Bill > SB361

This bill modifies Montana law to expand the circumstances under which health insurance providers and other entities responsible for healthcare payments cannot deny claims submitted by the Department of Public Health and Human Services (DPHHS). Specifically, the bill adds that claims cannot be denied solely due to a failure to obtain prior authorization for an item or service according to the third-party payer's rules. The bill maintains existing provisions that allow DPHHS to submit claims up to 3 years after service and enforce rights within 6 years of claim submission. Importantly, the bill clarifies that this does not require third parties to pay for services not covered under their healthcare plan, nor does it impose liability beyond what is already specified in existing plan documents. The legislation aims to provide more flexibility for DPHHS in submitting and recovering healthcare claims, while protecting the rights of insurance providers and other healthcare payment entities.

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https://bills.legmt.gov/#/laws/bill/2/LC1894