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Mont. Code Ann. § 33-22-1705

Incentives in health benefit plans

Known as the Preferred Provider Agreements Act

The act spans §§ 33–33 (7 sections).

En

(1) A health care insurer may issue a policy or a health benefit plan that provides for incentives for covered persons to use the health care services of preferred providers. The policy or health benefit plan must contain at least:

(a) a provision that if a covered person receives emergency care for services specified in the preferred provider agreement and cannot reasonably reach a preferred provider, the care rendered during the course of the emergency will be reimbursed as though the covered person had been treated by a preferred provider; and

(b) a provision that clearly identifies the difference in benefit levels for health care services of a preferred provider and benefit levels for the same health care services of a nonpreferred provider.

(2) A health care insurer may not require hospital staff privileges as criteria for designation as a preferred provider in a preferred provider agreement.

Official source: Montana Code Annotated (Montana Legislature). Reproduced from public-domain Montana statutes; confirm against the official source for the current text. Not legal advice.