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 […]
33-2-2402. Definitions
33-2-2402. Definitions. As used in this part, the following definitions apply: (1) ”Claims processing services” means the administrative services performed in connection with the processing and adjudicating of claims relating to pharmacist services that include either or both of the following: (a) receiving payments for pharmacist services; and (b) making payments to pharmacists or pharmacies. (2) ”Enrollee” means a member, […]
33-2-2204. and 33-2-2205 reserved
33-2-2204 and 33-2-2205 reserved.
33-2-2403. Licensing required
33-2-2403. Licensing required. (1) A person may not perform an act or do business in this state as a pharmacy benefit manager without a valid license issued under this part by the commissioner. (2) A license issued under this part is nontransferable. (3) A pharmacy benefit manager shall apply to the commissioner on a form prescribed by the […]
33-2-2206. Membership agreement — contents
33-2-2206. Membership agreement — contents. A membership agreement issued under this part must contain: (1) the effective dates of the membership agreement; (2) a grace period of 30 days for payment of a renewal membership fee; (3) a description of what constitutes acceptable insurance coverage if eligibility for the membership agreement is conditioned on the member’s current and continuing […]
33-2-2404. Pharmacy benefit manager prohibited practices
33-2-2404. Pharmacy benefit manager prohibited practices. (1) In any participation contracts between a pharmacy benefit manager and pharmacies or pharmacists providing prescription drug coverage, a pharmacy or pharmacist may not be prohibited, restricted, or penalized in any way from disclosing to any enrollee or injured worker any information the pharmacy or pharmacist considers appropriate regarding: (a) the […]
33-2-2207. Filings
33-2-2207. Filings. (1) Pursuant to Title 33, chapter 1, part 5, a private air ambulance service subject to this part shall file for approval any membership agreement, including any rider or endorsement. (2) A filing under subsection (1) must include all fee schedules associated with the membership agreement. History: En. Sec. 3, Ch. 210, L. 2017.