MontanaHB 57469th Legislature, Regular Session (2025)HouseWALLET

Authorizing implementation of the certified community behavioral health clinic model

Sponsored By: Jane Gillette (Republican)

Became Law

Health Care ServicesRule Making

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Bill Overview

Analyzed Economic Effects

4 provisions identified: 4 benefits, 0 costs, 0 mixed.

Clinic pay tied to costs, quality

The department sets clear rules for which costs count when paying clinics under Medicaid and Healthy Montana Kids. It analyzes clinic cost reports and rebases encounter rates at least every two years under federal guidance. The department also creates incentives that pay extra to clinics that show exceptional quality results and adopts rules to run that program.

Faster access and required services

Clinics must directly provide targeted case management, peer and family supports, and outreach and education. If a screening shows urgent need, they give services and an initial evaluation within 1 business day of first contact. New patients get a full diagnostic and treatment plan within 30 days of the first request. Outreach teams partner with hospitals, work with law enforcement on training and crisis responses, and engage high-cost Medicaid users who are not in treatment. Clinics may provide or contract for primary care screening and monitoring, services for veterans and service members, and outpatient psychiatric rehab when federal rules allow. They also coordinate with other providers to avoid duplicate services and keep a full range of care.

Montana creates clinic care program

The law creates a certified community behavioral health clinic program at the state health department. Subject to available funding, the department establishes it no later than October 1, 2026, following federal rules. The department monitors services, outcomes, and fraud, waste, and abuse, and can remove a clinic’s certification for cause. Clinics report deidentified quality data, including functional scores, housing, work, and law enforcement involvement. The department tracks pre- and post-program costs, including hospital and ER use, and gives quarterly updates to two legislative committees on access, outcomes, high Medicaid users, and costs.

Sliding fees and insurance-first billing

Clinics bill private insurance first; Medicaid pays last. They keep a public sliding fee scale based on income. Clinics do not deny care because you cannot pay.

Sponsors & Cosponsors

Sponsor

Jane Gillette
Republican • House

Cosponsors

Cora Neumann
Democrat • Senate

Roll Call Votes

All Roll Calls

Yes: 287 • No: 8

House vote • 4/12/2025

Do Concur

Yes: 48 • No: 2

House vote • 4/11/2025

Do Concur

Yes: 43 • No: 6

House vote • 3/5/2025

Do Pass

Yes: 98 • No: 0

House vote • 3/3/2025