BEFORE THE DEPARTMENT OF PUBLIC

HEALTH AND HUMAN SERVICES OF THE

STATE OF MONTANA

 

In the matter of the amendment of ARM 37.86.1001, 37.86.1004, 37.86.1005, and 37.86.1006 pertaining to Medicaid dental service providers' reimbursement rates

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NOTICE OF AMENDMENT

 

TO:  All Concerned Persons

 

1.  On April 30, 2009, the Department of Public Health and Human Services published MAR Notice No. 37-468 pertaining to the public hearing on the proposed amendment of the above-stated rules at page 444 of the 2009 Montana Administrative Register, Issue Number 8.

 

2.  The department has amended ARM 37.86.1001, 37.86.1005, and 37.86.1006 as proposed.

 

3.  The department has amended the following rule as proposed, but with the following changes from the original proposal, new matter underlined, deleted matter interlined:

 

            37.86.1004  REIMBURSEMENT METHODOLOGY FOR SOURCE BASED RELATIVE VALUE FOR DENTISTS (RVD)  (1)  For procedures listed in the relative values for dentists scale, reimbursement rates shall be determined using the following methodology:

            (a) through (b)(v) remain as proposed.

            (c)  The conversion factor used to determine the Medicaid payment amount for services provided to eligible individuals is $31.77 $32.75.

 

AUTH:  53-2-201, 53-6-113, MCA

IMP:  53-6-101, MCA

 

4.  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:  The Health Resources Division (division) of the Department of Public Health and Human Services (department) commented that the proposed conversion factor of $31.77 should be revised to $32.75.  The proposed value of $31.77 was calculated on April 20, 2009, prior to the end of the 2009 legislative session, to meet publication deadlines for proposed rules to be effective by July 1, 2009.  Using data now available regarding the legislative appropriation for state fiscal year (SFY) 2010 and historical and projected dental usage rates, the division revises its calculation of the conversion factor.

 

RESPONSE #1:  The department agrees that the conversion factor should be based on the final appropriation for SFY 2010 and the most current usage rates.  It accepts the proposed change and will adopt a conversion factor of $32.75.

 

            5.  These rule amendments are effective July 1, 2009.

 

 

 

/s/  Geralyn Driscoll                                       /s/  Anna Whiting Sorrell                              

Rule Reviewer                                               Anna Whiting Sorrell, Director

                                                                        Public Health and Human Services

           

Certified to the Secretary of State June 15, 2009.