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Like local jails nationwide, Montana鈥檚 small holding facilities have become institutions of last resort as patients in mental health crisis stall in backlogs, waiting for beds at the state-run mental hospital.
Republicans are pushing to implement requirements that Medicaid recipients work in order to obtain or retain coverage. Some states try to help enrollees find jobs. But states lack the data to show whether they鈥檙e effective.
The Montana health department says the Board of Public Assistance is redundant and a bureaucratic hurdle that helps few people. Current and former board representatives say the rare cases in which the panel helps people are important.
Though abortion rights supporters prevailed on ballot measures in seven of the 10 states where abortion was up for a vote on Nov. 5, the state supreme courts voters have elected indicate legal fights to come aren鈥檛 clear-cut.
Federal law says Native Americans aren鈥檛 liable for medical bills the Indian Health Service promises to pay. Some are billed anyway as a result of backlogs or mistakes from the agency, financial middlemen, or health systems.
The push-pull in Montana reflects a national tension as states try to decide what counts as fair checks on tax-exempt hospitals and industry players weigh in. The debate centers on whether nonprofit hospitals do enough good to earn their charitable status.
Conservative groups are working to undermine support for Montana鈥檚 Medicaid expansion ahead of a political fight over whether to keep the program.
As Montana鈥檚 population ages, providers serving low-income seniors say more people aren鈥檛 getting the care they need as they wait to get on Medicaid. Montana lawmakers are considering creating a shortcut to that care.
More pregnant women are being diagnosed with dangerously high blood pressure, which risks the life of the parent and child. Montana is one of the states improving screening and treatment as health facilities work to match care with best practices.
The Indian Health Service has a program that can pay for outside appointments when patients need care not offered at agency-funded sites. Critics say money shortages, complex rules, and administrative fumbles often block access, however.
Montana鈥檚 proposal to increase oversight is part of a national trend by states to ensure nonprofit hospitals act as charitable organizations as they claim tax-exempt status. But the state has yet to set standards for how much the hospitals must do.
One of Montana鈥檚 largest safety-net health centers announced it will lay off nearly 10% of its workforce because of revenue losses it attributes to vast Medicaid disenrollments. Such cuts are happening elsewhere too.
Montana has created a voucher program to help cover room and board costs at low-intensity residential programs for people with addiction. Those running the homes say bridging that care is urgent but that the program鈥檚 funding falls far below the need.
Agreeing to an out-of-network doctor鈥檚 own financial policy 鈥 which generally protects their ability to get paid and may be littered with confusing insurance and legal jargon 鈥 can create a binding contract that leaves a patient owing.
Used to operating with scarce resources, Montana Medicaid providers say gaps in state payments have left them struggling further.
Montana may join about a dozen other states in creating 鈥渟afe havens鈥 that keep health care professionals from facing scrutiny from licensure boards for seeking mental health or addiction treatment.
Facts don鈥檛 support claims by a likely Republican Senate candidate that a federal research laboratory in Montana infected bats with a coronavirus from China before the covid-19 outbreak.
The head of Montana鈥檚 health department said the agency is catching up on a months-long backlog of contracts with organizations that connect people to medical care that left organizations without pay, halted some services, and triggered job cuts.
The Montana Department of Public Health and Human Services is months behind in paying organizations contracted to connect people to care. The interruption is likely to have lasting effects, even after the state catches up.
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