37.80.316    REQUIREMENTS AND PROCEDURES FOR CHILD CARE PAYMENTS

(1) Except as provided in (2) and (3), the provider will receive payment for child care services when the care is provided outside the child's home.

(2) Payment will be made to the parent when a care giver, who does not live with the parent or child, provides child care in the child's home.

(3) Payment will be made to the provider when the provider participates in a tiered reimbursement program, as referenced in ARM 37.80.205(6). Tiered reimbursement programs are intended to benefit the higher quality child care provider.

(4) In the case of direct payment to the parents, the parents and/or the provider bear sole responsibility:

(a) for obtaining provider registration through ARM 37.95.103 prior to claiming payment for covered child care under this chapter; and

(b) for resolving disputes as to proper payment arising between the parent(s) and the provider.

(5) The provider must submit a claim for covered child care services on the billing form provided by the department. Except as provided in (4)(a), a completed billing form with all information and documentation necessary to process the claim must be received by the resource and referral agency of the department within 60 calendar days after the last day of the calendar month in which the service was provided. Timely filing of claims in accordance with the requirements of this rule is a prerequisite for payment. In addition:

(a) The claim must be for actual care provided by the provider designated on the child care authorization and corresponding authorization plan as defined in ARM 37.80.102 and subject to the limitations described in ARM 37.80.201(9). The provider may not bill for care subcontracted to another individual or facility.

(b) The claim must accurately reflect the child's time in and time out as indicated on the provider's sign-in/sign-out records.

(c) The claim must be verifiable through the provider's sign-in/sign-out records as required in ARM 37.80.301(5).

(d) If the authorization and corresponding authorization plans are not completed until after the calendar month in which the child care is provided, the claim will be considered to be filed timely if a completed billing form with all information and documentation necessary to process the claim is received by the department or the entity designated by the department for this purpose within 60 days after the billing document is sent to the provider.

(e) If corrections or adjustments to a submitted claim are necessary, they must be received by the department or its designated entity within the 60 day period prescribed by this rule for timely filing of the claim.

(6) Once an invoice is submitted, invoices are processed within three business days by the child care resource and referral agency.

(7) In cases where payments are made directly to the parent, a parent who fails to pay the provider will be ineligible for further child care assistance until the provider has been paid in full or the parent has made arrangements for payment which are satisfactory to the provider.

 

History: 52-2-704, MCA; IMP, 52-2-704, 52-2-711, 52-2-713, MCA; NEW, 1992 MAR p. 1863, Eff. 8/28/92; TRANS & AMD, from DFS, 1998 MAR p. 3117, Eff. 11/20/98; AMD, 2002 MAR p. 1553, Eff. 5/31/02; AMD, 2003 MAR p. 1306, Eff. 7/1/03; AMD, 2005 MAR p. 1057, Eff. 7/1/05; AMD, 2011 MAR p. 323, Eff. 3/11/11; AMD, 2014 MAR p. 599, Eff. 3/28/14; AMD, 2018 MAR p. 457, Eff. 2/24/18; AMD, 2018 MAR p. 1283; Eff. 7/7/18; AMD, 2020 MAR p. 687, Eff. 6/1/20.