Bill > HB758

This bill addresses out-of-network ambulance services and balance billing by establishing new regulations for health insurance plans in Montana. The legislation prohibits ambulance services from billing patients directly for ground transportation services beyond their in-network cost-sharing amount, effectively protecting patients from unexpected high medical bills. The bill limits out-of-pocket expenses for ambulance services to $100 and requires insurers to reimburse ambulance services at either the established local rate or at least 400% of the Medicare rate if no local rate exists. Insurers must apply out-of-pocket costs toward deductibles and cannot impose higher cost-sharing requirements for out-of-network providers compared to in-network providers. The bill mandates the creation of a public database of local ambulance service rates and requires ambulance services to submit their rates annually. The provisions apply to various health benefit plans, including state employee and university system plans, and self-funded group health plans that choose to participate. The legislation aims to increase transparency, reduce patient financial burden, and ensure fair compensation for ambulance services. The bill will take effect on January 1, 2026, giving stakeholders time to prepare for the new requirements.

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https://bills.legmt.gov/#/laws/bill/2/LC2288