Senate Bill 361, introduced by Montana Senator M. Yakawich on February 19, 2025, aims to enhance the claims process for health care services provided to Medicaid recipients. The bill proposes an additional basis on which parties responsible for payment of health care claims cannot deny claims submitted by the Department of Public Health and Human Services (DPHHS).

The key provisions of SB 361 include amendments to Section 33-1-111 of the Montana Code Annotated, which outlines the eligibility requirements for health insurance issuers and other entities involved in health care payments. The bill mandates that these entities must provide eligibility information to DPHHS upon request, respond to inquiries regarding claims within three years of service, and accept the department's right to recover payments on behalf of Medicaid recipients.

Supporters of the bill argue that it will streamline the claims process, ensuring that Medicaid recipients receive timely access to necessary health care services. They emphasize that the legislation addresses ongoing issues with claim denials that can delay or deny essential care for vulnerable populations.

However, the bill has faced some opposition. Critics express concerns that the additional requirements may impose burdens on health care providers and insurers, potentially leading to increased administrative costs. Some stakeholders worry that the bill could complicate existing processes rather than simplify them.

The implications of SB 361 are significant, as it seeks to improve the efficiency of Medicaid claims processing in Montana. By potentially reducing claim denials, the bill could enhance access to health care for low-income individuals and families. Experts suggest that if passed, the legislation could serve as a model for other states grappling with similar issues in their Medicaid systems.

As the legislative session progresses, SB 361 will be closely monitored for any amendments or debates that may arise, reflecting the ongoing discussions about health care access and administrative efficiency in Montana.