Montana Code Annotated 2023

TITLE 33. INSURANCE AND INSURANCE COMPANIES

CHAPTER 36. MANAGED CARE PLAN NETWORK ADEQUACY AND QUALITY ASSURANCE

Part 3. Quality Assurance

Quality Assurance -- National Accreditation

33-36-301. Quality assurance -- national accreditation. (1) A health carrier whose managed care plan has been accredited by a nationally recognized accrediting organization shall annually provide a copy of the accreditation and the accrediting standards used by the accrediting organization to the commissioner.

(2) If the commissioner finds that the standards of a nationally recognized accrediting organization meet or exceed state standards and that the health carrier has been accredited by the nationally recognized accrediting organization, the commissioner shall approve the quality assurance standards of the health carrier.

(3) The commissioner shall maintain a list of accrediting organizations whose standards have been determined by the commissioner to meet or exceed state quality assurance standards.

(4) Section 33-36-302 does not apply to a health carrier's managed care plan if the health carrier maintains current accreditation by a nationally recognized accrediting organization whose standards meet or exceed state quality assurance standards adopted pursuant to this part.

(5) This section does not prevent the commissioner from monitoring a health carrier's compliance with this part.

History: En. Sec. 23, Ch. 413, L. 1997; amd. Sec. 48, Ch. 157, L. 2023.