2019 Montana Code Annotated
Title 33. Insurance and Insurance Companies
Chapter 36. Managed Care Plan Network Adequacy and Quality Assurance
Part 1. General Provisions
33-36-105. Department -- general powers and duties -- rulemaking
33-36-105. Department -- general powers and duties -- rulemaking. (1) The department shall:
(a) adopt rules pursuant to the Montana Administrative Procedure Act establishing minimum state standards for network adequacy and quality assurance and procedures for ensuring compliance with those standards; and
(b) recommend action to the commissioner against a health carrier whose managed care plan does not comply with standards for network adequacy and quality assurance adopted by the department.
(2) Quality assurance standards adopted by the department must consist of some but not all of the health plan employer data and information standards. The department shall select and adopt only standards appropriate for quality assurance in Montana.
(3) The state may contract, through a competitive bidding process, for the development of network adequacy and quality assurance standards.
History: En. Sec. 12, Ch. 413, L. 1997.
