37.88.1405    INSTITUTIONS FOR MENTAL DISEASES, PROVIDER PARTICIPATION REQUIREMENTS

(1) An institution for mental diseases, as a condition of participation in the Montana medicaid program, under ARM 37.88.1401, 37.88.1402, 37.88.1405, 37.88.1406, 37.88.1410, 37.88.1411 and 37.88.1420 must be a provider that meets the following requirements:

(a) complies with the requirements set forth at ARM 37.40.306 for medicaid nursing facility service providers;

(b) has been determined by the department, in accordance with ARM 37.88.1402, to be an institution for mental diseases;

(c) complies with ARM 37.40.352 regarding utilization review and quality of care for nursing facilities; and

(d) enters into and maintains a written agreement with the department that specifies the respective responsibilities of the department and the provider including arrangements for:

(i) joint planning between the parties to the agreement;

(ii) development of alternative methods of care;

(iii) permission for immediate readmission to the institution when the recipient's need for readmission has been determined to be medically necessary;

(iv) access by the department to the recipient, the recipient's records and the facility;

(v) recording, reporting and exchanging medical and social information about recipients; and

(vi) other procedures necessary to carry out the agreement; or

(e) is a hospital which is devoted to the provision of inpatient psychiatric hospital care to adults. A publicly owned hospital devoted to the provision of inpatient psychiatric care to adults shall not be required to enter into and maintain a written agreement as provided in (1) (d) .

History: Sec. 53-6-113, MCA; IMP, Sec. 53-2-201, 53-6-101, 53-6-111 and 53-6-113, MCA; NEW, 1999 MAR p. 1301, Eff. 7/1/99; TRANS, from SRS, 2000 MAR p. 195; AMD, 2000 MAR p. 2036, Eff. 7/28/00.