Healthcare (Medicaid)

SB 100 establishes new rules for Medicaid payments in Montana's assisted living facilities. It requires the state agency to adjust room and board costs annually based on recipients' income (minus a $100 personal needs allowance) and directs the shift of Medicaid-covered assisted living services from the current "Big Sky Waiver" program to the federal "Community First Choice" program by 2026. The bill mandates quarterly reporting on service usage, waitlists, and costs for both programs. It affects Medicaid-eligible seniors receiving assisted living care, ensuring payments align with income and streamlining service delivery under federal Medicaid options.

SB 199 revises Montana's Medicaid expansion program (the Montana HELP Act) by introducing monthly "taxpayer integrity fees" for participants meeting specific asset thresholds. It requires fees based on excess real estate value ($5,000+ above homestead limits), vehicle equity ($20,000+ combined value), or agricultural land taxable value ($1,500+ annually), with a base fee of $100 plus $4 per $1,000 over limits. The bill also updates community engagement rules, mandating 80 monthly hours of work-related activities for 19-55-year-olds (with exemptions for medical conditions, caregivers, students, and others). These changes directly affect Medicaid expansion participants owning significant assets or required to meet work participation standards.

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.