Montana bill would require regular cost reports for Medicaid providers, sponsors say

Representative David Beatty opened the House Health and Human Services hearing on House Bill 419, telling the committee the bill requires periodic cost reporting so the adequacy of Medicaid provider rates can be assessed at least once every four years and supports budget requests to adjust reimbursements.

The bill would exclude hospital cost‑based reimbursements and services paid under resource‑based relative value systems, and the first report is scheduled to be due Sept. 1, 2026. Beatty said HB 419 includes a one‑time appropriation of $1,200,000, split between the state general fund and a federal special revenue match, and that it repeals a narrower reporting statute currently in the Montana Code Annotated.

Proponents described concrete effects they said the bill would prevent or remedy. Ms. Witt of Ability Montana said caregivers in a self‑directed personal care program were earning $12.75 per hour before recent rate increases, making recruitment and retention nearly impossible; after last session’s provider rate increases, Witt said wages rose to $18.25 per hour plus benefits and staffing and service continuity improved. "Adequate reimbursement rates are not just numbers on a budget," she said, arguing that fair cost assessments protect quality of life for people with disabilities.

Jackie Jant, project management specialist in the Office of Strategy and Transformation at the Department of Public Health and Human Services, told the committee HB 419 creates a cost‑reporting structure for Medicaid‑dependent providers not covered by the RBRVS system. She listed examples including private duty nursing, group homes, waiver services, psychiatric residential treatment facilities and inpatient residential substance‑use disorder treatment, and said the bill will give the legislature and the department regular information on rate adequacy.

Representatives of provider organizations and advocacy groups echoed those themes. Brad Rightnowar of Consumer Care Direct Network said standardized cost reporting is crucial to keep Medicaid rates viable and to avoid barriers to recruiting direct‑care workers. Matt Kuntz of the National Alliance on Mental Illness of Montana recalled broad rate cuts in 2017 and said periodic rate studies would help prevent repeating harmful policy choices. Hospital and children’s hospital representatives emphasized the need to monitor rates across a continuum of care.

Committee questioning focused on where current reporting exists and how this bill changes the status quo. Jant said the department does not now perform broad, routine cost determinations for the full set of services described in the bill and that current placement of cost‑reporting language in statute tied to home‑and‑community‑based services has limited the department’s ability to adjust rates for other Medicaid services.

Representative Beatty closed urging the committee to pass the bill. The hearing record contains no opponents and several DPHHS and provider fiscal witnesses indicated they would be available for follow‑up questions.

The committee closed the HB 419 hearing and moved on to other bills; no formal vote on HB 419 is recorded in this transcript.

Next steps: the committee will consider HB 419 in subsequent executive action; implementation details include a report due Sept. 1, 2026, and a one‑time appropriation listed in the bill.