Plans Must Cover Air Ambulance Services Related to Emergency Medical Conditions

On April 15, 2017, Gov. Bullock signed SB 44 into law, creating Chapter 231, which amends Sections 20-25-1403, 33-30-102, 33-31-111 and 33-35-306 of the Montana Code. This law requires health insurance issuers and health benefit plans to pay air ambulance service changes if the services are necessary due to an emergency medical condition. This would include amounts that exceed allowable copayments, coinsurance and deductibles and would also include services provided by out-of-network providers. In addition, the law establishes dispute resolution processes for air ambulance providers and insurers.

Emergency medical conditions means medical conditions characterized by symptoms of sufficient severity for a person knowledgeable in health and medicine to reasonably expect jeopardy to a person’s health (including the health of an unborn child), serious impairment to bodily functions or serious dysfunction of any bodily organ or part absent immediate medical attention.

Payment by issuers and plans would not be required if plan participants have an air ambulance membership subscription that pays for the services provided.

This amendment was effective upon passage.

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