33-2-2213. Rulemaking authority
33-2-2213. Rulemaking authority. The department shall adopt rules necessary to implement this part. History: En. Sec. 9, Ch. 210, L. 2017.
33-2-2301. Legislative findings and purpose
33-2-2301. Legislative findings and purpose. (1) The legislature finds that: (a) air ambulance services provide a necessary, and sometimes lifesaving, means of transporting Montanans experiencing health emergencies; (b) Montanans desire adequate access to air ambulance services; (c) in many cases the high charges assessed by out-of-network air ambulance services and limited insurer and health plan reimbursements have resulted in […]
33-2-2302. Hold harmless
33-2-2302. Hold harmless. (1) If a covered person receives services from a non-Montana hospital-controlled out-of-network air ambulance service for an emergency medical condition, an insurer or health plan shall assume the covered person’s responsibility, if any, for amounts charged in excess of allowed amounts for covered services and supplies, applicable copayments, coinsurance, and deductibles. (2) An insurer […]
33-2-2303. Disclosures by air ambulance service
33-2-2303. Disclosures by air ambulance service. An out-of-network nonhospital-controlled air ambulance service must disclose by July 1 of each year any relationships or financial arrangements with health care providers, insurers, or health plans. This includes but is not limited to employment arrangements, ownership interests, first call agreements, and board memberships. This information must be filed with […]
33-2-2304. Independent dispute resolution
33-2-2304. Independent dispute resolution. (1) If an insurer or health plan and air ambulance service enter into dispute resolution, the procedure in 33-2-2305 is to be used to determine the fair market price of the services that are the subject of the claim. (2) Payment of the fair market price calculated pursuant to 33-2-2305 constitutes payment in […]
33-2-2305. Independent dispute resolution procedure — exemptions
33-2-2305. Independent dispute resolution procedure — exemptions. (1) To initiate a dispute resolution procedure under this part, the parties shall file a written notice of dispute with the insurance commissioner. (2) Except as provided in subsection (3), within 30 days after the date of receipt of the notice of dispute, and if no independent reviewer is mutually […]
33-2-2306. Insurance commissioner duties — independent reviewer qualifications
33-2-2306. Insurance commissioner duties — independent reviewer qualifications. (1) The insurance commissioner shall: (a) approve any independent reviewer that is eligible to adjudicate disputes under this part; (b) maintain a list of independent reviewers eligible to adjudicate disputes under this part; (c) terminate approval of an independent reviewer and remove the independent reviewer from the list of approved independent […]
33-2-2202. Fees
33-2-2202. Fees. A private air ambulance service subject to this part shall pay the following fees to the commissioner for services rendered: (1) issuance of a certificate of authority, $300; (2) annual renewal fee, $300; and (3) filing of a membership agreement or other forms, $50. History: En. Sec. 2, Ch. 210, L. 2017.
33-2-2401. Short title — purpose
33-2-2401. Short title — purpose. (1) This part may be cited as the “Montana Pharmacy Benefit Manager Oversight Act”. (2) This part establishes the standards and criteria for the licensure and regulation of pharmacy benefit managers that provide claims processing services or other prescription drug or device services for health benefit plans and workers’ compensation insurance carriers. […]
33-2-2203. Suspension or revocation
33-2-2203. Suspension or revocation. (1) The commissioner may suspend or revoke a private air ambulance service certificate of authority if the private air ambulance service: (a) no longer meets the requirements for the certificate of authority; (b) materially fails to comply with a membership agreement issued to residents of Montana; (c) is in unsound fiscal condition or is demonstrated […]