MontanaMontana reviews Medicaid rates using provider cost reports
Providers report recent costs to Montana’s health department, which compares them with Medicaid rates and reports to lawmakers when funding allows.
What it does
The department must use a standard format to collect revenue and expense information from providers in several service areas, including mental health and long-term care.
If the legislature provides money for the work, the department must compare Medicaid rates with provider costs and share information to support budget requests for rate changes.
The department receives $600,000 from the general fund and $600,000 in federal matching money for the report during the two-year budget period beginning July 1, 2025.
Argument forRegular comparisons of rates and provider costs could help lawmakers decide whether to request money for needed payment changes.
Argument againstProviders could spend staff time gathering yearly cost records and responding to requested audits, leaving less time for other work.
More detail
The department must set up a standard process for collecting provider cost reports. The process covers adult and children’s mental health, substance use, developmental disabilities, and senior and long-term care services funded through Medicaid, state money, or other identified sources. The department must identify providers who must report and those who are exempt. The department must consult providers on the report format and protect their cost data. Providers must report costs from their most recent fiscal year. The department must update base-year cost data at least once every four years, but no more than once in any two-year period.
The department must report how current Medicaid rates compare with provider costs. The report covers rates for providers included in the cost-reporting process. The department must consider provider reports and other sources, including claims, federal data, and comparisons with other states. The report must support budget requests when rate changes are needed. The department must provide a report at least every four years. The first report is due September 1, 2026.
The law sets aside money for the department to develop the rate report. The money goes to the Department of Public Health and Human Services for the report. The federal special revenue serves as matching funds for the department. The appropriations cover the biennium beginning July 1, 2025.
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Where it stands
- Introduced
- Passed House
- Passed Senate
- To Governor
- Became Law
Looking ahead
No hearings or votes scheduled.
History
- 2025
- Jun 5Chapter Number AssignedLatest
- May 12(H) Signed by Governor Greg GianforteBecame Law
- May 5(H) Transmitted to GovernorTo Governor
- May 2(S) Signed by PresidentPassed Senate
- May 1(H) Signed by SpeakerPassed House
- Apr 28(H) Returned from Enrolling
- Apr 22(H) Sent to Enrolling
- Vote recorded Do Concur. Result: pass.Upper
- Apr 22(S) 3rd Reading
- Apr 22(S) Scheduled for 3rd ReadingMinor
- Apr 18(S) Committee Report - (S) Finance and Claims
- Vote recorded be_concurred_in. Result: pass.Upper
- Apr 18(S) Committee Executive Action - (S) Finance and Claims
- Apr 17(S) Hearing - (S) Finance and Claims
- Apr 16(S) Rereferred to Committee - (S) Finance and ClaimsMinor
- Vote recorded Do Concur. Result: pass.Upper
- Apr 16(S) 2nd ReadingMinor
- Apr 16(S) Scheduled for 2nd ReadingMinor
- Apr 15(S) Committee Report - (S) Public Health, Welfare and Safety
- Vote recorded be_concurred_in. Result: pass.Upper
- Apr 15(S) Committee Executive Action - (S) Public Health, Welfare and Safety
- Apr 7(S) Hearing - (S) Public Health, Welfare and Safety
- Mar 21(S) Referred to Committee - (S) Public Health, Welfare and SafetyMinor
- Mar 21(S) 1st Reading
- Mar 20(H) Transmitted to Senate
- Vote recorded Do Pass. Result: pass.Lower
- Mar 20(H) 3rd Reading
- Mar 20(H) Scheduled for 3rd ReadingMinor
- Mar 19(H) Committee Report - (H) Appropriations
- Vote recorded do_pass. Result: pass.Lower
- Mar 19(H) Committee Executive Action - (H) Appropriations
- Mar 18(H) Hearing - (H) Appropriations
- Vote recorded Do Pass. Result: pass.Lower
- Mar 18(H) Rereferred to Committee - (H) AppropriationsMinor
- Mar 18(H) 2nd ReadingMinor
- Mar 18(H) Scheduled for 2nd ReadingMinor
- Feb 26(H) Committee Report - (H) Human Services
- Feb 25(H) Committee Executive Action - (H) Human Services
- Vote recorded do_pass. Result: pass.Lower
- Feb 13(H) Fiscal Note Printed
- Feb 13(H) Hearing - (H) Human Services
- Feb 12(H) Fiscal Note Signed
- Feb 12(H) Fiscal Note ReceivedMinor
- Feb 7(H) 1st Reading
- Feb 7(H) Referred to Committee - (H) Human ServicesMinor
- Feb 6(H) Fiscal Note Requested
- Feb 6(H) Introduced
- Feb 6(LC) Draft Delivered to Requester
- Feb 6(LC) Draft Ready for Delivery
- Feb 5(LC) Draft in Assembly
- Feb 5(LC) Draft in Final Drafter Review
- Feb 2(LC) Draft in Input/Proofing
- Jan 29(LC) Draft in Edit
- Jan 29(LC) Draft in Legal Review
- Jan 29(LC) Draft Taken Off Hold
- 2024
- Nov 5(LC) Draft On Hold
- Nov 5(LC) Drafter AssignedIntroduced
HealthcareTaxes & Budget