Healthcare (Hospitals)

This bill (LC 3351) was a proposed legislative measure aimed at revising healthcare options to improve patient access to doctors. However, the bill never progressed beyond the drafting stage, as it was placed on hold in January 2025 and ultimately "died in process" on May 27, 2025. The context provided does not include the bill's specific provisions, mechanisms, or affected parties, only its title and status. Since no substantive details about the proposed changes were included in the available information, a factual summary of its policy content cannot be provided. The bill did not advance to a vote or become law.

HB 947 requires most individual health insurance policies in Montana to cover continuous glucose monitors (CGMs) and their supplies for people diagnosed with type I or type II diabetes when medically necessary, as prescribed by a healthcare provider. The bill prohibits insurers from denying coverage based on diabetes severity or insulin dependence, and bans special deductibles or limits specifically for CGMs - though standard deductibles may still apply. This affects diabetes patients covered by individual disability, health, or membership insurance plans (excluding Medicare supplements, hospital indemnity, or long-term care policies). The law aims to ensure consistent access to these critical blood sugar monitoring tools without discriminatory coverage barriers.

HB 758 aims to protect health benefit plan enrollees from balance billing for out-of-network ground ambulance services. It prohibits ambulance services from billing enrollees more than their in-network cost-sharing for covered transportation. The bill requires insurers to pay ambulance providers directly, caps out-of-pocket costs for these services at $100, and ensures these costs count towards deductibles. It also mandates that insurers reimburse ambulance services at established local rates or at least 400% of the Medicare rate if no contracted rate exists, and requires the state to create a public database of local ambulance rates.

HB 689 aimed to increase pricing transparency for hospitals. It required hospitals to publish a comprehensive list of all their standard charges for medical items and services, including gross charges, negotiated rates with third-party payors, and discounted cash prices. This information was to be made available on hospital websites in both machine-readable and consumer-friendly formats. The bill also included provisions for reporting to state departments, prohibiting debt collection by non-compliant hospitals, and allowing for enforcement actions.

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.

SB 554 (Montana) limits nonprofit hospitals (excluding critical access/rural emergency hospitals) to charging no more than 300% of the Medicare reimbursement rate for Medicare-eligible services. Hospitals exceeding this rate face an escalating excise tax (starting at 25% in 2027 and rising to 50% after 2030) and risk losing nonprofit status. The bill also requires hospitals to maintain written financial assistance and community benefit policies, submit annual reports including IRS Form 990, and comply with new reporting rules. This bill died in process in May 2025 and was never enacted.