37.83.811    QUALIFIED MEDICARE BENEFICIARIES, COVERAGE OF DEDUCTIBLES AND COINSURANCE FOR MEDICARE SERVICES ALSO COVERED BY FULL MEDICAID

(1) For a qualified medicare beneficiary, medicaid will participate in the deductibles and coinsurance for the following medicare services also covered by medicaid:

(a) inpatient hospital services;

(b) outpatient hospital services;

(c) home health services;

(d) skilled nursing home care;

(e) hospice care;

(f) outpatient physical therapy services;

(g) outpatient speech therapy services;

(h) outpatient occupational therapy services;

(i) prosthetic devices, durable medical equipment and medical supplies;

(j) physician services, including laboratory and x-ray services; and

(k) dental services which are oral surgery services.

(2) Medicaid requirements governing the services in (1) are found in Title 37, chapters 40, 82 and 86 of the Administrative Rules of Montana (ARM) . Medicare requirements prevail when medicare requirements as to the availability and delivery of services differ from those for medicaid.

History: Sec. 53-2-201 and 53-6-113, MCA; IMP, Sec. 53-6-101 and 53-6-131, MCA; NEW, 1989 MAR p. 835, Eff. 6/30/89; TRANS, from SRS, 2000 MAR p. 197; AMD, 2001 MAR p. 1476, Eff. 8/10/01; AMD, 2001 MAR p. 2156, Eff. 10/26/01.