NO. 90-068 

IN THE SUPREME COURT OF THE STATE OF MONTANA 

1990 

ANESTHESIOLOGY, P.C.; DR. C.W. McCOY; DR. GERALD H. SIEMENS; 

DR. NORMAN J. NICKMAN; and DR. J.E. JARRETT, 

Plaintiffs and Respondents, 

-vsBLUE CROSS AND BLUE SHIELD OF MONTANA, A Corporation, 

Defendant and Appellant, 

APPEAL FROM: District Court of the First Judicial District, 

In and for the County of Lewis and Clark, 

The Honorable Thomas C. Honzel, Judge presiding. 

COUNSEL OF RECORD: 

For Appellant: 

Hughes, Kellner, Sullivan & Alke, John Alke 

argued, Helena, Montana 

For Respondent: 

Snavely & Phillips, Robert J. Phillips argued, 

Missoula, Montana 

Submitted: September 05, 1990 

, Decided: October 26, 1990 

Filed: 

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Justice William E. Hunt, Sr., delivered the Opinion of the Court. 

Appellant and defendant Blue Cross and Blue Shield of Montana 

appeals from the order of the District Court of the First Judicial 

District, Lewis and Clark County, granting summary judgment to 

plaintiff and respondent, Dr. C. W. McCoy, for a lien filed for 

services rendered to an insured of the defendant. 

We reverse and remand for further proceedings in accordance 

with this opinion. 

The sole issue raised by this appeal is whether the 1987 

amendments to the Montana Insurance Code affect appellant's 

immunity from liens under the Physicians1 Lien Act. 

Blue Cross is a health service corporation, governed by fj 33- 

30-101 through 3 -1102, MCA, operating a nonprofit health care plan 

within the State of Montana. It enters into contracts with health 

care providers for services to its insureds. In the case of a 

contract between Blue Cross and a physician, the physician becomes 

a I1professional member. The professional member agrees to accept, 

as payment in full, a fee established by Blue Cross for services 

to Blue Cross insureds. The physician also forfeits the right to 

"balance billn the Blue Cross insured for any difference between 

the physicianls charge and the fee allowed by Blue Cross. The 

contract between Blue Cross and the professional member allows the 

professional member to directly bill Blue Cross for services 

provided to the insured. 

A physician who does not have a contract with Blue Cross is 

a I1nonmember physician. A nonmember physician must bill the 
insured for the entire cost of the services provided, and look to 

the insured for payment of those costs. Payments made by Blue 

Cross for services rendered by nonmember physicians are made 

directly to the insured. Any balance of the bill must be paid by 

the insured. 

Respondent, Dr. C. W. McCoy (a nonmember physician) provided 

health care services to Pamela Dark on December 15, 1987. Pamela 

was billed $1,790.00 for these services. On January 4, 1988, Dr. 

McCoy sent a lien notice to Blue Cross, claiming a lien against 

insurance benefits payable by Blue Cross to or on behalf of Pamela. 

Blue Cross ignored the lien and made payment directly to Pamela. 

In the action against Blue Cross, plaintiff McCoy was joined 

by Anesthesiology, P.C. The District Court granted judgment to 

Dr. McCoy but found that because Anesthesiology had filed its claim 

on November 2, 1987, before the 1987 amendments to the insurance 

code became effective, its claim was barred. Anesthesiology did 

not appeal that decision and is not a party to these proceedings. 

Appellant argues that the physicians' lien statutes of 1979 

were not affected by the 1987 amendments to the Montana Insurance 

Code, and that appellantts immunity from physicianst liens still 

exists. The physicianst lien statutes, 5 71-3-1111 through 5 71- 

3-1118, MCA, were enacted in 1979. They provide in part: 

If a person is an insured or a beneficiary under 

insurance which provides coverage in the event of injury 

or disease, a physician . . . upon giving the required 

notice of lien, has a lien for the value of services 

rendered on all proceeds or payments. . . . 

Section 71-3-1114 (2), MCA. At the time the lien statutes were 

enacted, health corporations such as Blue Cross were specifically 
excluded from the guidelines of Title 33 of the Montana Code (the 

Montana Insurance Code). 

The corporations were excluded by the 1979 insurance code. 

Specifically the legislature provided: 

This code shall not apply to health service corporations 

to the extent that the existence and operations of such 

corporations are authorized by Title 35, chapter 2, and 

related sections of the Montana Code Annotated. 

Section 33-1-102(3), MCA. In 1987 the legislature amended the 

insurance code to include health service corporations. 

For the purposes of this code, the following definitions apply 

unless the context requires otherwise: 

(6) I1Insurerg1 includes . . . . . a health service 

corporation in the provisions listed in 33-30-102. 

Section 33-1-201, MCA. 

The District Court found that because health service 

corporations were excluded from the insurance code from 1979 to 

1987, they were not subject to physicians liens during that time. 

The court then found that the legislature intended that physicians 

liens apply to health service corporations after the 1987 

amendments. Appellant argues otherwise, contending that the 

legislature never intended the 1987 amendments to the insurance 

code to imply that health service corporations are now subject to 

physicians' lien statutes of 1979. We agree with appellant. 

This Court will not intrude in areas properly the province of 

the legislature. We have consistently held that only in extreme 

circumstances is it appropriate to construe a subsequent statute 

against a former one without express legislative direction. "The 

presumption is that the legislature passes a law with deliberation 

and with a full knowledge of all existing ones on the same subject, 
and does not intend to interfere with or abrogate a former law 

relating to the same matter unless the repugnancy between the two 

is irreconcilable." London G. & A. Co., v. Industrial Accident 

Board, 82 Mont. 304, 310, 266 P. 1103, 1105 (1928). The Court 

followed the London reasoning in Fletcher v. Paige, 124 Mont. 114, 

220 P.2d 484 (1950): "It will not be presumed that a subsequent 

enactment of the legislature intended to repeal former laws upon 

the subject when former laws were not mentioned.I1 Fletcher at 119, 

220 P.2d at 487. 

In the case before us, the legislature failed to mention the 

physiciansv lien statutes when it amended the code in 1987. That 

the legislature intended the amendments to apply only to the 

insurance code is evidenced by the introduction to the definitions 

of the code, which states: IvFor the PurPoses of this code, the 

following definitions apply . . . (Emphasis added.) Section 33- 

1-201, MCA. By leaving intact these introductory words, the 

legislature clearly intended that the 1987 amendments be limited 

to the insurance code. 

Had the legislature intended to amend the physiciansv lien 

statutes when it revised the insurance code, it would have 

expressly stated that intention. Unless and until the legislature 

specifically amends the physicians' lien statutes, we will not 

infer an intent to do so. 

Reversed and remanded for further proceedings in accordance 

with this opinion. 

We Concur: 
Chief Justice 

Justices 

Justice Sheehy did not participate in these proceedings.