Montana has passed a number of measures to protect people from being overcharged by air ambulance services. SB1869 was adopted in Tennessee in 2018. The law compels medical facilities to inform patients, in writing and prior to treatment, if any of the facility's medical providers are out-of-network with the patient's insurance. If so, the patient will be billed only for the in-network rates. SB1869 also requires that patients be given a copy of their hospital's out-of-network fee schedule. And it prohibits hospitals from denying admission to or terminating care of an individual based on that person's inability to pay for their treatment. Balance billing is the practice of charging patients who are not insured or cannot afford their bills. It can occur when a health care provider charges more than what is permitted under their state's medical practice act or when a provider does not disclose their fees in advance. Patients do not have a right to refuse a service that is offered under these circumstances; therefore, they may feel forced to pay up front or leave the office. Balance billing can also happen when doctors share expenses with each other if one physician's patient too poor to pay decides to go to another doctor for help. In this case, the first doctor would still receive money from both patients. Patients' groups have long called for legislation to protect consumers from balance billing.