37.87.1206    PSYCHIATRIC RESIDENTIAL TREATMENT FACILITY SERVICES, PARTICIPATION REQUIREMENTS

(1) These requirements are in addition to those contained in rule generally applicable to Medicaid providers.

(2) Psychiatric residential treatment facility (PRTF) providers, as a condition of participation in the Montana Medicaid program, must comply with the following requirements:

(a) maintain a current license as a residential treatment facility under the rules of the department's Quality Assurance Division to provide PRTF services, or, if the provider's facility is not located within the state of Montana, maintain a current license in an equivalent category under the laws of the state in which the facility is located;

(b) maintain a current PRTF certification for Medicaid participation by the state in which the facility is located as required by the Centers for Medicare and Medicaid;

(c) for all providers, enter into and maintain a current provider enrollment form with the department's fiscal agent to provide psychiatric PRTF services;

(d) license and/or register facility personnel in accordance with applicable state and federal laws;

(e) for providers maintaining patient trust accounts, ensure that any funds maintained in those accounts are used only for those purposes for which the youth or legal representative has given written authorization. A provider may not borrow funds from these accounts for any purpose;

(f) maintain accreditation as a PRTF by an organization designated by the Secretary of the United States Department of Health and Human Services as authorized to accredit PRTF for Medicaid participation;

(g) submit to the department within 30 days of receipt, all documentation issued by the accrediting organization to the provider;

(h) agree to indemnify the department in the full amount of the state and federal shares of all Medicaid inpatient psychiatric services reimbursement paid to the facility during any period when federal financial participation is unavailable due to facility failure to meet the conditions of participation specified in these rules or due to other facility deficiencies or errors.

History: 53-2-201, 53-6-113, MCA; IMP, 53-2-201, 53-6-101, 53-6-111, MCA; NEW, 2008 MAR p. 2360, Eff. 1/1/09; AMD, 2010 MAR p. 1511, Eff. 6/25/10; AMD, 2011 MAR p. 1154, Eff. 6/24/11; AMD, 2015 MAR p. 2147, Eff. 12/11/15.