The Policy Holder Services Bureau examines insurance forms. Its actuaries examine rates, although Montana is one of only a few states without authority to review rates for health insurance. Most of the bureau’s work is responding to consumer complaints and questions about insurance policies, including Medicare Supplement Insurance policies (Medigap). A recently launched new website has online complaint forms at http://www.csi.mt.gov/forms/securities/COMPLAINT%20FORM.pdf.

The state auditor, also known as the commissioner of securities and insurance, regulates the sale of insurance and securities in Montana. The office produces annual consumer and rate-comparison guides on Medicare Supplement Insurance (Medigap) and also helps consumers with questions about Medicare Prescription Plans (Part D) enrollment and Medicare Advantage (Part C).

The Department of Public Health & Human Services (DPHHS) is the Montana state agency responsible for all welfare and health programs administered by the state, including: Medicare-related services; services for the elderly, disabled and mentally ill; nursing home regulation; and Medicaid. It is the largest state agency, with 3,000 employees and an annual budget of $1.9 billon.

The Governor’s Advisory Council on Aging advises the governor and the Department of Public Health & Human Services on fulfilling the objectives of the Montana Legislature regarding initiatives for the elderly and the federal Older Americans Act of 1965. It generally advocates for aging issues and organizes the annual Governor’s Conference on Aging. The governor appoints the 11-member council.

The division plans and oversees publicly funded long-term care services for Montana’s elderly and disabled. It also provides education and support on aging and long-term care issues to Montanans of all ages and operates two state nursing homes for veterans.

The Office on Aging develops the state plan on aging and approves service-delivery plans for the 10 Area Agencies on Aging located across the state. The area offices provide numerous services, including State Health Insurance and Assistance Program (SHIP) counselors, who help seniors enroll or re-enroll in the Medicare Prescription Drug Plans (Part D). They also operate "new to Medicare" classes for new enrollees.

AARP, formerly the American Association of Retired Persons, is a nonprofit, nonpartisan organization with a membership that advocates for people ages 50 and older. Since 1958, AARP has lobbied for senior issues, including the passage of Medicare in 1965. AARP offers support from staffed offices in all 50 states, Washington, D.C., Puerto Rico and the U.S. Virgin Islands. AARP is the dominant lobby and advocacy group for the elderly in Montana and is active on Medicare-related issues, such as helping seniors enroll in Medicare Prescription Drug Plans (Part D).

The State Health Insurance Assistance Program (SHIP) is a national program that offers counseling and assistance to people with Medicare and to their families. Coordinators provide counseling on Medicare benefits, Medicare Prescription Drug Plans (Part D), Social Security, Medicaid and veterans' benefits. SHIP, formerly the Information, Counseling and Assistance (ICA) grants program, was created under section 4360 of the Omnibus Budget Reconciliation Act of 1990. This act authorized the Centers for Medicare & Medicaid Services (CMS) to make grants to states for health advisory services programs for people with Medicare. More than 125 SHIP counselors are in Montana, advising Medicare recipients on enrollment, Medicare Supplement Insurance (Medigap) policies and related issues.

The Senior Medicare Patrol (SMP) program helps Medicare and Medicaid beneficiaries avoid, detect and prevent health care fraud. The goal is to protect older people and to preserve the integrity of the Medicare and Medicaid programs. The federal program was created in 1996 by the Health Insurance Portability and Accountability Act (HIPAA) and amended in 2006 by Titles II and IV of the Older Americans Act. The SMP is operated in Montana from the Missoula Area Agency on Aging office. The office helps Medicare beneficiaries learn how to read summary notices, understand bills and detect any waste or fraud.

Quality Improvement Organizations (QIOs) are private, mostly not-for-profit organizations, staffed by doctors and other health care professionals, who are trained to review medical care, to help beneficiaries with complaints about the quality of care and to implement improvements in the quality of care available throughout the spectrum of care. QIOs are required under Sections 1152-1154 of the Social Security Act.

The long-term care ombudsman advocates for residents of nursing homes and assisted living facilities. The office resolves complaints and educates seniors and long-term care providers about their rights and good care practices. The ombudsman also provides information to the public on nursing homes and other long-term care facilities and services, residents' rights, and legislative and policy issues. In 1978, an amendment to the federal Older Americans Act required every state to have an ombudsman program that addresses complaints and advocates for improvements in the long-term care system. The ombudsman program is administered by the Administration on Aging (AoA). Montana has 32 local ombudsmen who are hired and supervised by the Area Agencies on Aging.

The Area Agencies on Aging (AAA) were established under the Older Americans Act (OAA) Comprehensive Services Amendments in 1973 to respond to the needs of Americans 60 and older in every local community. The amendments added a new Title V, which authorized grants to local community agencies in every state. The AAAs provide a range of options that allow older adults to choose the home- and community-based services and living arrangements that suit them best. Montana’s area agencies on aging also operate "new to Medicare" classes for new enrollees. The agencies cover 10 separate Montana regions.

Before becoming medical director of physical medicine and rehabilitation at Kalispell Regional Medical Center, John V. Stevens served as rehabilitation director at Deaconess Medical Center and Sacred Heart Medical Center in Washington. He is certified by the American Board of Family Practice, the American Board of Physical Medicine and Rehabilitation and the American Board of Electrodiagnostic Medicine. He graduated from the University of Washington Medical School.

Before he became president and CEO of Providence Health & Services in 2003, John Koster held primary responsibility for the organization’s system operations. Earlier in his career, he was senior vice president of VHA Inc. in Irving, Texas. He is a member of the American College of Physicians and is certified by the American Board of Internal Medicine. He earned his medical degree from University of New Mexico Medical School.

Nicholas Wolter began his career as an intern and resident at the Mary Imogene Bassett Hospital in Cooperstown, N.Y. He is board certified in internal medicine and pulmonary medicine, and he is a member of the American College of Physician Executives. In addition to serving as CEO of Billings Clinic, he is a member of the boards of directors of VHA Health Foundation and LifeCenter Northwest. He received his M.D. from the University of Michigan Medical Center.

Steve Carlson’s professional experience includes nine years heading Flagstaff Medical Center in Arizona as well as serving as a senior executive officer for Northern Arizona Healthcare.

John Goodnow has been president and CEO of Benefis Health System since 2002. Before joining Benefis, he was executive vice president and CEO of St. Rita’s Medical Center in Lima, Ohio. Earlier in his career he also served as an administrator at hospitals in Riyadh, Saudi Arabia, Scranton, Pa.; Milwaukee; Nashville; Jackson, Mo.; and Detroit. He is a fellow of the American College of Healthcare Executives and holds a master’s degree in health services administration from the University of Michigan.

This Senate committee considers matters pertaining to the health of Montana residents.

This House committee considers matters pertaining to the health of Montana residents.