House Bill No. introduced by S. Gist and E. Buttrey seeks to revise Montana's insurance law by prohibiting balance billing for out-of-network emergency services and establishing payment requirements for ambulance ground transportation. The bill mandates that insurers directly indemnify ambulance service providers and prohibits these services from billing enrollees for covered transportation if the enrollee has already paid the in-network cost-sharing amount. It sets a maximum out-of-pocket cost of $100 for both in-network and out-of-network providers and requires insurers to reimburse ambulance services at local rates or at least 400% of the Medicare rate if no local rate exists. The Department of Insurance will create a public database of local rates and enforce compliance through rulemaking and potential civil penalties.

Additionally, the bill amends several sections of the Montana Code Annotated (MCA) to ensure compliance with the new ambulance service billing provisions for state employee and university system group benefits plans. It includes a delayed effective date for the new regulations and mandates that insurers provide an explanation of benefits reflecting cost-sharing amounts. The bill also protects patients from negative credit reporting related to unpaid ambulance bills under certain conditions. Furthermore, it clarifies the regulatory framework for health maintenance organizations (HMOs) and self-funded multiple employer welfare arrangements, ensuring HMOs comply with specific regulations while streamlining the rules for self-funded arrangements. The new provisions will be integrated into Title 33, chapter 22, part 1, and will take effect on January 1, 2026.

Statutes affected:
LC Text: 2-18-704, 30-14-2602, 33-31-111, 33-35-306
HB0758_1(1): 2-18-704, 30-14-2602, 33-31-111, 33-35-306
HB0758_1(2): 2-18-704, 30-14-2602, 33-31-111, 33-35-306
HB0758_1(3): 2-18-704, 30-14-2602, 33-31-111, 33-35-306
HB0758_1(4): 2-18-704, 30-14-2602, 33-31-111, 33-35-306
HB0758_1(5): 2-18-704, 30-14-2602, 33-31-111, 33-35-306
HB0758_1: 2-18-704, 30-14-2602, 33-31-111, 33-35-306
HB0758_2(1): 2-18-704, 30-14-2602, 33-31-111, 33-35-306
HB0758_2(10): 2-18-704, 30-14-2602, 33-31-111, 33-35-306
HB0758_2(11): 2-18-704, 30-14-2602, 33-31-111, 33-35-306
HB0758_2(12): 2-18-704, 30-14-2602, 33-31-111, 33-35-306
HB0758_2(2): 2-18-704, 30-14-2602, 33-31-111, 33-35-306
HB0758_2(3): 2-18-704, 30-14-2602, 33-31-111, 33-35-306
HB0758_2(4): 2-18-704, 30-14-2602, 33-31-111, 33-35-306
HB0758_2(5): 2-18-704, 30-14-2602, 33-31-111, 33-35-306
HB0758_2(6): 2-18-704, 30-14-2602, 33-31-111, 33-35-306
HB0758_2(7): 2-18-704, 30-14-2602, 33-31-111, 33-35-306
HB0758_2(8): 2-18-704, 30-14-2602, 33-31-111, 33-35-306
HB0758_2(9): 2-18-704, 30-14-2602, 33-31-111, 33-35-306
HB0758_2: 2-18-704, 30-14-2602, 33-31-111, 33-35-306