Rule Chapter: 37.79
	Chapter Title: HEALTHY MONTANA KIDS (HMK)

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	37.79 : HEALTHY MONTANA KIDS (HMK)

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Rule No. Rule Title Latest Version Effective Date Subchapter 1 General Provisions 37.79.101 HEALTHY MONTANA KIDS (HMK) PLAN 2/15/2013 37.79.102 DEFINITIONS 7/1/2014 37.79.106 ELECTRONIC APPLICATIONS AND SIGNATURES 10/1/2009 37.79.110 PROCESS FOR IDENTIFYING AND APPROVING ENROLLMENT PARTNERS 10/1/2009 37.79.115 ACTIVE ENROLLMENT PROCESS 10/1/2009 37.79.117 PRESUMPTIVE ELIGIBILITY 1/1/2011 37.79.120 MOVEMENT BETWEEN HMK AND HMK PLUS 2/15/2013 37.79.125 POINT OF ACCESS 10/1/2009 37.79.130 TRANSITION 10/1/2009 37.79.135 PROSPECTIVE PAYMENT SYSTEM FOR FEDERALLY QUALIFIED HEALTH CENTER (FQHC) REIMBURSEMENT 7/1/2010 37.79.140 OUTREACH EFFORTS 10/1/2009 Subchapter 2 Eligibility 37.79.201 ELIGIBILITY 2/15/2013 37.79.202 NONQUALIFYING APPLICANTS 10/1/2010 Rules 37.79.203 through 37.79.205 reserved 37.79.206 ELIGIBILITY REDETERMINATION, NOTICE OF CHANGES 2/15/2013 37.79.207 TERMINATION OF ELIGIBILITY AND GUARDIAN LIABILITY 2/15/2013 37.79.208 PROVISIONAL BENEFITS, DETERMINATION OF ELIGIBILITY, AND APPLICATIONS FOR HMK 10/1/2009 37.79.209 ELIGIBILITY VERIFICATION REVIEWS REP 10/1/2009 Subchapter 3 Benefits 37.79.301 COVERED BENEFITS REP 2/15/2013 37.79.302 COVERAGE LIMITATIONS 10/1/2010 37.79.303 BENEFITS NOT COVERED REP 2/15/2013 37.79.304 SERVICES COVERED 2/25/2023 Rules 37.79.305 and 37.79.306 reserved 37.79.307 INPATIENT HOSPITAL BENEFITS REP 2/15/2013 37.79.308 OUTPATIENT HOSPITAL BENEFITS REP 2/15/2013 37.79.309 PHYSICIAN AND ADVANCED PRACTICE REGISTERED NURSE BENEFITS, LIMITATIONS, AND EXCLUSIONS REP 2/15/2013 Rules 37.79.310 and 37.79.311 reserved 37.79.312 PRESCRIPTION DRUG BENEFITS REP 2/15/2013 37.79.313 LABORATORY AND RADIOLOGY BENEFITS REP 2/15/2013 Rules 37.79.314 and 37.79.315 reserved 37.79.316 MENTAL HEALTH BENEFITS REP 2/15/2013 37.79.317 SUBSTANCE USE DISORDER BENEFITS REP 2/15/2013 Rules 37.79.318 through 37.79.320 reserved 37.79.321 VISION BENEFITS 2/13/2004 37.79.322 EYEGLASS BENEFITS 2/13/2004 Rules 37.79.323 and 37.79.324 reserved 37.79.325 AUDIOLOGY BENEFITS REP 2/15/2013 37.79.326 DENTAL BENEFITS 9/9/2023 Subchapter 4 reserved Subchapter 5 Enrollment Provisions 37.79.501 COST SHARING PROVISIONS 10/1/2013 Rule 37.79.502 reserved 37.79.503 ENROLLMENT 2/15/2013 37.79.504 RIGHT TO CHOOSE PRIMARY CARE PROVIDER REP 1/18/2008 37.79.505 DISENROLLMENT 2/15/2013 Subchapter 6 Services and Provider Requirements 37.79.601 CONTRACT FOR SERVICES 10/1/2009 37.79.602 PROVISION OF BENEFITS 2/15/2013 Rules 37.79.603 and 37.79.604 reserved 37.79.605 PARTICIPATING PROVIDERS 10/1/2009 37.79.606 REIMBURSEMENT OF THIRD PARTY ADMINISTRATOR 1/18/2008 37.79.607 UTILIZATION REVIEW AND QUALITY ASSURANCE 1/18/2008 Subchapter 7 reserved Subchapter 8 Hearing and Appeal Procedures 37.79.801 GRIEVANCE AND APPEAL PROCEDURES 2/15/2013