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Rule requiring prior OK for Medicaid-paid abortions halted
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AP


RULE REQUIRING PRIOR OK FOR MEDICAID-PAID ABORTIONS HALTED


A JUDGE IN MONTANA HAS TEMPORARILY BLOCKED A NEW RULE THAT WOULD HAVE REQUIRED
PHYSICIANS IN THE STATE TO PROVIDE PRIOR DOCUMENTATION SHOWING THAT AN ABORTION
IS MEDICALLY NECESSARY BEFORE THE STATE’S MEDICAID PROGRAM WILL AUTHORIZE
PAYMENT FOR THE PROCEDURE

 * AP
 * May 1, 2023
 * 1 hr ago
 * 0

FILE - Republican Gov. Greg Gianforte signs one of three bills restricting
access to abortion in Montana as sponsor of one of the bills, state Rep. Lola
Sheldon-Galloway, R-Great Falls, watches in Helena, Mont., on April 26, 2021. A
judge in Montana temporarily blocked a new rule Monday, May 1, 2023, that would
have required physicians in the state to provide prior documentation showing
that an abortion is medically necessary before the state's Medicaid program will
authorize payment for the procedure.

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AP

HELENA, Mont. (AP) — A judge in Montana temporarily blocked a new rule Monday
that would have required physicians in the state to provide prior documentation
showing that an abortion is medically necessary before the state’s Medicaid
program will authorize payment for the procedure.

District Court Judge Mike Menahan wrote that his order “will serve the public
interest by ensuring that Medicaid-eligible Montanans continue to have access to
constitutionally protected abortions and safe, effective medical care.”

All three of the state’s abortion providers sued in District Court in Helena on
Friday to challenge the rule they argue will “effectively eliminate abortion
access for most Medicaid patients in the state.”




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“It shouldn’t matter what zip code you live in, how much money you make, or what
insurance you use—everyone deserves access to the full range of reproductive
health care services available in Montana,” Planned Parenthood of Montana said
Monday in a joint statement.




The abortion providers, along with the ACLU of Montana and the Center for
Reproductive Rights, argued that the rule, which was set to take effect May 8,
violates the right to privacy and equal protection under the Montana
Constitution. A hearing on their request for a preliminary injunction is
scheduled for May 12. “We stand by our rule to protect the integrity of
Montana’s Medicaid program and look forward to defending it in court,” Charlie
Brereton, director of the Montana Department of Public Health and Human
Services, said after the rule was challenged.



Under the rule, in order for Medicaid to pay for abortions, physicians must
provide information about the number of pregnancies and children the woman has,
the results of a physical exam, pregnancy test, gestational estimate as well as
documentation of the reason for the procedure and a signed consent form. The
prior authorization process is supposed to be completed within three working
days.




Montana’s Legislature also passed a bill last week to put similar requirements
into state law starting on July 1. That measure will go to Republican Gov. Greg
Gianforte for his signature.



The health department said a review of abortions over the past decade led it to
believe it was paying for elective abortions because the agency did not receive
enough documentation from providers to prove the procedures were medically
necessary.



Medicaid regulations say federal money can only be used for abortion care in
cases of rape, incest or a threat to the life of the mother. But under a 1995
court ruling, Montana Medicaid must also cover the cost of abortions that are
considered medically necessary.

Montana Medicaid will only cover abortions provided by physicians — the rule and
the legislation state — to meet federal Medicaid guidelines.



Physician assistants can legally provide abortion care in Montana and the
Montana Supreme Court heard arguments in December over whether nurse
practitioners can provide abortion care if they are properly trained. One nurse
practitioner in Montana has been allowed to perform abortions since 2018 under a
ruling in that case.




The health department argued a physical exam and documentation ensures the
safety of the patient, can rule out ectopic pregnancy and ensure the gestational
age is within Food and Drug Administration guidelines for the type of abortion
being performed.

The state does acknowledge that in the case of rare, severe fetal abnormalities
that would be incompatible with life upon delivery, the situation may not meet
the definition of medical necessity and that Medicaid wouldn’t provide coverage.



Planned Parenthood has clinics in Billings, Great Falls and Helena. Other
providers have in-person clinics in Missoula and Whitefish.



Copyright 2023 The Associated Press. All rights reserved. This material may not
be published, broadcast, rewritten or redistributed without permission.


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 * Abortion
 * Courts
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FILE - Republican Gov. Greg Gianforte signs one of three bills restricting
access to abortion in Montana as sponsor of one of the bills, state Rep. Lola
Sheldon-Galloway, R-Great Falls, watches in Helena, Mont., on April 26, 2021. A
judge in Montana temporarily blocked a new rule Monday, May 1, 2023, that would
have required physicians in the state to provide prior documentation showing
that an abortion is medically necessary before the state's Medicaid program will
authorize payment for the procedure.

 * Thom Bridge - member image share, Independent Record

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