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Health department director expresses 'grave concerns' after a review of Medicaid-funded abortion.

Montana’s top health official says he’s concerned about the process for how Medicaid recipients receive coverage for abortions.

Federal Medicaid dollars cover abortion in cases of rape, incest or life endangerment. But a legal precedent in Montana requires the state to cover Medicaid patients’ abortions when “medically necessary” – a broader definition than federal law.

During the 2021 legislative session, Republican lawmakers ordered the state health department to study Medicaid-covered abortions as part of a broader policy effort to restrict access to the procedure.

Charlie Brereton, director of the Department of Public Health and Human Services, recently gave lawmakers a rundown of that review.

The department looked at more than 5,000 Medicaid-covered abortions between 2011 and 2021. It then conducted an in-depth review of cases between 2019 and 2021. Brereton said 221 of those cases lack documentation to verify that they meet the criteria of “medically necessary.”

“I, as director, have grave concerns with these findings. We are evaluating various policy options, nothing has been determined at this point in time, but want you to know that we intend to take action,” Brereton said.

The department is recommending updating the requirements for Medicaid coverage for abortions and requiring uniform documentation from physicians. Specifics on those requirements aren’t yet public.

Last legislative session, Republican lawmakers considered creating a politically-appointed review panel to decide on a case-by-case basis which Medicaid patients receive coverage for abortions. The proposal was introduced late in the session and did not advance.

Shaylee is Montana Public Radio's Capitol reporter. She previously worked for the Bozeman Daily Chronicle and covered the 2019 legislative session for the University of Montana's Legislative News Service.