Montana payer mix, regulation & malpractice drivers
- Surprise billing protection: Moderate state statute — partial state-level surprise billing protection alongside federal NSA
- Certificate of Need (CON) status: Extensive Certificate of Need — broad CON program covering hospitals, ASCs, imaging, and surgical capacity
- Medicaid expansion status: ACA Medicaid expanded — coverage to 138% federal poverty level
- Malpractice non-economic damages cap: Hard statutory non-economic damages cap — $250,000 non-economic cap under MCA § 25-9-411
- Hospital price transparency mandate: Federal CMS Hospital Price Transparency Rule (45 CFR Part 180) only — no state-level supplement
- Dominant health insurance market structure: Regional-system dominant — vertically-integrated regional health system shapes market
Montana medical board & physician licensing
- License status: Statewide license required
- License board: Montana Board of Medical Examiners (BME) (official site)
- Permit: Montana Board of Medical Examiners MD/DO license required; DEA Schedule II-V + Montana Prescription Drug Registry (MPDR); hospital privileging at Billings Clinic / Bozeman Health / St. Vincent Healthcare / Providence St. Patrick; CON required through Montana DPHHS under MCA § 50-5-301; Montana Health Improvement Plan (HELP) Section 1115 Medicaid waiver
How medical care costs vary in Montana
State-specific code or insurance rule: Montana operates the Montana Health and Economic Livelihood Partnership Act (HELP) Section 1115 Medicaid expansion waiver — one of the few state Medicaid expansions that imposes monthly premiums on enrollees above 50% FPL plus a workforce development engagement requirement (technically not a 'work requirement' but a workforce-engagement framework) — and Montana operates one of the longer-running rural-Critical-Access-Hospital (CAH) ecosystems in the country with 47 CAHs serving Eastern Plains and Western Montana counties (one of the highest per-capita CAH counts in the U.S.), plus Montana Code Annotated § 25-9-411 caps medical malpractice non-economic damages at $250,000.
Cities in Montana
Compare medical care pricing for Montana.
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