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MontanaSB 56069th Legislature, Regular Session (2025)Senate

Provide for a hospital community benefit fee

Sponsored By: Matt Regier (Republican)

Signed by Governor

Health Care ServicesTaxationRevenue, StateRule MakingTaxation--Property

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Bill Overview

Analyzed Economic Effects

3 provisions identified: 1 benefits, 0 costs, 2 mixed.

Stronger hospital protections for patients

Beginning January 1, 2027, hospitals must keep a written policy that bans discrimination based on ability to pay. The policy covers all patients, including Medicaid and Medicare. Hospitals may not transfer a patient because the patient cannot pay. Nonprofit hospitals must keep written financial‑assistance and community‑benefit policies that follow federal and department standards, post them, and follow them. Critical access hospitals and rural emergency hospitals have until January 1, 2031 to meet these rules.

Fee on nonprofits funds rural hospitals

DPHHS compares each nonprofit hospital’s reported community benefit to its prior year potential property tax liability. If the benefit is lower, the hospital pays a fee equal to the difference. If it is higher, no fee is charged. The Department of Revenue calculates the potential tax bill using last year’s taxable value and mills, treats hospital property as class four commercial, excludes property that already pays taxes, gives one combined statement for multi‑county hospitals, and provides a dispute process. The state deposits all fees into a new Critical Access Health Care Special Revenue Account. DPHHS pays the money out by June 30 each year to every critical access hospital on a per‑bed basis. DPHHS makes fee decisions within 30 days after a hospital files its IRS return.

Standard reports on hospital community benefits

Each nonprofit hospital must send the state a copy of IRS Form 990 Schedule H within 30 days after it files with the IRS. The state uses this to compare the hospital’s reported community benefit to its potential property tax bill. Hospitals must also file a detailed community benefit report based on Schedule H. The report lists community health improvement, community benefit operations, community building, and how they link to the hospital’s community health needs plan. It also lists financial assistance, means‑tested programs, subsidized services, bad debt, charitable gifts, and the net costs. The law defines “community benefit” and “potential property tax liability” using Schedule H data and prior‑year property tax rules, and clarifies which hospitals count as nonprofit. It also removes an old July 1, 2024 rulemaking deadline for the department.

Sponsors & Cosponsors

Sponsor

  • Matt Regier

    Republican • Senate

Cosponsors

There are no cosponsors for this bill.

Roll Call Votes

All Roll Calls

Yes: 299 • No: 96

Senate vote • 4/29/2025

Do Pass

Yes: 50 • No: 0

Senate vote • 4/28/2025

Do Pass

Yes: 49 • No: 0

House vote • 4/24/2025

Do Concur

Yes: 72 • No: 28

House vote • 4/23/2025

Do Concur

Yes: 67 • No: 33

Senate vote • 4/5/2025

Do Pass

Yes: 30 • No: 18

Senate vote • 4/4/2025

Do Pass

Yes: 31 • No: 17

Actions Timeline

  1. Chapter Number Assigned

    5/19/2025Senate

  2. Signed by Governor

    5/13/2025Senate

  3. Transmitted to Governor

    5/5/2025Senate

  4. Signed by Speaker

    5/5/2025House

  5. Signed by President

    5/2/2025Senate

  6. Returned from Enrolling

    5/1/2025Senate

  7. Sent to Enrolling

    4/29/2025Senate

  8. 3rd Reading House Amendments

    4/29/2025Senate

  9. 2nd Reading House Amendments

    4/28/2025Senate

  10. Returned to Senate with Amendments

    4/24/2025House

  11. 3rd Reading

    4/24/2025House

  12. 2nd Reading

    4/23/2025House

  13. Committee Report

    4/18/2025House

  14. Committee Executive Action

    4/17/2025House

  15. Tabled in Committee

    4/17/2025House

  16. Fiscal Note Printed

    4/11/2025Senate

  17. Fiscal Note Signed

    4/10/2025Senate

  18. Fiscal Note Received

    4/9/2025Senate

  19. Hearing

    4/7/2025House

  20. 1st Reading

    4/7/2025House

  21. Referred to Committee

    4/7/2025House

  22. Transmitted to House

    4/5/2025Senate

  23. 3rd Reading

    4/5/2025Senate

  24. 2nd Reading

    4/4/2025Senate

  25. Committee Report

    4/3/2025Senate

Bill Text

  • Enrolled

    4/29/2025

    PDF

  • As Amended (Version 2)

    4/18/2025

    PDF

  • Introduced

    3/31/2025

    PDF

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