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 these rates and ensure compliance through rulemaking and potential civil penalties.

Additionally, the bill amends various sections of the Montana Code Annotated (MCA) to incorporate these changes, including compliance requirements for the state employee group benefits plan and the Montana university system group benefits plan. It introduces new sections that codify certain provisions and establishes an effective date of January 1, 2026, for the act. The bill also clarifies that the insurance or health service corporation laws do not apply to health maintenance organizations (HMOs) authorized under this chapter, while specifying that HMOs are not practicing medicine and are exempt from certain medical practice regulations. Furthermore, it includes deletions of specific legal language from existing law regarding the application of the insurance code to self-funded multiple employer welfare arrangements, which will now face a more limited scope of regulation.

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