reglab/housing_qa huggingface dataset:
MT Code § 33-2-2301 (2021)
2021 Montana Code Annotated|Title 33. Insurance and Insurance Companies|Chapter 2. Regulation of Insurance Companies|Part 23. Air Ambulance Providers and Insurers|33-2-2301. Legislative findings and purpose

  33-2-2301. Legislative findings and purpose. (1) The legislature finds that:   (a) air ambulance services provide a necessary, and sometimes lifesaving, means of transporting Montanans experiencing health emergencies;   (b) Montanans desire adequate access to air ambulance services;   (c) in many cases the high charges assessed by out-of-network air ambulance services and limited insurer and health plan reimbursements have resulted in Montanans incurring excessive out-of-pocket expenses; and   (d) the federal Airline Deregulation Act preempts states from enacting any law related to a price, route, or service of an air carrier, which is interpreted as applying to air ambulance services.   (2) The purpose of this part is to prevent Montanans from incurring excessive out-of-pocket expenses in out-of-network air ambulance situations in a manner that is not preempted by the Airline Deregulation Act.   History: En. Sec. 1, Ch. 231, L. 2017.
MT Code § 33-2-2303 (2021)
2021 Montana Code Annotated|Title 33. Insurance and Insurance Companies|Chapter 2. Regulation of Insurance Companies|Part 23. Air Ambulance Providers and Insurers|33-2-2303. Disclosures by air ambulance service

  33-2-2303. Disclosures by air ambulance service. An out-of-network nonhospital-controlled air ambulance service must disclose by July 1 of each year any relationships or financial arrangements with health care providers, insurers, or health plans. This includes but is not limited to employment arrangements, ownership interests, first call agreements, and board memberships. This information must be filed with the department of public health and human services and also posted prominently on the commissioner of insurance's website. The air ambulance service must ensure the continued accuracy of this information throughout the year by submitting written updates within 5 days of any changes to the information.   History: En. Sec. 3, Ch. 231, L. 2017.
MT Code § 33-2-2304 (2021)
2021 Montana Code Annotated|Title 33. Insurance and Insurance Companies|Chapter 2. Regulation of Insurance Companies|Part 23. Air Ambulance Providers and Insurers|33-2-2304. Independent dispute resolution

  33-2-2304. Independent dispute resolution. (1) If an insurer or health plan and air ambulance service enter into dispute resolution, the procedure in 33-2-2305 is to be used to determine the fair market price of the services that are the subject of the claim.   (2) Payment of the fair market price calculated pursuant to 33-2-2305 constitutes payment in full of the claim.   (3) A determination under this section is not binding on the insurer or health plan and the air ambulance service.   (4) Unless otherwise agreed to by the parties, each party shall:   (a) bear its own attorney fees and costs incurred under the procedure provided in 33-2-2305; and   (b) equally bear all fees and costs of the independent reviewer.   (5) As used in this section, "fair market price" means the value of the services provided as determined by the independent reviewer based on the factors provided in 33-2-2305(6).   History: En. Sec. 4, Ch. 231, L. 2017.
MT Code § 33-2-2305 (2021)
2021 Montana Code Annotated|Title 33. Insurance and Insurance Companies|Chapter 2. Regulation of Insurance Companies|Part 23. Air Ambulance Providers and Insurers|33-2-2305. Independent dispute resolution procedure -- exemptions

  33-2-2305. Independent dispute resolution procedure -- exemptions. (1) To initiate a dispute resolution procedure under this part, the parties shall file a written notice of dispute with the insurance commissioner.   (2) Except as provided in subsection (3), within 30 days after the date of receipt of the notice of dispute, and if no independent reviewer is mutually agreed to by the insurer or health plan and air ambulance service under subsection (3), the insurance commissioner shall appoint an independent reviewer having the qualifications listed in 33-2-2306. The insurance commissioner shall select an independent reviewer randomly from a list established under 33-2-2306.   (3) The insurer or health plan and air ambulance provider may by mutual agreement select an independent reviewer. The parties shall notify the insurance commissioner of the mutually agreed independent reviewer prior to the appointment of an independent reviewer under subsection (2).   (4) An independent reviewer's sole substantive determination under this part is the fair market price of the services that are the subject of the claim.   (5) The independent reviewer may make procedural rulings necessary to regulate the proceedings.   (6) The factors to be used in the independent reviewer's determination are:   (a) the training, qualifications, and composition of the air ambulance service personnel;   (b) the fees for rotor wing or fixed wing services originating or provided entirely within the state of Montana that are:   (i) usually charged by the air ambulance service in Montana;   (ii) usually accepted as payment in full by the air ambulance service in Montana;   (iii) usually charged by other air ambulance services doing business in Montana;   (iv) usually accepted as payment in full by other air ambulance services doing business in Montana; and   (v) usually paid by the insurer or health plan for the service provided in Montana;   (c) whether the air ambulance service was provided in a rural or urban context;   (d) the applicable medicare rate of payment for the services that are the subject of the claim; and   (e) any other factors the independent reviewer determines to be relevant in determining fair market price in accordance with established precedent.   (7) Participation in a dispute resolution procedure under 33-2-2304 through 33-2-2306 exempts an insurer from 33-18-201(6) and (8) and 33-18-232(2).   History: En. Sec. 5, Ch. 231, L. 2017.
MT Code § 33-2-2306 (2021)
2021 Montana Code Annotated|Title 33. Insurance and Insurance Companies|Chapter 2. Regulation of Insurance Companies|Part 23. Air Ambulance Providers and Insurers|33-2-2306. Insurance commissioner duties -- independent reviewer qualifications

  33-2-2306. Insurance commissioner duties -- independent reviewer qualifications. (1) The insurance commissioner shall:   (a) approve any independent reviewer that is eligible to adjudicate disputes under this part;   (b) maintain a list of independent reviewers eligible to adjudicate disputes under this part;   (c) terminate approval of an independent reviewer and remove the independent reviewer from the list of approved independent reviewers upon determining that an independent reviewer no longer meets the requirements to adjudicate disputes; and   (d) adopt rules necessary to implement this part, including rules regarding discovery and other procedures regarding the dispute resolution process and eligibility of an independent reviewer.   (2) An individual is eligible to be an independent reviewer under this part if the individual is knowledgeable and experienced in applicable principles of contract and insurance law.   (3) In approving an individual as an independent reviewer, the insurance commissioner shall ensure that the individual does not have a conflict of interest that would adversely impact the individual's independence and impartiality in rendering a decision in an independent dispute resolution procedure under 33-2-2304 and 33-2-2305. A conflict of interest includes but is not limited to an ownership or direct familial interest in an insurer, a health care provider, or an air ambulance service that may be involved in an independent dispute resolution procedure under 33-2-2304 and 33-2-2305.   (4) In approving an individual as an independent reviewer, the insurance commissioner may not approve an individual who is currently serving in any matter as a hearing officer for the commissioner.   History: En. Sec. 6, Ch. 231, L. 2017.
MT Code § 33-2-2401 (2021)
2021 Montana Code Annotated|Title 33. Insurance and Insurance Companies|Chapter 2. Regulation of Insurance Companies|Part 24. Pharmacy Benefit Manager Oversight|33-2-2401. Short title -- purpose

  33-2-2401. Short title -- purpose. (1) This part may be cited as the "Montana Pharmacy Benefit Manager Oversight Act".  (2) This part establishes the standards and criteria for the licensure and regulation of pharmacy benefit managers that provide claims processing services or other prescription drug or device services for health benefit plans and workers' compensation insurance carriers.   (3) The purpose of this part is to:   (a) promote, preserve, and protect the public health, safety, and welfare through regulation and licensure of pharmacy benefit managers;   (b) provide for powers and duties of the commissioner in licensing and regulating pharmacy benefit managers; and   (c) provide penalties for violations of this part.   History: En. Sec. 1, Ch. 501, L. 2021.
MT Code § 33-2-2404 (2021)
2021 Montana Code Annotated|Title 33. Insurance and Insurance Companies|Chapter 2. Regulation of Insurance Companies|Part 24. Pharmacy Benefit Manager Oversight|33-2-2404. Pharmacy benefit manager prohibited practices

  33-2-2404. Pharmacy benefit manager prohibited practices. (1) In any participation contracts between a pharmacy benefit manager and pharmacies or pharmacists providing prescription drug coverage, a pharmacy or pharmacist may not be prohibited, restricted, or penalized in any way from disclosing to any enrollee or injured worker any information the pharmacy or pharmacist considers appropriate regarding:  (a) the decision of utilization reviewers or similar persons to authorize or deny drug coverage or benefits; and   (b) the process that is used to authorize or deny drug coverage or benefits.   (2) (a) A pharmacy benefit manager contract with a participating pharmacy or pharmacist in this state may not prohibit, restrict, or limit disclosure of information to the commissioner when the commissioner is investigating or examining a complaint or conducting a review of a pharmacy benefit manager's compliance with the requirements of this part.   (b) A pharmacy benefit manager may not terminate the contract of or penalize a pharmacy or pharmacist for sharing any portion of the pharmacy benefit manager contract with the commissioner for investigation of a complaint or a question regarding whether the contract complies with this part.   (c) Any examination or review under this section must follow the examination procedures and requirements applicable to insurers under Title 33, chapter 1, part 4, including but not limited to the confidentiality provisions of 33-1-409.   History: En. Sec. 4, Ch. 501, L. 2021.
MT Code § 33-2-2405 (2021)
2021 Montana Code Annotated|Title 33. Insurance and Insurance Companies|Chapter 2. Regulation of Insurance Companies|Part 24. Pharmacy Benefit Manager Oversight|33-2-2405. Marketing and advertising

  33-2-2405. Marketing and advertising. (1) A pharmacy benefit manager may not cause or knowingly permit the use of an advertisement, promotion, solicitation, representation, proposal, or offer that is untrue, deceptive, or misleading.  (2) The commissioner may not review or approve a pharmacy benefit manager's marketing or advertising documents prior to use by the pharmacy benefit manager.   (3) The commissioner shall review complaints related to pharmacy benefit manager marketing and advertising material to determine whether the materials violate the provisions of this section.   History: En. Sec. 5, Ch. 501, L. 2021.
MT Code § 33-2-2408 (2021)
2021 Montana Code Annotated|Title 33. Insurance and Insurance Companies|Chapter 2. Regulation of Insurance Companies|Part 24. Pharmacy Benefit Manager Oversight|33-2-2408. Pharmacy benefit manager appeals report

  33-2-2408. Pharmacy benefit manager appeals report. (1) Pharmacy benefit managers shall track, monitor, and report to the commissioner each quarter the following aggregated information related to appeals filed pursuant to 33-22-173:  (a) the number of appeals filed by pharmacies;   (b) whether the appeals were denied or upheld by the pharmacy benefit manager and, if denied, the reasons for the denials;   (c) for each denial, confirmation that the pharmacy benefit manager provided the pharmacy in writing the pricing and other information required under 33-22-173;   (d) the total amount of price adjustments made by the pharmacy benefit manager; and   (e) the average amount of days taken to make price adjustments.   (2) The report must be filed within 30 days of the close of each calendar quarter.   (3) The commissioner may request information required under this section at any time if the commissioner believes the information is reasonably necessary to ensure compliance with this part, 33-22-170 through 33-22-177, and 33-22-180.   History: En. Sec. 8, Ch. 501, L. 2021.
MT Code § 33-2-2409 (2021)
2021 Montana Code Annotated|Title 33. Insurance and Insurance Companies|Chapter 2. Regulation of Insurance Companies|Part 24. Pharmacy Benefit Manager Oversight|33-2-2409. Network adequacy

  33-2-2409. Network adequacy. (1) A pharmacy benefit manager shall provide an adequate and accessible pharmacy network for the provision of prescription drugs to ensure reasonable proximity of pharmacies to the businesses or personal residences of enrollees and injured workers.  (2) In determining whether a pharmacy benefit manager has complied with the requirements of this section, consideration must be given to the relative availability of physical pharmacies in a geographic area.   (3) The commissioner shall adopt rules for network adequacy.   History: En. Sec. 9, Ch. 501, L. 2021.
MT Code § 33-2-2410 (2021)
2021 Montana Code Annotated|Title 33. Insurance and Insurance Companies|Chapter 2. Regulation of Insurance Companies|Part 24. Pharmacy Benefit Manager Oversight|33-2-2410. Federal 340B drug pricing program

  33-2-2410. Federal 340B drug pricing program. A pharmacy benefit manager or health carrier may not:  (1) prohibit a federally certified health entity or a pharmacy under contract with an entity to provide pharmacy services from participating in the pharmacy benefit manager's or health carrier's provider network;   (2) reimburse a federally certified health entity or a pharmacy under contract with an entity differently than it reimburses other similarly situated pharmacies;   (3) require a claim for a drug to include a modifier to indicate that the drug is a 340B drug unless the claim is for payment, directly or indirectly, by the medicaid program provided for in Title 53, chapter 6, part 1; or   (4) create a restriction or an additional charge on a patient who chooses to receive drugs from a federally certified health entity or a pharmacy under contract with an entity, including but not limited to a patient's inability to fully pay a copayment. (Subsection (3) terminates June 1, 2023--sec. 26, Ch. 501, L. 2021.)   History: En. Sec. 10, Ch. 501, L. 2021.
MT Code § 33-2-2411 (2021)
2021 Montana Code Annotated|Title 33. Insurance and Insurance Companies|Chapter 2. Regulation of Insurance Companies|Part 24. Pharmacy Benefit Manager Oversight|33-2-2411. Enforcement -- penalties

  33-2-2411. Enforcement -- penalties. (1) The commissioner shall enforce the provisions of this part, 33-22-170 through 33-22-177, and 33-22-180 and may examine the affairs of a pharmacy benefit manager to determine compliance with the provisions.  (2) Any examination under this section must follow the examination procedures and requirements applicable to insurers under Title 33, chapter 1, part 4, including the confidentiality provisions of 33-1-409.   (3) A pharmacy benefit manager may not be regularly examined under the same time period as required of insurers under 33-1-401 but the commissioner may examine the pharmacy benefit manager at any time if the commissioner believes it is reasonably necessary to ensure compliance with this part.   (4) The commissioner may impose a fine in accordance with 33-1-317 and 33-1-318 for a violation of this part, 33-22-170 through 33-22-177, and 33-22-180.   History: En. Sec. 11, Ch. 501, L. 2021.
MT Code § 33-2-2412 (2021)
2021 Montana Code Annotated|Title 33. Insurance and Insurance Companies|Chapter 2. Regulation of Insurance Companies|Part 24. Pharmacy Benefit Manager Oversight|33-2-2412. Rulemaking

  33-2-2412. Rulemaking. The commissioner may adopt rules as necessary to implement the provisions of this part.  History: En. Sec. 12, Ch. 501, L. 2021.
MT Code § 33-3-101 (2021)
2021 Montana Code Annotated|Title 33. Insurance and Insurance Companies|Chapter 3. Domestic Stock and Mutual Insurers|Part 1. General Provisions|33-3-101. Scope of chapter

  33-3-101. Scope of chapter. This chapter shall apply only to domestic stock insurers and domestic mutual insurers transacting or proposing to transact insurance on the cash premium or legal reserve plan, except that 33-3-414(2) and 33-3-503 shall also apply to foreign and alien insurers.   History: En. Sec. 418, Ch. 286, L. 1959; R.C.M. 1947, 40-4701.
MT Code § 33-3-102 (2021)
2021 Montana Code Annotated|Title 33. Insurance and Insurance Companies|Chapter 3. Domestic Stock and Mutual Insurers|Part 1. General Provisions|33-3-102. Definitions

  33-3-102. Definitions. (1) A "domestic mutual insurer" is an incorporated insurer without capital stock, and the governing body of which is elected by the policyholders.   (2) A "domestic stock insurer" is an incorporated insurer with capital divided into shares and owned by its stockholders.   History: En. Secs. 419, 420, Ch. 286, L. 1959; R.C.M. 1947, 40-4702, 40-4703.
MT Code § 33-3-103 (2021)
2021 Montana Code Annotated|Title 33. Insurance and Insurance Companies|Chapter 3. Domestic Stock and Mutual Insurers|Part 1. General Provisions|33-3-103. Applicability of general corporation statutes

  33-3-103. Applicability of general corporation statutes. (1) The applicable laws of this state as to domestic corporations formed for profit shall apply as to domestic stock insurers and domestic mutual insurers except where in conflict with the express provisions of this code and the reasonable implications of such provisions.   (2) Except as provided in part 6 of this chapter, 35-14-1401 through 35-14-1405 apply to the voluntary dissolution of a domestic insurer.   History: En. Sec. 421, Ch. 286, L. 1959; R.C.M. 1947, 40-4704; amd. Sec. 1, Ch. 389, L. 1987; amd. Sec. 188, Ch. 368, L. 1991; amd. Sec. 231, Ch. 271, L. 2019.
MT Code § 33-3-104 (2021)
2021 Montana Code Annotated|Title 33. Insurance and Insurance Companies|Chapter 3. Domestic Stock and Mutual Insurers|Part 1. General Provisions|33-3-104. Extinguishment of unused corporate charters

  33-3-104. Extinguishment of unused corporate charters. (1) The corporate charter of any corporation formed under the laws of this state for the purpose of becoming an insurer, and which corporation during any period of 36 consecutive months after January 1, 1961, is not actively engaged in business as a domestic insurer under a certificate of authority issued to it by the commissioner under law currently in force, is automatically hereby extinguished and nullified at the expiration of such 36-month period.   (2) The period during which any such corporation referred to in subsection (1) above is the subject of delinquency proceedings under part 13, chapter 2, of this title shall not be counted as part of any such 36-month period.   History: En. Sec. 467, Ch. 286, L. 1959; R.C.M. 1947, 40-4750(2), (3); amd. Sec. 141, Ch. 575, L. 1981.
MT Code § 33-3-105 (2021)
2021 Montana Code Annotated|Title 33. Insurance and Insurance Companies|Chapter 3. Domestic Stock and Mutual Insurers|Part 1. General Provisions|33-3-105. Commissioner's request of biographical information

  33-3-105. Commissioner's request of biographical information. (1) The commissioner may request from domestic insurers biographical information from officers, directors, and persons in a position to control the activity of the following entities:   (a) insurers provided for in Title 33, chapter 3;   (b) farm mutual insurers provided for in Title 33, chapter 4;   (c) reciprocal insurers provided for in Title 33, chapter 5;   (d) health service corporations provided for in Title 33, chapter 30;   (e) health maintenance organizations provided for in Title 33, chapter 31; and   (f) the state fund provided for in Title 39, chapter 71, part 23.   (2) Officers, directors, or other persons in a position to control the activity of the entities listed in subsection (1) shall submit biographical information on a form prescribed by the commissioner.   History: En. Sec. 2, Ch. 227, L. 2001; amd. Sec. 7, Ch. 62, L. 2019.
MT Code § 33-3-202 (2021)
2021 Montana Code Annotated|Title 33. Insurance and Insurance Companies|Chapter 3. Domestic Stock and Mutual Insurers|Part 2. Formation|33-3-202. Articles of incorporation -- approval

  33-3-202. Articles of incorporation -- approval. (1) The incorporators of a proposed domestic insurer shall deliver an electronic copy of the proposed articles of incorporation to the commissioner. The commissioner shall examine the proposed articles of incorporation. If the commissioner finds that the articles comply with this chapter and are not in conflict with the constitution and laws of the United States or of this state, the commissioner shall approve the articles. However, if the commissioner finds that the proposed insurer would not be eligible for a certificate of authority under 33-2-112, the commissioner shall refuse to approve the articles of incorporation and shall provide in writing the reasons for the refusal. The commissioner shall forward the approved articles and the applicable fees to the secretary of state.   (2) If the commissioner finds that the proposed articles of incorporation do not comply with law, the commissioner shall refuse to approve the proposed articles of incorporation and shall provide a written statement of the reasons for the refusal.   (3) The corporation has legal existence as a corporation upon the issuance of the certificate of incorporation by the secretary of state, but the corporation may not transact business as an insurer until it has qualified for and received from the commissioner a certificate of authority as provided in this title.   (4) A copy of the certificate of incorporation, certified by the secretary of state, is admissible in all the courts of this state as prima facie evidence of proper incorporation.   History: En. Sec. 423, Ch. 286, L. 1959; R.C.M. 1947, 40-4706; amd. Sec. 1, Ch. 373, L. 1983; amd. Sec. 5, Ch. 316, L. 1999; amd. Sec. 17, Ch. 472, L. 1999; amd. Sec. 8, Ch. 62, L. 2019; amd. Sec. 4, Ch. 117, L. 2019.