A Montana woman has filed a proposed class action lawsuit against Billings Clinic, alleging the health care system used tracking technology embedded on its website to share patients' online activity with third-party advertising companies — without patients' knowledge or consent. The lawsuit alleges the practice violated both federal and state privacy laws.

The tracking technology at the center of the lawsuit is the kind of pixel-based and cookie-based software that major health systems have deployed widely over the past decade to monitor web traffic and improve digital marketing. Federal regulators and plaintiffs' attorneys have increasingly scrutinized whether that technology, when used by health care providers, runs afoul of HIPAA and related state protections because it can transmit information about which medical services or conditions a user was researching.

Billings Clinic is the largest health system in Montana and serves patients from across the state, including many from the Helena area who travel to Billings for specialty care. If certified as a class action, the lawsuit could encompass a substantial number of Montana patients who used the clinic's website to research conditions, schedule appointments, or access patient portal services.

Billings Clinic has not yet responded publicly to the lawsuit. The case adds Montana to a growing list of states where health systems are facing legal exposure over website tracking practices — a wave of litigation that has already resulted in settlements at major health systems nationally.