Senate Bill No. [insert bill number] aims to revise laws related to payments made by health carriers in Montana, establishing prompt payment requirements and clean claim procedures. The bill introduces definitions for key terms such as "clean claim," "health carrier," and "enrollee," and mandates that health carriers must issue payments for clean claims within specified timeframes—14 calendar days for electronic submissions and 30 calendar days for other submissions. Additionally, the bill outlines procedures for notifying providers of any deficiencies in claims and establishes penalties for health carriers that fail to comply with these requirements.

The legislation also grants enforcement authority to the Commissioner of Insurance and the Department of Justice, allowing for civil penalties against non-compliant health carriers. It provides a private right of action for individuals aggrieved by violations of the bill's provisions, enabling them to seek remedies in court. The bill amends Section 33-31-111 of the Montana Code Annotated and includes a codification instruction to integrate the new sections into Title 33, Chapter 22, with an applicability date set for claims filed on or after January 1, 2026.

Statutes affected:
LC Text: 33-31-111
SB0448_1(1): 33-31-111
SB0448_1(2): 33-31-111
SB0448_1(3): 33-31-111
SB0448_1(4): 33-31-111
SB0448_1: 33-31-111