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MONTANA SELF INSURERS' ASSOCIATION

MSIA Update / Leg. Week 13

  • Legislative Action – Revenue & Appropriations Transmittal Days
  • MSF Annual Medical Conference – Whitefish May 14 – 16  
  • MSIA Bus & Annual Meeting 9/3 – Billings - Featuring Dr. Claire Muselman!

Legislative Action – Revenue & Appropriations Transmittal Days

Revenue & Appropriations Transmittal Days

Revenue bill Transmittal Day is tomorrow – Saturday 4/5 and Appropriation bill Transmittal Day is Tuesday 4/8. Transmittal Day means a bill must have passed its’ originating chamber by that day, or it is technically dead-ish.

As a result, most of the tax and spend bills are taking priority this week. The state budget has passed the House, which is where it originates. So, that hurdle is completed. We now have all the other stuff that follows along like pet projects, pet efforts and bills that will cost money outside of the expected budget process. This week, committee meetings started earlier, ended later and full floor sessions were longer, in an effort to meet the deadlines. The Governor’s preferred property tax and income tax bills were stalled this week. There are other vehicles to address those issues, but the original bill numbers are not likely to be the bills that ultimately pass.

One of the rules I live by is that the legislature makes the rules, they can change the rules. In my past, I was involved with a legislature that was required to adopt a budget by April 30. Since they could not reach agreement, they physically stopped the clock on the floor at 11p on that day, so they could meet their deadline. They make the rules, they can change the rules…

The Senate Finally Takes Action On Ellsworth – What Does It Mean?

The Senate finally censured former Senate President Jason Ellsworth (R-Hamilton). Ellsworth has been banned from the Senate floor for life and has been removed from Committee assignments. He will be permitted to vote on issues but will have to do so remotely. The vote was 44-6. Ellsworth is term-limited from his Senate seat, so will not be back in that Chamber. It is not unusual, and somewhat expected that Senators will become House members, and House members will run for Senate seats when they reach term limits. Whether he will be back in the legislature is not yet known. Last year, he primaried Bowen Greenwood for the Clerk of the Supreme Court seat, largely perceived in an effort to broaden his name recognition state-wide, perhaps with an eye on a different statewide seat?

Ellsworth has been at the center of Senate attention since before the session started. Ellsworth ran for re-election as Senate President and lost to Matt Regier (R-Kalispell) a freshman Senator who was Speaker of the House last session. At the end of his Senate President term in December 2024, after losing to Regier, Ellsworth created two contracts (allegedly to avoid routine review based on dollars involved) for a business associate to review expected Judicial reform bills impacts. This is work that the legislative staff regularly does, and there is some question about the individual’s qualifications to do the work in the first place. The Legislative Auditor (an independent office from leadership) found that Ellsworth engaged in waste fraud and abuse of his office based on these contracts. No money ever changed hands and the contracts were cancelled immediately upon public identification.

Regier and Senate leadership (and House for that matter) are conservative Republicans. In the Senate, Regier and leadership had originally set up a committee to review and approve the Governor’s appointments and legislative proposals – something I have never seen done before – in any legislature, in any state, over my 40 years of doing this work. However, it was a clear message to the Governor that just because there is a clear R majority, the legislative leadership is far more conservative than the Governor, and they were going to make him work dance, somewhat to their tune.

Not so fast. On the first day of session, Ellsworth and eight other moderate Republicans staged a coup which has continued, leading to questions about who is actually leading the Senate. ‘The nine’ teamed up with the Senate minority to change all the rules, upend the Executive Branch Review Committee and change committee assignments to give the minority more votes in the Committees. As a result of those committee assignments, if the members of ‘the nine’ teamed up with the minority members of the committees, they could and have passed bills.

That’s exactly what happened and continues to happen. Some of our work, and some of the bills we are concerned with, have passed, where in prior years, there would not be much discussion about their inability to get out of committee. SB 295 – the Employee Choice of Physician bill passed the Senate Business & Labor committee – unheard of. It died on the Senate floor – with some of ‘the nine’ committee members changing their votes, but why was it there in the first place? SB 308 – to eliminate the cap on WC benefits also passed the same committee and was assigned to Senate Finance & Claims. Same story – we were able to kill it in Finance & Claims (where money bills – either expenditures or revenue generators – go) because of the costs involved. SB 394 – to provide PTSD coverage for first responders had the same path – except that passed Senate Finance & Claims – and passed that committee with the support of ‘the nine’ assigned to the committee. SB 394 – with the genie out of the bottle passed the Senate 29 – 20. There’s more on this bill below. And one of our bills, SB 345 to eliminate the deference provided to treating providers and make getting an IME easier went to Finance & Claims too. We are still not sure why. SB 345 has passed the Senate and had a hearing in the House Business & Labor Committee this week. More on this bill below as well.

Anyway – the Senate tried a couple of weeks ago to expel or censure Ellsworth and both motions failed to get the 2/3 majority to pass – they got a majority, but not the 2/3s required. Thus, knowing that something had to be done at some point and in some way this deal, to ban Ellsworth from the Senate floor and strip him of Committee assignments, was made. He will still be able to vote – but must do it remotely.

So – it’s been a screwy session in the Senate – and we still don’t know what the full impact of ‘the nine’ will be. We know that if the Governor wants it – regardless of leadership, and if the Democrats do not find it overly dis-tasteful, it will at least see some action – and potentially more. How much more the Dems will get remains to be seen. One question remains – who actually controls the Senate? Sometimes it looks like leadership, sometimes it looks like Minority Leader Pat Flowers (D-BZN). I think the only predictable answer is, “Well, it depends…” 

Legislative Action – Revenue & Appropriations Transmittal Days

  • SB 345 – Eliminate Tx Provider Deference & Ease of IMEs – Heard 3/31 - Your Help Needed
  • SB 394 – PTSD for First Responders – Senate floor action
  • HB 740 – Family Pharmacy PBM Bill – Heard in Sen Judiciary 4/1


SB 345 / Hertz (R-Polson)

This is a MSIA requested bill to end the deference to treating physicians in litigated cases and ask the Judge to provide credibility on testimony and experience, make it easier to secure an IME and provide some ancillary benefits to support an IME when travel is involved. The bill was heard in House Bus & Labor on 3/31 with MSIA as the lead proponent joined by the Plan 2 carriers, businesses, as well as MSIA members MCCF and MSGIA and MSF. I have attached talking points if you know any of the majority members on the House Bus & Labor Committee.

 

SB 394 / Neumann (D-BZN)

This bill provides for PTSD claim opportunities for law enforcement and first responders. Rather than provide a presumption, the language requires claims to go through the WC process for compensability determination. However, it provides a carve out from the existing prohibition on ‘mental-mental’ claims. There are only 12 states which continue to exclude mental-mental claims in their WC systems. And the trend across the country has been to provide presumptive PTSD coverage for first responders. MSIA was the lead opponent to the bill, as was MSIA members MCCF and MSGIA. MSIA offered what may be a unique program in Georgia, which may be a better approach to addressing the issue by creating a special program within municipalities’ health care programs for PTSD for first responders. The bill passed Finance & Claims 12-10, with all members of the nine voting with the Democrats. The bill then moved to the Senate floor for its first vote. MSIA organized businesses and authored a letter in opposition from a broader business community, including MSIA members MDDC. MSBGIA, MT Electric Co-Ops’ Assoc, MMIA, the Plan 2 carriers, APCIA, the MT Chamber of Commerce, MT BIA, the MCA and the Helena Chamber of Commerce and distributed the letter to each Senate desk and handed them out in the hall. The bill passed the Senate 29-20 on 4/4. We will continue to try to defeat this bill, or find an alternative solution, rather than pushing all these costs onto employers. The Governor’s office does not oppose this bill. MSIA was the lead opponent to this bill.

 

HB 740 / Bertoligio (R-Clancy)

This bill is aimed at providing more control over PBM relationships by independent pharmacies. While an initial amendment eliminated the reference to application to the workers’ compensation statutes, there remained a reference to the PBM statutory language which would have increased pharmacy costs to WC carriers (including self insurers). MSIA is working with others to make a final amendment to eliminate that reference so there is no impact to WC coverage. First, WC is a minimal payer to pharmacies, in comparison to health coverage and there is already a WC pharmacy fee schedule. At the least, not making this change would result in a conflict within the statutory language. The bill has passed the House 98-1 on 3/7. MSIA is working on an amendment to this language to eliminate reference to the WC statutory language. The bill was heard on 4/1 in the Senate Judiciary Committee and our amendment has been accepted by the sponsor and should be adopted, if the bill continues to move.

For a full list of legislation we are following – see the attached spreadsheet for more details and access to links to the language, fiscal notes or amendments. Bills that are now dead-ish are included at the bottom of the spreadsheet. We do not consider any proposal dead, dead, until two days after session ends.

MSF Annual Medical Conference – Whitefish May 14 – 16

Featuring MSIA Members - Challenges and Innovations: Solutions for a Changing Workers' Comp World

The MSF Annual Medical Conference brings together some of the country's top medical minds working in workers’ compensation to Montana to speak with claims professionals, Montana based medical providers and others. It is a unique opportunity to hear from leaders from across the country here in Montana. Registration information is here: Montana State Fund 23rd Annual Medical Conference.

Since it focuses on the top medical voices in the country, it’s not a surprise the Conference also features three MSIA members. Here is the current lineup of speakers:

  • Kelly Stokes, Injured Employee, Montana State Fund
  • Dr. Lisa Fitzpatrick, DrOT, CHT, CAE, CEAS, President/CEO, XcelABLE – an MSIA Member
  • Jonathan Lindsey, Claims Manager, CIGA
  • Terri Harrison, Director of Claims, CIGA
  • Kathleen Collins, Senior Clinical Pharmacist, Craig Hospital – an MSIA Member
  • Kurt Hegmann, MD, MPH, Center Director, RMCOEH
  • Jan A. Saunders, CPO, LPO, Clinical Director, Prosthetics, Paradigm Care at Home – an MSIA Member
  • Dean Blackaby, Attorney at Law, Montana Work Comp Solutions
  • Honorable Judge Lee Bruner, Montana Workers’ Compensation Court
  • Marcos Iglesias, MD, MMM, FAAFP, FACOEM, Chief Medical Director, Accident Fund Group

MSIA Business & Annual Meeting 9/3 – Billings

Dr. Claire Muselman!

We’re waaaaay early but have some exciting news! Dr. Claire Muselman of Drake University has accepted our invitation to be the MSIA Business & Annual Meeting guest speaker. Muselman will bring her messages to Empower Leaders, Elevating Organizations and Sparkling Results to our members and guests. The MSIA B & A meeting will start at 8:15a on Wednesday, September 3 at the Doubletree Hotel, downtown Billings. As usual, our meeting kicks off the Governor’s Conference which will run into Friday, September 5, at the same hotel.

Book your rooms now – if you haven’t already. They always go fast for what is the best WC meeting in the state.