6.6.8601    PURPOSE AND SCOPE

(1) These rules are intended to establish an expedient and economical process for resolving billing disputes between insurers or health plans and air ambulance services. The independent reviewer shall conduct all aspects of the dispute resolution process in a manner that furthers these objectives while providing for accurate determination of fair market price.

(2) The rules in this subchapter apply to disputes between:

(a) health insurance issuers, as defined in 33-22-140, MCA, government health plans authorized in Title 2, chapter 18, part 7, MCA, or health plans established by the Montana university system authorized by Title 20, chapter 25, part 13, MCA; and

(b) out-of-network air ambulance services, which are not owned or controlled by a Montana hospital system.

(3) the rules in this subchapter do not apply to any disputes:

(a) with self-funded health plans, unless they are expressly identified in (2); or

(b) with air ambulance services owned or controlled by a Montana hospital system.

 

History: 2-18-720, 20-25-1320, 33-2-2306, MCA; IMP, 2-18-720, 20-25-1320, 33-2-2306, MCA; NEW, 2017 MAR p. 1877, Eff. 10/14/17.