BEFORE THE Department of PUBLIC

HEALTH AND HUMAN SERVICES

OF THE STATE OF MONTANA

 

In the matter of the adoption of New Rules I and II, and the amendment of ARM 37.40.705, 37.40.1105, 37.40.1303, 37.79.102, 37.79.304, 37.85.105, 37.85.212, 37.86.105, 37.86.205, 37.86.805, 37.86.1004, 37.86.1006, 37.86.1105, 37.86.1506, 37.86.1802, 37.86.1807, 37.86.2005, 37.86.2206, 37.86.2207, 37.86.2230, 37.86.2405, 37.86.2505, 37.86.2605, 37.86.3020, 37.86.3515, 37.86.4010, 37.86.4205, 37.87.901, 37.87.1303, 37.87.1313, 37.87.1314, 37.87.1333, 37.87.2233, 37.88.907, 37.89.125, 37.89.523, and 37.90.408 pertaining to revision of fee schedules for Medicaid provider rates

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CORRECTED NOTICE OF Adoption AND AMENDMENT

 

            TO: All Concerned Persons

 

1.  On April 25, 2013, the Department of Public Health and Human Services published MAR Notice No. 37-636 pertaining to the public hearing on the proposed adoption and amendment of the above-stated rules at page 621 of the 2013 Montana Administrative Register, Issue Number 8. On May 23, 2013, the Department of Public Health and Human Services published an Amended Notice of Public Hearing on Proposed Adoption and Amendment at page 824 of the 2013 Montana Administrative Register, Issue Number 10. On June 20, 2013, the department published the notice of adoption and amendment at page 1111 of the 2013 Montana Administrative Register, Issue Number 12.

 

2. Two comments received by the department, pertaining to MAR Notice No. 37-636, were inadvertently left out of the final notice of adoption and amendment. These comments and the responses are as follows:

 

COMMENT #1: One commenter asked why the appropriations approved in HB 2 for targeted case management (TCM) are not reflected in the rule notice or in the Medicaid Youth Mental Health Fee Schedule.

 

RESPONSE #1: The TCM rate published in the fee schedule reflects a 2% increase. This is because Montana does not have an approved state plan amendment (SPA) to increase the TCM rate to the amount appropriated by the 63rd Montana Legislature in HB 2. The department will submit an SPA to the Centers for Medicare and Medicaid Services (CMS) with a request to increase the TCM rate for seriously emotional disturbed youth to the amount appropriated by the Legislature, effective July 1, 2013. The department will promulgate a retroactive rule change to the CMS-approved rate once CMS approval is received.

 

COMMENT #2: One commenter stated that they recall that provider rates for the services provided for in ARM 37.87.1314 and 37.87.1333 were not decreased by 2% during the previous biennium when the core Medicaid rates were decreased. They would like to know why, if the rates were not decreased previously, they would now be eligible for the rate increase along with the other Medicaid rates.

 

RESPONSE #2: The department would like to clarify that ARM 37.87.1314 is new effective January 1, 2013 and therefore, was not subject to any previous provider rate increases or decreases. ARM 37.87.1333 is specific to the Home and Community-Based 1915(c) Bridge Waiver for Youth with Serious Emotional Disturbance effective October 1, 2012 (previously, this program was the PRTF Home and Community-Based Services for Youth with Serious Emotional Disturbance). The rates for the services included in ARM 37.87.1333 have basically remained unchanged since the inception of the PRTF Waiver Program and have not experienced provider rate increases or corresponding decreases. Only two services, "respite per 15 minute unit" and "non-Medical transportation per mile," received a slight increase relative to legislative provider rate increases as these two codes were shared with the other waiver programs. There was a rate study completed for some of the bridge waiver services which included service units being redefined and subsequent rates applied. This was not part of any provider rate increase or decrease per the Legislature.

 

 

/s/ John Koch                                               /s/ Mary E. Dalton acting for                      

John Koch                                                    Richard H. Opper, Director

Rule Reviewer                                             Public Health and Human Services

 

Certified to the Secretary of State July 1, 2013.