As used in this part, unless the context indicates otherwise, the following definitions apply:
(1)
- (a) "Administrator" has the meaning provided for in 33-17-102(3).
- (b) The term includes a pharmacy benefit manager as defined in 33-2-2402.
(2) "Enroller" means a person who:
- (a) solicits the purchase or renewal of a medical care discount card through that person;
- (b) transmits, for consideration, from a supplier to another person or from another person to a supplier a contract or application for a medical care discount card or the renewal of a medical care discount card; or
- (c) acts or aids in another manner in the delivery or negotiation of a medical care discount card or the renewal or continuance of a medical care discount card.
(3) "Health care provider" means:
- (a) an individual licensed by the department of labor and industry to practice or who holds a temporary permit to practice a branch of the healing arts;
- (b) a professional corporation organized pursuant to Title 35, chapter 4, by one or more individuals described in subsection (3)(a);
- (c) a Montana limited liability company organized pursuant to Title 35, chapter 8, for the purpose of rendering professional services by individuals described in subsection (3)(a);
- (d) a partnership of individuals described in subsection (3)(a);
- (e) a Montana nonprofit corporation organized pursuant to Title 35, chapter 2, for the purpose of rendering professional health care services by one or more individuals described in subsection (3)(a); or
- (f) a health care facility as defined in 50-5-101.
- (4) "Health insurance issuer" means a health insurance issuer, as defined in 33-22-140, that is authorized to do business in this state and its affiliates, as defined in 33-2-1101.
(5)
- (a) "Medical care discount card" means a paper or plastic device or other mechanism, arrangement, account, or other device that does not constitute insurance, as defined in 33-1-201, that purports to grant, for consideration, a discount or access to a discount in a medical care-related purchase from a health care provider.
- (b) The term does not include a pharmacy discount card unless a pharmacy discount benefit is combined with another type of medical care discount.
- (6) "Medical care discount card supplier" means a person engaged in selling or furnishing, either as principal or agent, for consideration, one or more medical care discount cards to another person or persons.
- (7) "Network of health care providers" means two or more health care providers who are contractually obligated to provide services in accordance with the terms and conditions applicable to a medical care discount card.
- (8) "Pharmacy discount card" means a paper or plastic device or other mechanism, arrangement, account, or other device that does not constitute insurance, as defined in 33-1-201, that purports to grant, for consideration, a discount or access to a discount on one or more prescription drugs, and that is not combined with another type of medical care discount.
- (9) "Pharmacy discount card supplier" means a person engaged in selling or furnishing, either as a principal or agent, for consideration, one or more pharmacy discount cards to another person or persons.
- (10) "Preferred provider organization company" means a company that contracts with health care providers for lower fees than those customarily charged by the health care provider for services and contracts with health insurance issuers, administrators, or self-insured employers to provide access to those lower fees to a particular group of insureds, subscribers, participants, beneficiaries, members, or claimants.
- (11) "Prescription drug provider" means a pharmacy or other business that is contractually bound to provide a discount on one or more prescription drugs in conjunction with the use of a pharmacy discount card.
- (12) "Service area" means the area within a 60-mile radius of the home or place of business of a medical care discount card user or pharmacy discount card user.
History: En. Sec. 5, Ch. 456, L. 2005; amd. Sec. 20, Ch. 501, L. 2021.