status, view department notices, report eligibility changes, and update contact information for their clients. The portal also allows, but does not require, assisters to submit initial applications or redeterminations and upload verification documents. This aims to streamline the application process for individuals seeking Medicaid assistance through community organizations.

Topics ✓ HealthcareSupports HealthcareStreamlines Medicaid application process via portal, improving access to healthcare coverage for low-income individuals by facilitating community assister support.95% confidence | Rep's Stance ✓ Voted Yes ✓ Supports Healthcare

signed · Montana · House May 8, 2025

HB 687: Revise age of expanded Medicaid participants required to engage in community engagement activities

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.

Topics ✗ HealthcareOpposes HealthcareExtends mandatory community engagement requirements for Medicaid participants, potentially restricting access to healthcare coverage by adding new compliance barriers for 19-62-year-olds.92% confidence | Rep's Stance ✗ Voted No ✓ Supports Healthcare

signed · Montana · House May 8, 2025

HB 56: Establish ambulance provider assessment fee program

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.

Topics ✓ Budget & TaxesSupports Budget & TaxesCreates mandatory 5.75% fee on ambulance providers to generate revenue specifically designated for Medicaid ambulance payments, directly funding public healthcare services via new state revenue.92% confidence ✓ HealthcareSupports HealthcareBill establishes fee to fund ambulance services via Medicaid supplementation, directly supporting healthcare access and provider reimbursement.95% confidence | Rep's Stance ✓ Voted Yes ✓ Supports Healthcare

signed · Montana · Senate May 8, 2025

SB 191: Provide for the licensure of residential treatment centers

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.

Topics ✓ HealthcareSupports HealthcareEstablishes licensing standards requiring CMS-approved accreditation and insurance compliance for residential treatment centers, strengthening quality oversight in healthcare services.85% confidence | Rep's Stance ✓ Voted Yes ✓ Supports Healthcare

passed both · Montana · Senate May 6, 2025

SJ 49: Interim study of youth and family behavioral health prevention

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.

Topics ✓ HealthcareSupports HealthcareBill initiates study to identify gaps in youth mental health prevention programs, aiming to strengthen system through comprehensive review of funding, workforce, and delivery settings.90% confidence | Rep's Stance ✓ Voted Yes ✓ Supports Healthcare

Track

signed · Montana · House May 5, 2025

HB 447: Enact the Respiratory Care Interstate Compact

HB 447 enacts the Respiratory Care Interstate Compact, allowing licensed respiratory therapists to practice in multiple member states without needing a full license in each. This aims to increase public access to respiratory therapy services and improve workforce mobility, including for military members and their spouses. The compact establishes a "compact privilege" for therapists to practice in other member states while preserving each state's regulatory authority. It also includes provisions for criminal background checks for license applicants.

Topics ✓ HealthcareSupports HealthcareBill explicitly increases public access to respiratory therapy services by enabling interstate practice, improving workforce mobility for therapists, and aligning with healthcare access indicators.92% confidence ✓ VeteransSupports VeteransBill explicitly includes military members and spouses in workforce mobility benefits, supporting veteran family employment through interstate practice privileges.85% confidence | Rep's Stance ✓ Voted Yes ✓ Supports Healthcare

signed · Montana · House May 5, 2025

HB 454: Revise visit frequency required of supervisory physical therapists

HB 454 revises the required frequency of patient visits by a licensed physical therapist when supervising a physical therapy assistant. This bill directly affects licensed physical therapists, physical therapy assistants, and the patients they serve. It changes the supervisory requirement, allowing a physical therapist to make an onsite or telehealth visit once for every eight visits made by an assistant, rather than six. Additionally, the time-based supervisory visit is extended from every two weeks to every 30 days, whichever occurs first.

Topics ✓ HealthcareSupports HealthcareReduces mandatory supervision frequency for physical therapists, increasing efficiency and potentially improving patient access to services through streamlined care delivery.85% confidence | Rep's Stance ✓ Voted Yes ✓ Supports Healthcare