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SB 72

Provide presumptive eligibility for Medicaid coverage of home and community-based services

2025 Regular Session Introduced by Mike Yakawich

SB 72 allows presumptive Medicaid eligibility for home and community-based services during application processing, accelerating care access while eligibility is verified.

(S) Veto Override Failed in Legislature
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Bill Summary · SB 72

Legislative bill overview

SB 72 would establish presumptive eligibility for Medicaid coverage of home and community-based services (HCBS) in Montana, allowing individuals to receive these services while their full Medicaid eligibility is being determined. This streamlines access to services like in-home care, adult day services, and other community alternatives to institutional care. The bill aims to reduce delays in service delivery for vulnerable populations needing immediate support.

Why is this important

Home and community-based services enable seniors and people with disabilities to remain in their homes rather than entering nursing facilities, which is typically more humane and often more cost-effective. Presumptive eligibility reduces waiting periods during application processing, preventing gaps in care that can lead to health deterioration, institutionalization, or caregiver burnout. This policy affects thousands of Montanans who depend on Medicaid for long-term services and supports.

Potential points of contention

  • Fiscal impact: Expanding presumptive eligibility could increase state Medicaid costs if individuals ultimately prove ineligible, requiring budget justification and potential reallocation of resources
  • Implementation burden: Healthcare providers and Medicaid administrators need systems to verify presumptive eligibility and recover costs if applicants don't qualify, creating administrative complexity
  • Eligibility verification: Retroactively denying services to those deemed ineligible raises ethical concerns about service interruption and potential debt collection from vulnerable individuals

Compiled from official sources — confirm details with the bill’s official record.

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