BEFORE THE Department of Public

health and human services of the

STATE OF MONTANA

 

In the matter of the amendment of ARM 37.86.5101, 37.86.5102, 37.86.5103, 37.86.5104, 37.86.5110, 37.86.5111, and 37.86.5112 pertaining to passport to health

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NOTICE OF AMENDMENT

 

TO: All Concerned Persons

 

1. On June 20, 2013, the Department of Public Health and Human Services published MAR Notice No. 37-638 pertaining to the public hearing on the proposed amendment of the above-stated rules at page 1016 of the 2013 Montana Administrative Register, Issue Number 12.

 

2. The department has amended the above-stated rules 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 commenter discussed the lack of timely updating of the Medicaid eligibility system and how this makes it difficult to operationalize the Passport Program.

 

RESPONSE #1: These concerns have been forwarded to the Human Community Services Division, which includes the Public Assistance Policy/Services Bureau.

 

COMMENT #2: A commenter asked for the rationale of the requirement to "keep a paper or electronic log, spreadsheet, or other record of all Passport referrals given and received."

 

RESPONSE #2: The requirement is in current Passport provider agreements and should be standard operating procedure for all Passport providers. The requirement protects a Passport provider from a referred-to provider storing and using a Passport number for services not in the referral. Montana Medicaid performs monthly audits of selected providers' referral logs to make sure that the referral process is not being abused.

 

COMMENT #3: A commenter suggested that the department consider a rule that would allow providers to opt out of the Passport Program.

 

RESPONSE #3: The comment is not applicable to the rules being amended in this

notice; however, Montana Medicaid is active in and will continue to be involved in

discussions of the Patient-Centered Medical Home Advisory Council.

 

COMMENT #4: A commenter stated that there should be no barriers to a family choosing the right primary care provider for their child, including a provider's current Passport caseload.

 

RESPONSE #4: Montana Medicaid cannot force a provider to take Passport members beyond the caseload capacity the provider sets. The department is eliminating the pending status of members that could potentially be used by providers to pick and choose from among the members. The department believes that all Medicaid members should have the assurance that they will be able to see the Passport provider they choose. There is currently no restriction of member access to a primary care provider in Montana due to provider caseload capacities.

 

 

/s/ John Koch                                               /s/ Richard H. Opper                                   

John Koch                                                    Richard H. Opper, Director

Rule Reviewer                                              Public Health and Human Services

 

           

Certified to the Secretary of State July 29, 2013.