reglab/housing_qa huggingface dataset:
MT Code § 33-1-707 (2021)
2021 Montana Code Annotated|Title 33. Insurance and Insurance Companies|Chapter 1. Administration and General Provisions|Part 7. Hearings and Appeals|33-1-707. Administrative or civil action -- statute of limitations

  33-1-707. Administrative or civil action -- statute of limitations. (1) Unless otherwise provided by law, the department shall commence an administrative or civil action for a violation of the insurance code within 2 years of the date of the violation or within 2 years after the department discovers the violation or, through the use of reasonable diligence, should have discovered the violation, whichever occurs later.   (2) Regardless of when the department discovers a violation or should have discovered a violation through the use of reasonable diligence, the department may not commence an administrative or civil action unless it is brought within 5 years of the date of the violation.   History: En. Sec. 4, Ch. 227, L. 2001; amd. Sec. 13, Ch. 396, L. 2017.
MT Code § 33-1-708 (2021)
2021 Montana Code Annotated|Title 33. Insurance and Insurance Companies|Chapter 1. Administration and General Provisions|Part 7. Hearings and Appeals|33-1-708. through 33-1-710 reserved

  33-1-708 through 33-1-710 reserved.
MT Code § 33-1-711 (2021)
2021 Montana Code Annotated|Title 33. Insurance and Insurance Companies|Chapter 1. Administration and General Provisions|Part 7. Hearings and Appeals|33-1-711. Appeals of commissioner's order -- stays -- exceptions

  33-1-711. Appeals of commissioner's order -- stays -- exceptions. (1) Except as provided in subsection (2), an appeal of the commissioner's order must be filed with the district court in Lewis and Clark County pursuant to the procedures provided for in Title 2, chapter 4, part 7.   (2) Appeals from the suspension or revocation of the certificate of authority of a domestic insurer or of the license of an insurance producer or surplus lines insurance producer may be filed in the district court of the county of Montana that the insurer or producer has its principal place of business or the licensee resides.   (3) Any request for a stay of the commissioner's order must be made within 30 days of filing an appeal in district court.   (4) Costs must be awarded as in civil actions.   (5) This section does not apply to appeals for matters covered by Title 33, chapter 16.   History: En. Sec. 44, Ch. 286, L. 1959; R.C.M. 1947, 40-2725; amd. Sec. 1, Ch. 119, L. 1987; amd. Sec. 24, Ch. 537, L. 1987; amd. Sec. 8, Ch. 713, L. 1989; amd. Sec. 1, Ch. 798, L. 1991; amd. Sec. 21, Ch. 227, L. 2001.
MT Code § 33-1-801 (2021)
2021 Montana Code Annotated|Title 33. Insurance and Insurance Companies|Chapter 1. Administration and General Provisions|Part 8. Interference With Medical Communications|33-1-801. Definitions

  33-1-801. Definitions. As used in this part, unless the context requires otherwise, the following definitions apply:   (1) "Enrollee" means the individual to whom a health care service is provided or will be provided under a health plan.   (2) "Health care provider" or "provider" means a health care professional or facility.   (3) "Health carrier" means an entity that is subject to the insurance laws and rules of this state and that contracts, offers to contract, or enters into an agreement to provide, deliver, arrange for, pay for, or reimburse any of the costs of health care services. The term includes a disability insurer, health maintenance organization, or a health service corporation or other entity providing a health benefit plan.   (4) "Health plan" or "health benefit plan" means a policy, contract, certificate, or agreement entered into, offered, or issued by a health carrier to provide, deliver, arrange for, pay for, or reimburse any of the costs of health care services.   (5) "Managed care organization" means an entity that manages, owns, contracts with, or employs health care providers to provide health care services under a health plan. The term includes a health maintenance organization, as defined in 33-31-102, and an entity that does not itself provide health plans.   (6) "Medical communication" means:   (a) a communication made by a health care provider to an enrollee or to the guardian or other legal representative of an enrollee receiving health care services from the provider:   (i) concerning the mental or physical health care needs or treatment of the enrollee and the provisions, terms, or requirements of the health plan or another health plan relating to the needs or treatment of the enrollee; and   (ii) including a communication concerning:   (A) a test, consultation, or treatment option and a risk or benefit associated with the test, consultation, or option;   (B) variation among health care providers and health care facilities, as defined in 50-5-101, in experience, quality of health care services, or health outcomes;   (C) the basis or standard for the decision of the enrollee's health carrier or managed care organization to authorize or deny a health care service;   (D) the process used by the enrollee's health carrier or managed care organization to determine whether to authorize or deny a health care service; or   (E) a financial incentive or disincentive provided by the enrollee's health carrier or managed care organization to a health care provider to authorize or deny a health care service;   (b) a communication made by a health care provider to another health care provider, an employee or contractor of the enrollee's managed care organization, or an employee of the health carrier advocating a particular method of treatment on behalf of an enrollee.   History: En. Sec. 2, Ch. 527, L. 1997.
MT Code § 33-1-802 (2021)
2021 Montana Code Annotated|Title 33. Insurance and Insurance Companies|Chapter 1. Administration and General Provisions|Part 8. Interference With Medical Communications|33-1-802. Gag clauses and other action affecting medical communications prohibited -- exceptions

  33-1-802. Gag clauses and other action affecting medical communications prohibited -- exceptions. (1) A health carrier or managed care organization may not by an oral or written contract, by an oral or written direction or requirement, or by a financial inducement or penalty prohibit a provider from making or interfere with a provider making a medical communication to an enrollee. A contract, direction, requirement, or financial inducement or penalty violating this subsection is void.   (2) Subsection (1) does not apply to:   (a) an oral or written contract, direction, requirement, or financial inducement or penalty prohibiting a provider from disclosing a trade secret, as defined in 30-14-402, to the same extent as other employees or contractors of the health carrier or managed care organization are prohibited from disclosing the trade secret;   (b) an oral or written contract, direction, requirement, or financial inducement or penalty prohibiting a health care provider from referring an enrollee to another health plan or managed care organization in which the provider making the referral has a direct financial interest; and   (c) the terms of an oral or written contract mutually agreed upon by a health carrier or managed care organization and a provider requiring the provider to participate in and cooperate with all programs, policies, and procedures implemented by the health carrier or managed care organization to ensure, review, or improve the quality of health care.   History: En. Sec. 3, Ch. 527, L. 1997.
MT Code § 33-1-803 (2021)
2021 Montana Code Annotated|Title 33. Insurance and Insurance Companies|Chapter 1. Administration and General Provisions|Part 8. Interference With Medical Communications|33-1-803. Sanction because of medical communication prohibited

  33-1-803. Sanction because of medical communication prohibited. A health carrier or managed care organization may not take any of the following actions with regard to a health care provider because the provider made a medical communication to an enrollee or to the guardian or legal representative of the enrollee:   (1) terminate an agreement between the health carrier or managed care organization and the health care provider to provide health care services;   (2) reduce compensation to the provider;   (3) demote the provider in regard to relative seniority within the managed care organization;   (4) transfer the provider to other duties within the managed care organization;   (5) deny the provider admitting or other privileges; or   (6) take other action against the provider in retaliation for a medical communication made by the provider to an enrollee.   History: En. Sec. 4, Ch. 527, L. 1997.
MT Code § 33-1-804 (2021)
2021 Montana Code Annotated|Title 33. Insurance and Insurance Companies|Chapter 1. Administration and General Provisions|Part 8. Interference With Medical Communications|33-1-804. Civil penalty -- civil action for collection of penalty

  33-1-804. Civil penalty -- civil action for collection of penalty. (1) A health carrier or a managed care organization violating 33-1-802 or 33-1-803 is subject to a civil penalty, as provided in 33-1-317, for each violation. Each day of violation constitutes a separate violation for the purposes of this section.  (2) In addition to other enforcement methods provided by law, the commissioner may bring a civil action in the district court in the county in which the violation occurred to collect the civil penalty provided for in subsection (1) from a person violating a provision of this part. If the violation occurred in more than one county, any county in which the violation occurred is a proper venue for a civil action. An amount collected by the commissioner pursuant to this section must be deposited in the general fund.   History: En. Sec. 5, Ch. 527, L. 1997; amd. Sec. 15, Ch. 535, L. 2021.
MT Code § 33-1-1101 (2021)
2021 Montana Code Annotated|Title 33. Insurance and Insurance Companies|Chapter 1. Administration and General Provisions|Part 11. Jurisdiction of Providers of Health Care Benefits|33-1-1101. Short title

  33-1-1101. Short title. This part may be cited as the "Jurisdiction to Determine Jurisdiction of Providers of Health Care Benefits Act".   History: En. Sec. 1, Ch. 497, L. 1983.
MT Code § 33-1-1102 (2021)
2021 Montana Code Annotated|Title 33. Insurance and Insurance Companies|Chapter 1. Administration and General Provisions|Part 11. Jurisdiction of Providers of Health Care Benefits|33-1-1102. Authority and jurisdiction of insurance department

  33-1-1102. Authority and jurisdiction of insurance department. Notwithstanding any other provision of law and except as provided in this part, any person or other entity that provides coverage in this state for medical, surgical, chiropractic, physical therapy, speech-language pathology, audiology, professional mental health, dental, hospital, or optometric expenses, whether such coverage is by direct payment, reimbursement, or otherwise, is presumed to be subject to the jurisdiction of the department unless the person or other entity shows that while providing such services it is subject to the jurisdiction of another agency of this or another state or any subdivision thereof or the federal government.   History: En. Sec. 2, Ch. 497, L. 1983; amd. Sec. 6, Ch. 413, L. 1989.
MT Code § 33-1-1103 (2021)
2021 Montana Code Annotated|Title 33. Insurance and Insurance Companies|Chapter 1. Administration and General Provisions|Part 11. Jurisdiction of Providers of Health Care Benefits|33-1-1103. through 33-1-1110 reserved

  33-1-1103 through 33-1-1110 reserved.
MT Code § 33-1-1111 (2021)
2021 Montana Code Annotated|Title 33. Insurance and Insurance Companies|Chapter 1. Administration and General Provisions|Part 11. Jurisdiction of Providers of Health Care Benefits|33-1-1111. How to show jurisdiction

  33-1-1111. How to show jurisdiction. A person or entity may show that it is subject to the jurisdiction of another agency of this or another state or any subdivision of this state or another state or the federal government by providing the commissioner with the appropriate certificate, license, or other document issued by the other governmental agency that permits or qualifies it to provide those services. If it is not the practice of the governmental agency to issue a certificate, license, or other document establishing that the agency permits the person or entity to provide those services, the person or entity may show that it is subject to the jurisdiction of the agency by other means appropriate under the circumstances.   History: En. Sec. 3, Ch. 497, L. 1983; amd. Sec. 16, Ch. 420, L. 1995.
MT Code § 33-1-1112 (2021)
2021 Montana Code Annotated|Title 33. Insurance and Insurance Companies|Chapter 1. Administration and General Provisions|Part 11. Jurisdiction of Providers of Health Care Benefits|33-1-1112. Subject to state laws

  33-1-1112. Subject to state laws. A person or entity unable to show that it is subject to the jurisdiction of another agency of this or another state or any subdivision thereof or the federal government is subject to all appropriate provisions of this code regarding the conduct of its business.   History: En. Sec. 5, Ch. 497, L. 1983.
MT Code § 33-1-1113 (2021)
2021 Montana Code Annotated|Title 33. Insurance and Insurance Companies|Chapter 1. Administration and General Provisions|Part 11. Jurisdiction of Providers of Health Care Benefits|33-1-1113. Examination

  33-1-1113. Examination. A person or entity which is unable to show under 33-1-1111 that it is subject to the jurisdiction of another agency of this or another state or a subdivision thereof or the federal government must submit to an examination by the commissioner to determine the organization and solvency of the person or entity and to determine whether or not such person or entity complies with the applicable provisions of this code.   History: En. Sec. 4, Ch. 497, L. 1983.
MT Code § 33-1-1114 (2021)
2021 Montana Code Annotated|Title 33. Insurance and Insurance Companies|Chapter 1. Administration and General Provisions|Part 11. Jurisdiction of Providers of Health Care Benefits|33-1-1114. Disclosure

  33-1-1114. Disclosure. (1) A production agency or administrator that advertises, sells, transacts, or administers the coverage in this state described in 33-1-1102 and that is required to submit to an examination by the insurance commissioner under 33-1-1113 shall, if such coverage is not fully insured or otherwise fully covered by an admitted life or disability insurer or nonprofit health service corporation, advise every purchaser, prospective purchaser, and covered person of such lack of insurance or other coverage.   (2) An administrator that advertises or administers the coverage in this state described in 33-1-1102 and is required to submit to an examination by the commissioner under 33-1-1113 shall advise any production agency of the elements of the coverage, including the amount of "stop-loss" insurance in effect.   History: En. Sec. 6, Ch. 497, L. 1983.
MT Code § 33-1-1201 (2021)
2021 Montana Code Annotated|Title 33. Insurance and Insurance Companies|Chapter 1. Administration and General Provisions|Part 12. Insurance Fraud Protection|33-1-1201. Short title -- purpose

  33-1-1201. Short title -- purpose. (1) This part may be cited as the "Insurance Fraud Protection Act".   (2) The purpose of this part is to facilitate the detection of insurance fraud and reduce the occurrence of insurance fraud through the development of fraud prevention programs, improved investigative and prosecutorial services, and increased consumer awareness.   History: En. Sec. 1, Ch. 237, L. 1995.
MT Code § 33-1-1202 (2021)
2021 Montana Code Annotated|Title 33. Insurance and Insurance Companies|Chapter 1. Administration and General Provisions|Part 12. Insurance Fraud Protection|33-1-1202. Administrative or civil insurance fraud

  33-1-1202. Administrative or civil insurance fraud. A person commits the act of administrative or civil insurance fraud when the person:   (1) for the purpose of obtaining any money or benefit, presents or causes to be presented to any insurer, purported insurer, producer, or administrator, as defined in 33-17-102, any written or oral statement, including computer-generated documents, containing false, incomplete, or misleading information concerning any fact or thing material to, as part of, or in support of a claim for payment or other benefit pursuant to an insurance policy;   (2) assists, abets, solicits, or conspires with another to prepare or make any written or oral statement containing false, incomplete, or misleading information concerning any fact that is intended to be presented to any insurer or purported insurer or in connection with, material to, or in support of any claim for payment or other benefit pursuant to an insurance policy or contract;   (3) presents or causes to be presented to or by an insurer, purported insurer, producer, or administrator, as defined in 33-17-102, a materially false or altered application of insurance;   (4) accepts premium money knowing that coverage will not be provided;   (5) as a health care provider, submits a false or altered bill or report of physical condition to an insurer;   (6) offers or accepts a direct or indirect inducement to file a false statement of claim with the intent of deceiving an insurer; or   (7) presents or causes to be presented counterfeit insurance documents to any person.   History: En. Sec. 2, Ch. 237, L. 1995; amd. Sec. 8, Ch. 380, L. 2003; amd. Sec. 2, Ch. 169, L. 2013; amd. Sec. 14, Ch. 396, L. 2017.
MT Code § 33-1-1203 (2021)
2021 Montana Code Annotated|Title 33. Insurance and Insurance Companies|Chapter 1. Administration and General Provisions|Part 12. Insurance Fraud Protection|33-1-1203. Powers and duties of commissioner -- confidentiality of documents

  33-1-1203. Powers and duties of commissioner -- confidentiality of documents. (1) The commissioner may:   (a) initiate independent inquiries and conduct independent investigations when the commissioner has reason to believe that insurance fraud may be, has been, or is currently being committed;   (b) respond to notice or complaints generated by federal, state, county, and local law enforcement officers, other entities with law enforcement responsibilities, or governmental agencies or units;   (c) review and respond to notices or reports of insurance fraud submitted by any person, select the incidents of suspected fraud that in the commissioner's judgment require further and more detailed investigation, and conduct the investigations;   (d) conduct independent examinations of insurance fraud to determine the extent of insurance fraud, deceit, or intentional misrepresentation;   (e) after investigation, report any meritorious alleged violation of the law to the appropriate prosecuting authority or licensing agencies; and   (f) assemble evidence, prepare charges, and prosecute, if requested, or otherwise assist any prosecuting authority that has jurisdiction, including the attorney general.   (2) Papers, records, documents, reports, materials, or other evidence relative to the subject of an insurance fraud investigation must remain confidential and must be treated as confidential criminal justice information as defined in 44-5-103. Evidence procured pursuant to this section may not be disseminated, except as provided in 44-5-303.   (3) The commissioner shall notify the person who or the entity that has given notice of an alleged insurance fraud pursuant to 33-1-1205(2) of receipt of the notice by the commissioner and of the disposition of the notice and any resulting investigation.   History: En. Sec. 3, Ch. 237, L. 1995.
MT Code § 33-1-1204 (2021)
2021 Montana Code Annotated|Title 33. Insurance and Insurance Companies|Chapter 1. Administration and General Provisions|Part 12. Insurance Fraud Protection|33-1-1204. Cooperation with law enforcement, licensing authorities, and other fraud agencies

  33-1-1204. Cooperation with law enforcement, licensing authorities, and other fraud agencies. (1) The commissioner shall cooperate with law enforcement authorities and all other authorized agencies and related insurance and professional licensing boards of this and other states. As used in this section, the term "authorized agencies" means:   (a) the attorney general of the state of Montana;   (b) the prosecuting attorney responsible for prosecution;   (c) the department of insurance of other jurisdictions;   (d) the United States attorney's office when that office is charged with investigation of the fraud; or   (e) the federal bureau of investigation or any other federal agency charged with investigation of the fraud.   (2) The commissioner shall cooperate to the extent allowed by law with insurance fraud investigators, related organizations of this and other states, and insurance commissioners of other states.   (3) If the commissioner determines that sufficient evidence of the commission of an act of insurance fraud exists, the commissioner shall inform the appropriate prosecuting authority and professional licensing boards.   History: En. Sec. 4, Ch. 237, L. 1995.
MT Code § 33-1-1205 (2021)
2021 Montana Code Annotated|Title 33. Insurance and Insurance Companies|Chapter 1. Administration and General Provisions|Part 12. Insurance Fraud Protection|33-1-1205. Duties of authorized insurers, adjusters, administrators, consultants, and producers -- notice exception

  33-1-1205. Duties of authorized insurers, adjusters, administrators, consultants, and producers -- notice exception. (1) Each insurer, independent adjuster, independent administrator, independent consultant, and independent producer shall cooperate fully with the commissioner with respect to the provisions of this part.   (2) Except as provided in subsection (4), an insurer, an officer, or an employee of the insurer, an independent adjuster, an independent administrator, an independent consultant, or an independent producer who has reason to believe that an insurance fraud has been or is being committed shall provide notice of the alleged insurance fraud to the commissioner within 60 days. A producer of an insurer who has reason to believe that an insurance fraud has been or is being committed shall report the alleged fraud to the insurer within 60 days of discovery of the alleged insurance fraud. The insurer shall review the report. If the insurer determines that there is reasonable likelihood that fraud has occurred, the insurer shall forward the report to the commissioner within 30 days of receipt of the report.   (3) Notice to the commissioner by an insurer who has reason to believe that an insurance fraud has been committed in connection with an insurance claim, application, or policy tolls any applicable time period, for the commissioner, in any applicable insurance statute or related insurance regulation, or any applicable provisions of Title 33, chapter 1, part 15, and tolls any time period arising under 33-18-232 or 33-18-242 regarding unfair claims settlement practices.   (4) Notice of an alleged insurance fraud involving an insurance claim or application submitted to the state compensation insurance fund or a policy issued by the state compensation insurance fund must be made within 60 days to the fraud detection and prevention unit established pursuant to 39-71-211.   History: En. Sec. 5, Ch. 237, L. 1995; amd. Sec. 4, Ch. 276, L. 1997; amd. Sec. 2, Ch. 531, L. 1997; amd. Sec. 15, Ch. 396, L. 2017.