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Bill to let residents bill outside training program draws support as rural workforce tool
Summary
Senate Bill 347, heard by the House Business and Labor Committee, would change Montana licensure so medical residents could take approved outside shifts and have those services billed. Proponents said the change would help rural hospitals fill gaps; program directors described safeguards. No committee vote was recorded.
The House Business and Labor Committee took testimony on Senate Bill 347, a proposal to revise Montana’s medical-resident licensure and allow residents to perform approved additional clinical shifts outside their residency program and for facilities to bill payers for those services.
Sponsor Sue Vinton said Montana has relatively few physician residents per capita and that enabling residents to work additional approved shifts could help address shortages, particularly in rural counties. She told the committee that Montana’s residents-per-100,000 figure was 7.8 versus a national average of 43.8 and said the change would align Montana with the licensing practice in many other states.
Proponents included Billings Clinic Logan Health, which said its residency programs train more than 50 residents and use rural rotations to encourage clinicians to remain in the state. Heather O’Hara of the Montana Hospital Association and Jean Branscum of the Montana Medical Association said allowing residents to take approved outside shifts would help hospitals fill weekend and after‑hours coverage and reduce reliance on costly contract providers.
Program directors described oversight safeguards. Rob Stenger, program director at the family-medicine residency of Western Montana and chair of the Montana Graduate Medical Education Council, said programs already review any proposed moonlighting activities, assess resident competence and could refuse requests that exceed a resident’s training. "If a resident moonlighted without the program director approving that activity, they could face dismissal from their residency," Stenger said, describing program-level checks on hours and supervision.
Supporters said the change would allow facilities to bill for resident work that is already performed in some settings but currently cannot be billed because residents lack full licensure. Testimony noted that residents in some psychiatry programs travel to neighboring states to fill shifts they currently cannot do in Montana because of billing and licensure limits.
Kevin Bragg, bureau chief for professional licensing at the Department of Labor and Industry (an informational witness), answered questions about statutory and administrative steps needed if the change is adopted.
Committee members asked whether physician assistants or nurse practitioners would be covered (the sponsor said the bill applies strictly to medical residents), and how program oversight would work. Proponents emphasized that approval is discretionary and based on competency, patient‑safety standards and residency accreditation rules.
No committee vote was taken at the hearing. Proponents urged a "do pass" recommendation, saying the statutory change would remove a billing barrier while preserving program oversight and patient-safety protections.
Why it matters: Supporters framed the bill as a targeted workforce measure to expand care access in rural Montana and to retain physicians trained in-state; program directors and licensing staff stressed oversight mechanisms to protect patients.
