MontanaSB 51669th Legislature, Regular Session (2025)Senate

Update licensing requirements for facilities licensed by the department of public health and human services

Sponsored By: Mike Yakawich (Republican)

Signed by Governor

Health Care ServicesHealth

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Bill Overview

Analyzed Economic Effects

8 provisions identified: 2 benefits, 0 costs, 6 mixed.

Stronger oversight of community disability homes

Community homes for people with severe disabilities must be licensed and inspected every year. The department may inspect at any time and review records. If abuse, neglect, or major noncompliance is proven, the department can shorten the license or issue a provisional license for less than 1 year, as long as residents are not put in danger.

Assisted living rules by care level

The law sets clearer assisted-living placement rules. Category A residents must need physical help with at least one daily activity and meet medical and behavior limits. Category B residents need a licensed professional to visit each quarter, sign an assessment, and confirm needs can be met. People subject to 46-14-301 cannot be placed in Category D. The department provides voluntary standard forms and training. In adult foster care, caregivers may help or supervise prescription use but may not give the medicine.

Medicaid adds services, cuts one option

Montana Medicaid covers more services. It pays for care by physician assistants, by certified Indian Health providers, fertility preservation as allowed by law, and planned home births for low-risk pregnancies with licensed midwives, including prenatal and postpartum care. At the same time, the law removes pediatric complex care assistants from the optional home-health list, which may reduce coverage for those services.

New licensing and inspection rules for facilities

The law sets firmer licensing steps for health care facilities. You must apply at least 45 days before opening, name an administrator, and attest you understand the rules. Licenses are site-specific, cannot be sold or assigned, must be posted at admission, and must be returned or destroyed when you close or sell. The department inspects new facilities within 45 days and renewals without notice before the license expires. The department may issue a provisional license for up to 1 year, revoke a license for up to 2 years, and take enforcement without certificate-of-need steps.

Abortion clinic rules exclude rural hospitals

Rural emergency hospitals are not treated as abortion clinics. A site that gives an abortion-inducing drug to fewer than five patients in a year is also not an abortion clinic. This narrows which places must follow abortion-clinic rules.

Day-care medicine and licensing updates

For day-care medicine rules, the law updates which clinics count as a health care facility. The department may give a provisional day-care license for up to 1 year when a provider is working to meet standards. This can keep care open while fixes are made.

New facility types and hospital categories

The law updates who counts as a health care facility. It adds rural emergency hospitals and substance use disorder facilities and ties rural and critical access definitions to federal rules. It also says critical access and rural emergency hospitals are not specialty hospitals. For trauma rules, only hospitals and critical access hospitals count. These changes guide licensing, designations, and oversight.

County and insurance definitions updated

County law no longer lists "medical assistance facility" as a health care facility. Insurance law removes that term and adds rural emergency hospitals to the definition of a facility. This can change how counties regulate providers and how insurers handle claims and networks.

Sponsors & Cosponsors

Sponsor

Mike Yakawich
Republican • Senate

Cosponsors

Josh Kassmier
Republican • Senate
Valerie Moore
Republican • House

Roll Call Votes

All Roll Calls

Yes: 297 • No: 1

House vote • 4/11/2025

Do Concur

Yes: 100 • No: 0

House vote • 4/11/2025

Do Concur

Yes: 99 • No: 0

Senate vote • 3/6/2025

Do Pass

Yes: 49 • No: 1