House Bill No. [insert number] seeks to amend 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 prevents these services from billing enrollees for covered transportation if the in-network cost-sharing amount has already been paid. 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 several sections of the Montana Code Annotated (MCA) to incorporate these new provisions, ensuring that the state employee group benefits plan and the Montana university system group benefits plan adhere to the new ambulance billing regulations. It also clarifies the regulatory obligations of health maintenance organizations (HMOs) and self-funded multiple employer welfare arrangements, specifying that HMOs must comply with certain regulations while being exempt from others. The bill introduces new sections with an effective date of January 1, 2026, and includes deletions of specific language from current law to streamline the regulatory framework for self-funded arrangements.

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(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