Committee hears bill to expand electronic health record APIs, adds 72-hour hold for sensitive results

Representative Greg Oblander opened the hearing on House Bill 590 seeking to modernize electronic health records (EHRs) in Montana by requiring health carriers to establish and maintain certain application programming interfaces (APIs) to support patient access and interoperability.

Proponents, including Adam Meier of Cicero Action and Matt Kuntz of NAMI Montana, said the bill aligns state‑regulated plans with federal interoperability standards and would reduce paperwork and improve care coordination. Meier said the measure fills gaps left by federal rules that currently apply mainly to federally regulated plans and noted the bill’s “common sense” exception for sensitive results. Kuntz highlighted improved patient access and reduced administrative burdens for people with mental health needs.

Opponents from the insurance industry, led by Drew Chuck of Blue Cross Blue Shield of Montana and Sarah Clerget of the American Health Insurance Plans, said the bill would “jump the gun” by accelerating deadlines tied to federal implementation. Chuck testified that technical work to enable APIs across additional lines of business is substantial and that certain federal requirements are not effective until 2027; he said a rushed state mandate could force carriers to build interfaces before provider uptake and federal clarity are known.

During questioning, proponents and opponents discussed implementation timelines, Tennessee’s experience with similar state law, and whether the bill would require immediate change for some sections. Sponsor Greg Oblander and Mr. Meier said the bill is intended to be complementary to federal timelines and flexible if federal dates shift. Committee members asked about the bill’s practical impact and the scope of the sensitive‑results exception. Meier said the exception is narrow and intended to allow clinicians time to personally deliver news such as malignancy, HIV, hepatitis or certain genetic markers rather than push notifications to patients’ devices. The sponsor agreed to revise an effective‑date clause to address committee concerns.

Nut graf: The bill aims to extend federal interoperability advances to state‑regulated plans and to provide a narrow exception to federal “information‑blocking” obligations so clinicians can withhold auto‑delivery of some sensitive test results for up to 72 hours to permit clinician‑delivered disclosure. Insurers warned that the change could require costly technical builds before platforms and providers are ready.

The hearing record includes technical questions about which APIs (provider access, prior authorization, etc.) will be useful unless providers also adopt connected interfaces, and about whether the bill should wait until federal implementation data are available. The committee did not take a vote at the hearing.