Montana health officials are considering requiring prior authorization before the state's health department pays for abortions for Medicaid patients.
The proposed rule by the state's Department of Public Health and Human Services would require doctors to provide medical documentation that shows an abortion is necessary to save a patient's life or"medically necessary" for another reason before Medicaid would agree to cover the procedure.Health providers would be required to provide records supplying patient information such as age, smoking, behavioral health issues, and illegal substance history.
The state health department said the proposal would write into state codes a 1995 court decision that determined Montana's state Medicaid funds must cover abortions if they are medically necessary. It would define a medically necessary abortion as one that is performed to protect the mother's life or to prevent"significantly" aggravating a physical or psychological condition that the patient has been previously diagnosed with. The proposed rule would also require that physicians provide abortions, leaving out physician assistants or advanced practice nurses.
The proposal has gotten blowback from opponents who argue it would delay or deny abortions for low-income women in the state. Over 20 opponents, including doctors, patients, and advocacy groups, voiced their concerns about the proposal in an online hearing on Thursday, suggesting prior authorization would pose risks to patients who need expedited care.
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