Managed Care Organizations
The Montana Department of Labor and Industry certifies managed care organizations (MCOs). Organizations seeking certification are required to submit an application and pay a fee of $1,500. Once certified, the MCO can contract with insurers to receive their referrals. These organizations are formed to serve the medical needs of injured workers in an efficient and cost-effective manner by managing the delivery of medical services for a defined population of injured workers. Injured workers who have a loss of wages for any duration, suffer an injury that will result in a permanent impairment, require referral to another medical provider for specialized treatment, or need specialized diagnostic tests, may be referred for treatment to a MCO.
39-71-1101 et. seq. MCA
Current Certified MCOs
Majoris Health Systems Montana Inc
Lynn Parnell
Dispute Resolution/Quality Assurance Specialist
PO Box 1728
Lake Oswego, Oregon 97035
(503) 601-8256
Certification Renewal: June 30, 2022
MCO Certification Renewal Process
(based on ARM 24.29.2361)
1. MCO sends renewal notice to Montana Department of Labor (60 to 120 days before expiration).
2. MCO must be current in all reporting requirements (ARM 24.29.2351):
A. Copy of MCO-insurer contract(s).
B. Copy of service contracts or modifications within 10 days of signing.
C. Copy of contracts with other entities to perform some functions of the plan within 30 days of signing.
D. Addition or termination of members within 30 days.
E. Change in licensure of members or staff within 30 days.
F. Changes in administrative staff within 30 days.
G. Changes in service location within 30 days.;
H. Expiration, termination, or cancellation of any service contract within 30 days.
I. Annual report (ARM 24.29.2351 (5) --- see separate information sheet).
J. Report any data required to comply with reporting requirements of the Department of Labor.
K. Report any additional information required by the Department of Labor.
3. MCO Certification Renewal Application will contain:
A. Statement: MCO not formed, owned, or operated by WC insurer or self-insured employer; statement must be signed by day-to-day administrator.
B. Liaison’s name, title, address, telephone number and email address.
C. Day-to-day administrator’s name, title, address, telephone number and email address.
D. Medical director’s (if any) name, title, address, telephone number and email address.
E. Current members’ names, specialty, addresses, telephone numbers and email addresses. (Medical director or day-to-day administrator must include signed statement that each individual listed is properly licensed)
F. List of insurers contracted with, including expiration dates of contracts.
G. Summary of any sanctions or punitive actions taken by MCO against members.
Contact Info
Managed Care Organizations
Operations Bureau
PO Box 8011
Helena, MT 59604-8011
(406) 444-6543
