Revise health care laws relating to out-of-network services

This bill prohibits balance billing for out-of-network emergency ambulance services in Montana, requiring insurers to pay providers directly and preventing patients from being charged beyond their in-network cost-sharing amounts. It establishes that ambulance ground transportation must be reimbursed at established local rates or at least 400% of the Medicare rate if no local rate exists, while also limiting out-of-pocket maximums to $100 for these services. The Montana Insurance Department will create a public database of ambulance rates and enforce compliance through rulemaking and potential civil penalties. The law applies to most health insurance plans, including those for state employees and Medicare supplement policies, with self-funded plans able to opt-in by notifying the department.