37.40.1007    SELF-DIRECTED COMMUNITY FIRST CHOICE SERVICES: GENERAL REQUIREMENTS

(1) Self-directed Community First Choice Services (CFCS) may only be delivered by an attendant who is the employee of a Medicaid-enrolled provider and who is selected by the member or their personal representative.

(2) Agency-based CFCS managed by provider agencies under agreement with Medicaid are not available to members who are participating in the self-directed CFCS program. The use of CFCS managed by provider agencies may be permissible in the event that the member's backup plan fails.

(3) Home health and home and community-based waiver skilled nursing services are not available to members for the completion of health maintenance activities which the member has been authorized to manage. The use of home health and home and community-based waiver skilled nursing services may be permissible in the event that the member's backup plan fails. In this case the service must be prior authorized.

(4) Members who have been terminated from the self-directed program may apply for agency-based CFCS through the Medicaid CFCS program managed by approved provider agencies.

History: 53-2-201, MCA; IMP, 53-2-201, 53-6-113, MCA; NEW, 2014 MAR p. 3075, Eff. 12/25/14.