Generally revise laws related to payments made by health carriers
SB 448 would create a new set of prompt-payment rules for health carriers in Montana, focused on claims submitted by health care providers and suppliers for services furnished to enrollees in health benefits plans. The bill defines key terms such as “clean claim,” “health carrier,” “provider,” and “supplier,” and requires carriers to pay clean claims within 14 calendar days for electronic claims and 30 calendar days for paper or other claims. It also requires carriers to send deficiency notices within specified deadlines if a claim is not clean, and limits later requests for additional information to the defects already identified.
The bill further provides that if a carrier misses the payment deadline on a clean claim, it must pay interest at a specified treasury-based rate, with the commissioner authorized to waive interest in exigent circumstances such as natural disasters. The bill also requires electronic claims and interest payments to be made through the provider’s chosen method without transactional fees imposed by the plan or its vendors. It expressly preserves other legal rights and remedies, prohibits waivers of the bill’s protections in most agreements, and states that federal law controls if there is a conflict.
SB 448 would amend Montana insurance law by adding a new prompt-payment and clean-claim framework to Title 33, chapter 22, and by expressly making those provisions applicable to health maintenance organizations through an amendment to 33-31-111, MCA. It would give the insurance commissioner enforcement authority to impose civil penalties, restitution, and other remedies, and would also authorize the Department of Justice and private parties to seek declaratory or injunctive relief. The bill would affect health carriers, HMOs, insurers, providers, suppliers, and enrollees, and would apply to claims filed on or after January 1, 2026.
The available voting record suggests the bill had at least some support in committee, passing a Senate Business, Labor and Economic Affairs motion to table by a 12-0 vote, but the bill ultimately died in process. Because there are no committee transcript excerpts provided, the broader discussion record is limited, but the bill’s structure indicates a generally pro-provider, pro-payment-timeliness policy approach aimed at reducing claim delays and improving predictability in reimbursement. The unanimous committee vote on the motion suggests no recorded opposition at that stage, even though the measure did not advance to enactment.
The main points of potential contention are the bill’s strict deadlines, mandatory interest penalties, and expanded enforcement mechanisms. Health carriers may view the 14-day electronic and 30-day paper payment deadlines, along with limits on delaying adjudication and restrictions on repeated documentation requests, as burdensome or costly. Providers and suppliers are likely to support those provisions because they improve cash flow and reduce administrative delay. Another possible area of dispute is the private right of action and the commissioner’s authority to impose substantial civil penalties and restitution, which increase compliance exposure for carriers. The bill also includes a federal-preemption clause and a prohibition on contractual waivers, which may be significant for insurers and plan administrators.