Montana § 33-22-1705 Incentives In Health Benefit Plans

Montana Statutes

§ 33-22-1705 — Incentives In Health Benefit Plans

Montana § 33-22-1705

Title 33INSURANCE AND INSURANCE COMPANIES

Ch. 22DISABILITY INSURANCE

Part 17Preferred Provider Agreements

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Bluebook

Mont. Code Ann. § 33-22-1705 (2026).

Text

33-22-1705 . Incentives in health benefit plans.

(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 provi

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33-22-1705 . Incentives in health benefit plans. (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.