MT SB554

Nonprofit hospitals (excluding critical access and rural emergency hospitals) are prohibited from charging more than 300% of Medicare reimbursement rates for Medicare-eligible services or items

Hospitals violating the 300% cap face an escalating excise tax on excess charges: 25% in 2027, 35% in 2028, 45% in 2029, and 50% from 2030 onward

Tax revenue is deposited into a new account with funds allocated: 65% to Montana Medicaid, 25% to rural health care workforce development, and 10% to administration

Nonprofit hospitals must submit annual reports by September 1 to DPHHS and the legislative interim committee, including unredacted IRS Form 990 Schedule H information

Effective date is December 31, 2026, with the excise tax applying to services provided after that date