Bill Summary – FastDemocracy

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68th Legislature 2023                                                                                               SB 564.1
                                                SENATE BILL NO. 564
                                         INTRODUCED BY T. MCGILLVRAY
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  A BILL FOR AN ACT ENTITLED: “AN ACT REVISING THE MONTANA HEALTH CORPS ACT; EXPANDING
  ELIGIBILITY FOR SERVICES PROVIDED BY HEALTH CORPS PHYSICIANS; REVISING LEGAL LIABILITY
  PROVISIONS FOR SERVICES PROVIDED BY HEALTH CORP PHYSICIANS; REVISING THE APPLICATION
  FEE FOR INITIAL ENROLLMENT IN THE HEALTH CORPS PROGRAM; PROVIDING A DEFINITION;
  PROVIDING RULEMAKING AUTHORITY; AMENDING SECTIONS 27-1-736, 37-3-203, 37-3-802, 37-3-803,
  37-3-804, 37-3-805, AND 37-3-806, MCA; AND PROVIDING AN EFFECTIVE DATE, AN APPLICABILITY
  DATE, AND A TERMINATION DATE.”
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  BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MONTANA:
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          Section 1. Section 27-1-736, MCA, is amended to read:
          "27-1-736.   Limits on liability of medical practitioner or dental hygienist who provides services
  without compensation. (1) A medical practitioner, as defined in 37-2-101, or a dental hygienist licensed under
  Title 37, chapter 4, who renders, at any site, any health care within the scope of the provider's license,
  voluntarily and without compensation, to a patient of a clinic, to a patient referred by a clinic, or in a community-
  based program to provide access to health care services for uninsured persons is not liable to a person for civil
  damages resulting from the rendering of the care unless the damages were the result of gross negligence or
  willful or wanton acts or omissions by the medical practitioner or dental hygienist. Each patient must be given
  notice that under state law the medical practitioner or dental hygienist cannot be held legally liable for ordinary
  negligence if the medical practitioner or dental hygienist does not have malpractice insurance.
          (2)      A physician participating in the Montana health corps act provided for in Title 37, chapter 3,
  part 8, is immune from liability as provided in 37-3-806.
          (2)(3)   For purposes of this section:
          (a)      "clinic" means a place for the provision of health care to patients that is organized for the
  delivery of health care without compensation or that is operated as a health center under 42 U.S.C. 254b;
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68th Legislature 2023                                                                                              SB 564.1
            (b)      "community-based program to provide access to health care services for uninsured persons"
  means a local program in which care is provided without compensation to individuals who have been referred
  through that community-based program and in which the medical practitioner or dental hygienist has entered
  into a written agreement to provide the service;
            (c)      "health care" has the meaning provided in 50-16-504;
            (d)      "without compensation" means that the medical practitioner or dental hygienist voluntarily
  rendered health care without receiving any reimbursement or compensation, except for reimbursement for
  supplies.
            (3)(4)   Subsection (1) applies only to a medical practitioner or dental hygienist who:
            (a)      does not have malpractice insurance coverage because the medical practitioner or dental
  hygienist is retired or is otherwise not engaged in active practice; or
            (b)      has malpractice insurance coverage that has a rider or exclusion that excludes coverage for
  services provided under this section."
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            Section 2. Section 37-3-203, MCA, is amended to read:
            "37-3-203.   Powers and duties -- rulemaking authority. (1) The board may:
            (a)      adopt rules necessary or proper to carry out the requirements in Title 37, chapter 3, parts 1
  through 4, this chapter and of chapters covering podiatry, acupuncture, physician assistants, nutritionists, and
  emergency care providers as set forth in Title 37, chapters 6, 13, 20, and 25, and 50-6-203, respectively. Rules
  adopted for emergency care providers with an endorsement to provide community-integrated health care must
  address the scope of practice, competency requirements, and educational requirements.
            (b)      hold hearings and take evidence in matters relating to the exercise and performance of the
  powers and duties vested in the board;
            (c)      aid the county attorneys of this state in the enforcement of parts 1 through 4 and 8 of this
  chapter as well as Title 37, chapters 6, 13, 20, and 25, and Title 50, chapter 6, regarding emergency care
  providers licensed by the board. The board also may assist the county attorneys of this state in the prosecution
  of persons, firms, associations, or corporations charged with violations of the provisions listed in this subsection
  (1)(c).
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68th Legislature 2023                                                                                                SB 564.1
           (d)     review certifications of disability and determinations of eligibility for a permit to hunt from a
  vehicle as provided in 87-2-803(11); and
           (e)     fund additional staff, hired by the department, to administer the provisions of this chapter, by
  increasing license fees as necessary.
           (2)     (a)      The board shall establish a medical assistance program to assist and rehabilitate
  licensees who are subject to the jurisdiction of the board and who are found to be physically or mentally
  impaired by habitual intemperance or the excessive use of addictive drugs, alcohol, or any other drug or
  substance or by mental illness or chronic physical illness.
           (b)     The board shall ensure that a licensee who is required or volunteers to participate in the
  medical assistance program as a condition of continued licensure or reinstatement of licensure must be allowed
  to enroll in a qualified medical assistance program within this state and may not require a licensee to enroll in a
  qualified treatment program outside the state unless the board finds that there is no qualified treatment program
  in this state.
           (3)     (a) The board shall report annually on the number and types of complaints it has received
  involving physician practices in providing written certification, as defined in 16-12-502, for the use of marijuana
  for a debilitating medical condition provided for in Title 16, chapter 12, part 5. The report must contain:
           (i)     the number of complaints received by the board pursuant to 37-1-308;
           (ii)    the number of complaints for which a reasonable cause determination was made pursuant to
  37-1-307;
           (iii)   the general nature of the complaints;
           (iv)    the number of investigations conducted into physician practices in providing written
  certification; and
           (v)     the number of physicians disciplined by the board for their practices in providing written
  certification for the use of marijuana for a debilitating medical condition.
           (b)     Except as provided in subsection (3)(c), the report may not contain individual identifying
  information regarding the physicians about whom the board received complaints.
           (c)     For each physician against whom the board takes disciplinary action related to the physician's
  practices in providing written certification for the use of marijuana for a debilitating medical condition, the report
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68th Legislature 2023                                                                                                 SB 564.1
  must include:
          (i)        the name of the physician;
          (ii)       the general results of the investigation of the physician's practices; and
          (iii)      the disciplinary action taken against the physician.
          (d)        The board shall provide the report to the economic affairs interim committee in accordance with
  5-11-210 and shall make a copy of the report available on the board's website.
          (4)        The board may enter into agreements with other states for the purposes of mutual recognition
  of licensing standards and licensing of physicians and emergency care providers from other states under the
  terms of a mutual recognition agreement."
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          Section 3. Section 37-3-802, MCA, is amended to read:
          "37-3-802.     Purpose -- establishment of program. (1) The purposes of this part are to:
          (a)(1)     provide primary outpatient care to low-income individuals and to individuals eligible for
  medicare or medicaid by retired physicians at affordable prices;
          (b)(2)     keep the elderly or infirm in their homes longer; and
          (c)(3)     provide home health care visits for patients who have difficulty in traveling.
          (2)     The board shall adopt rules to establish the program. The rules must provide procedures for
  enrolling retired physicians in the health corps and procedures under which physicians or health care facilities
  may refer medicare or medicaid patients to members of the health corps."
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          Section 4. Section 37-3-803, MCA, is amended to read:
          "37-3-803.     Definitions. As used in this part, unless the context requires otherwise, the following
  definitions apply:
          (1)        "Health care" has the meaning provided in 50-16-504.
          (2)        "Health care facility" has the meaning provided in 50-5-101.
          (3)        "Low income" means a person who is:
          (a)        eligible for the medical assistance program provided for in Title 53, chapter 6; or
          (b)        uninsured and whose family income does not exceed 200% of the federal poverty level."
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68th Legislature 2023                                                                                             SB 564.1
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          Section 5. Section 37-3-804, MCA, is amended to read:
          "37-3-804.    Eligibility for participation. A retired physician who is properly licensed and in good
  standing in Montana may participate in the health corps provided for in this part on:
          (1)      payment of a $30 fee for a new applicant or payment of a renewal fee established by the board
  by rule; and
          (2)      providing a listing of clinical services offered by the applicant and the location where the
  services are offered if the services are rendered outside of a person's home. The board shall accept
  applications for participation in the health corps and provide written guidelines to participants in the health corps
  concerning the provisions of this part and rules adopted to implement this part."
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          Section 6. Section 37-3-805, MCA, is amended to read:
          "37-3-805.    Referral of patients to program -- visits Visits -- charges. (1) The board shall adopt
  rules under which physicians or health care facilities may refer medicare or medicaid patients to the health
  corps program.
          (2)(1)    A health corps member shall may make home visitations to eligible patients for the purpose of
  providing health care to eligible patients.
          (3)(2)   A health corps member may charge $10 for a patient contact or visit and may submit a charge
  to medicare or medicaid."
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          Section 7. Section 37-3-806, MCA, is amended to read:
          "37-3-806.    Limitation on liability. (1) A physician who renders health care within the scope of the
  physician's license to a patient under this part and submits a payment to medicare or medicaid for the care is
  not liable to a patient or other person for civil damages resulting from the rendering of the care unless the
  damages were the result of gross negligence or willful or wanton acts or omissions by the physician.
          (2)      (a) A physician who renders health care within the scope of the physician's license and does
  not submit a claim to medicare or medicaid is immune from any cause of action associated with services
  provided in accordance with this part.
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68th Legislature 2023                                                                                               SB 564.1
          (b)      If a patient who receives health care services from a physician who has not submitted a claim
  to medicare or medicaid for the care believes the physician committed gross negligence or willful or wanton
  acts or omissions when providing care, the person may file a complaint of unprofessional conduct with the
  board as provided in 37-1-308. This subsection (2)(b) does not limit a patient's ability to file a complaint of
  unprofessional conduct related to other aspects of the physician's services.
          (c)      The board shall maintain a record of any disciplinary action taken pursuant to this subsection
  (2).
          (3)      Each patient must be given notice that under state law the physician may not be held legally
  liable for ordinary negligence of the limitations on a physician's legal liability for services provided under the
  health corps program."
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          NEW SECTION. Section 8.         Effective date. [This act] is effective July 1, 2023.
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          NEW SECTION. Section 9.         Applicability. [This act] applies to health care services provided on or
  after July 1, 2023.
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          NEW SECTION. Section 10.          Termination. [Sections 1 through 7] terminate June 30, 2029.
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Statutes affected: 
SB0564_1.pdf: 27-1-736, 37-3-203, 37-3-802, 37-3-803, 37-3-804, 37-3-805, 37-3-806
SB0564_2.pdf: 27-1-736, 37-3-203, 37-3-802, 37-3-803, 37-3-804, 37-3-805, 37-3-806
SB0564_3.pdf: 27-1-736, 37-3-203, 37-3-802, 37-3-803, 37-3-804, 37-3-805, 37-3-806
SB0564_X.pdf: 27-1-736, 37-3-203, 37-3-802, 37-3-803, 37-3-804, 37-3-805
Amended: 27-1-736, 37-3-203, 37-3-802, 37-3-803, 37-3-804, 37-3-805, 37-3-806
Introduced: 27-1-736