BEFORE THE Department of Public

health and human services of the

STATE OF MONTANA

 

In the matter of the amendment of ARM 37.85.105 pertaining to updating Medicaid provider rates, fee schedules, and effective dates

) ) ) )

NOTICE OF AMENDMENT

 

TO: All Concerned Persons

 

1. On November 6, 2020, the Department of Public Health and Human Services published MAR Notice No. 37-933 pertaining to the public hearing on the proposed amendment of the above-stated rule at page 2048 of the 2020 Montana Administrative Register, Issue Number 21. On November 20. 2020, the department published an amended notice pertaining to the proposed amendment at page 2111 of the 2020 Montana Administrative Register, Issue Number 22. On January 15, 2021, the department published a notice of extension of comment period to the proposed amendment at page 51 of the 2021 Montana Administrative Register, Issue Number 1.

 

2. The department has amended the above-stated rule as proposed.

 

3. The department has thoroughly considered the comments and testimony received. A summary of the comments received and the department's responses are as follows:

 

COMMENT #1: A provider association commented that they support the department's efforts to update codes and rates, but they did not have enough time to fully evaluate the department's proposed rule amendments because the proposed fee schedule was not available during the comment period.

 

RESPONSE #1: The department appreciates the support. In response to the comment, the department extended the comment period to January 22, 2021, by filing a notice of extension of comment period on the proposed amendment. The department was able to provide and publish updated fee schedules to its website on January 15, 2021, allowing for public comment of the posted fee schedules. Ultimately, there were no changes to the optometric fee schedule.

 

COMMENT #2: A provider association commented that optometrists should be reimbursed a fee equal to the rate physicians are paid for performing the same services.

 

RESPONSE #2: As provided in 53-6-125, MCA, the legislature has directed the department to establish a conversion factor for physicians with doctor of medicine or doctor of osteopathy degrees relative to the increase in the consumer price index for medical care for the previous year. The department uses the same resource-based relative value scale (RBRVS) methodology in determining reimbursement rates for physicians who are ophthalmologists and optometrists, and thus the professions are reimbursed in the same manner.

 

            4. The department intends to apply these rules retroactively to January 1, 2021, except for the amendment of ARM 37.85.105(4)(a) which will be retroactive to October 1, 2020. A retroactive application of the proposed rule amendments does not result in a negative impact to any affected party.

 

 

/s/ Brenda K. Elias                                       /s/ Erica Johnston                                       

Brenda K. Elias                                            Erica Johnston, Acting Director

Rule Reviewer                                              Public Health and Human Services

 

 

Certified to the Secretary of State February 2, 2021.