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| Montana Administrative Register Notice 37-670 | No. 8 04/24/2014 | |
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BEFORE THE DEPARTMENT OF PUBLIC HEALTH AND HUMAN SERVICES OF THE STATE OF MONTANA
TO: All Concerned Persons
1. On May 15, 2014, at 1:30 p.m., the Department of Public Health and Human Services will hold a public hearing in the auditorium of the Department of Public Health and Human Services Building, 111 North Sanders, Helena, Montana, to consider the proposed amendment of the above-stated rules.
2. The Department of Public Health and Human Services will make reasonable accommodations for persons with disabilities who wish to participate in this rulemaking process or need an alternative accessible format of this notice. If you require an accommodation, contact Department of Public Health and Human Services no later than 5:00 p.m. on May 8, 2014, to advise us of the nature of the accommodation that you need. Please contact Kenneth Mordan, Department of Public Health and Human Services, Office of Legal Affairs, P.O. Box 4210, Helena, Montana, 59604-4210; telephone (406) 444-4094; fax (406) 444-9744; or e-mail [email protected].
3. The rules as proposed to be amended provide as follows, new matter underlined, deleted matter interlined:
37.85.104 EFFECTIVE DATES OF PROVIDER FEE SCHEDULES FOR MONTANA NON-MEDICAID SERVICES (1) The department adopts and incorporates by reference the fee schedule for the following programs within the Addictive and Mental Disorders Division and Developmental Services Division on the dates stated: (a) Mental health services plan provider reimbursement, as provided in ARM 37.89.125, is effective (b) 72-hour presumptive eligibility for adult-crisis stabilization services reimbursement for services, as provided in ARM 37.89.523, is effective (c) Youth respite services reimbursement for services as provided in ARM 37.87.2233, is effective (2) Copies of the department's current fee schedules are posted at http://medicaidprovider.hhs.mt.gov and may be obtained from the Department of Public Health and Human Services, Health Resources Division, 1401 East Lockey, P.O. Box 202951, Helena, MT 59620-2951. A description of the method for setting the reimbursement rate and the administrative rules applicable to the covered service is published in the chapter or subchapter of this title regarding that service.
AUTH: 53-2-201, 53-6-101, 53-6-113, MCA IMP: 53-2-201, 53-6-101, 53-6-111, MCA
37.85.105 Effective dates, CONVERSION FACTORS, POLICY ADJUSTERS, AND COST-TO-CHARGE RATIOS of Montana Medicaid Provider Fee Schedules (1) remains the same. (2) The department adopts and incorporates by reference, the resource-based relative value scale (RBRVS) reimbursement methodology for specific providers as described in ARM 37.85.212 on the date stated. (a) Resource-based relative value scale (RBRVS) means the version of the Medicare resource-based relative value scale contained in the Medicare Physician Fee Schedule adopted by the Centers for Medicare and Medicaid Services (CMS) of the U.S. Department of Health and Human Services and published at (b) Fee schedules are effective (c) Policy adjustors are effective (d) The (e) The specific percents for modifiers adopted by the department is effective (f) Psychiatrists receive a 112% provider rate of reimbursement adjustment to the reimbursement of physicians effective (g) Midlevel practitioners receive a 90% provider rate of reimbursement adjustment to the reimbursement of physicians for those services described in ARM 37.86.205(5)(b) effective (h) Optometric services receive a 112% provider rate of reimbursement adjustment to the reimbursement for allied services as provided in ARM 37.85.105(2) effective (i) Reimbursement for physician administered drugs described at ARM 37.86.105 is determined at 42 CFR 414.904. (3) The department adopts and incorporates by reference, the fee schedule for the following programs within the Health Resources Division, on the date stated. (a) The inpatient hospital services fee schedule and inpatient hospital base fee schedule rates including: (i) the APR-DRG fee schedule for inpatient hospitals as provided in ARM 37.86.2907, effective (ii) the Montana Medicaid APR-DRG relative weight values, average national length of stay (ALOS), outlier thresholds, and APR grouper version (b) The outpatient hospital services fee schedules including: (i) the Outpatient Prospective Payment System (OPPS) fee schedule as published by the Centers for Medicare and Medicaid Services (CMS) in 71 Federal Register 226, effective (ii) the conversion factor for outpatient services on or after (iii) the Medicaid statewide average outpatient cost-to-charge ratio is (iv) the bundled composite rate of (c) The hearing aid services fee schedule, as provided in ARM 37.86.805, is effective (d) The Relative Values for Dentists, as provided in ARM 37.86.1004, reference published in (e) The dental services covered procedures, the Dental and Denturist Program Provider Manual, as provided in ARM 37.86.1006, is effective (f) The outpatient drugs reimbursement, dispensing fees range as provided in ARM 37.86.1105(2)(b) is effective (i) a minimum of $2.00 and a maximum of $4.94 for brand-name and nonpreferred generic drugs; (ii) a minimum of $2.00 and a maximum of (g) The outpatient drugs reimbursement, compound drug dispensing fee range as provided in ARM 37.86.1105(4), will be $12.50, $17.50, or $22.50 based on the level of effort required by the pharmacist, effective July 1, 2013. (h) The outpatient drugs reimbursement, vaccine administration fee as provided in ARM 37.86.1105(5), will be $21.32 for the first vaccine and (i) The out-of-state providers will be assigned a $3.50 dispensing fee. (j) The outpatient drugs reimbursement, unit dose prescriptions fee as provided in ARM 37.86.1105(9), will be $0.75 per pharmacy-packaged unit dose medication, effective November 1, 2013. (k) The home infusion therapy services fee schedule, as provided in ARM 37.86.1506, is effective (l) Montana Medicaid adopts and incorporates by reference the Region D Supplier Manual which outlines the Medicare coverage criteria for Medicare covered durable medical equipment, local coverage determinations (LCDs), and national coverage determinations (NCDs) as provided in ARM 37.86.1802, effective January 1, 2014. The prosthetic devices, durable medical equipment, and medical supplies fee schedule, as provided in ARM 37.86.1807, is effective January 1, 2014. (m) The early and periodic screening, diagnostic and treatment (EPSDT) services fee schedules for private duty nursing, nutrition and orientation, and mobility specialists as provided in ARM 37.86.2207(2), is effective (n) The transportation and per diem fee schedule, as provided in ARM 37.86.2405, is effective (o) The specialized nonemergency medical transportation fee schedule, as provided in ARM 37.86.2505, is effective July 1, 2013. (p) The ambulance services fee schedule, as provided in ARM 37.86.2605, is effective (q) The audiology fee schedule, as provided in ARM 37.86.705, is effective July 1, 2014. (r) The therapy fee schedules for occupational therapists, physical therapists, and speech therapists, as provided in ARM 37.85.610, are effective July 1, 2014. (4) The department adopts and incorporates by reference, the fee schedule for the following programs within the Senior and Long-Term Care Division on the date stated: (a) Home and community-based services for elderly and physically disabled persons fee schedule, as provided in ARM 37.40.1421, is effective (b) Home health services fee schedule, as provided in ARM 37.40.705, is effective (c) Personal assistance services fee schedule, as provided in ARM 37.40.1105, is effective (d) Self-directed personal assistance services fee schedule, as provided in ARM 37.40.1303, is effective (5) The department adopts and incorporates by reference, the fee schedule for the following programs within the Addictive and Mental Disorders Division on the date stated: (a) Case management services for adults with severe disabling mental illness reimbursement, as provided in ARM 37.86.3515, is effective (b) Mental health center services for adults reimbursement, as provided in ARM 37.88.907, is effective (c) Home and community-based services for adults with severe disabling mental illness, reimbursement, as provided in ARM 37.90.408, is effective (d) Targeted case management services for substance use disorders, reimbursement, as provided in ARM 37.86.4010, is effective (6) The department adopts and incorporates by reference, the fee schedule for the following programs within the Developmental Services Division, on the date stated (a) Mental health services for youth, as provided in ARM 37.87.901 in the Medicaid Youth Mental Health Services Fee Schedule, is effective (b) Mental health services for youth, as provided in ARM 37.87.1313 in the 1915(i) HCBS State Plan Program for Youth with Serious Emotional Disturbance Fee Schedule, is effective (c) Mental health services for youth, as provided in ARM 37.87.1030 in the 1915(c) HCBS Bridge Waiver for Youth with Serious Emotional Disturbance Fee Schedule, is effective
IMP: 53-2-201, 53-6-101, 53-6-402, MCA
4. STATEMENTS OF REASONABLE NECESSITY
STATEMENT OF REASONABLE NECESSITY - HEALTH RESOURCES DIVISION
The Health Resources Division of the Department of Public Health and Human Services (the department) is proposing amendments to ARM 37.85.105 for the purpose of implementing an approximate 2% increase in Medicaid fees to providers. This increase is funded by House Bill 2 (HB2) of the 63rd Montana Legislature. The increase is necessary to maintain Medicaid provider rates at a level consistent with efficiency, economy, quality of care, and to ensure the continued participation of providers.
Updates will be added regarding fee schedules, effective dates, conversion factors, percentages, and rates for services provided through the Health Resources Division (HRD). These services include inpatient hospital, outpatient hospital, physician, pharmacy, and allied health services.
In addition, language describing the "by report" reimbursement methodology will be changed to "payment-to-charge ratio." This is necessary because the Center for Medicare and Medicaid Services (CMS) no longer recognize the "by report" reimbursement methodology. This proposed change in language will affect those services provided within the Health Resources Division that utilize the payment-to-charge reimbursement methodology.
Statement of Reasonable Necessity - Physician Services
The resource-based relative value scale (RBRVS) is used nationwide by most health plans, including Medicare and Medicaid. The relative value unit component of RBRVS is revised annually by the CMS and the American Medical Association. The department annually amends ARM 37.85.105 to adopt current relative value units (RVUs). An RVU is a numerical value assigned to each medical procedure. RVUs are based on physician work, practice expense, and malpractice insurance expenses and express the relative effort and expense expended to provide one procedure compared with another. RVUs are added for new procedures and the RVUs of particular procedures may increase or decrease from year to year.
The department annually calculates conversion factors for physician services, allied services, mental health services, and anesthesia services. These conversion factors are calculated by dividing the Montana Legislature's appropriation for Medicaid member's health care during the upcoming State Fiscal Year (SFY) by the estimated total units of health care, expressed as total RVUs paid, to be provided during the upcoming SFY. The resulting quotient is the conversion factor. The RVU for a procedure multiplied by the conversion factor is the fee paid for the procedure. The conversion factor for licensed physicians is further set by 53-6-124 through 53-6-127, MCA, and the fees paid are funded by legislative appropriations.
In SFY 2015, the physician services conversion factor will increase by 4.5%. HB2 also funds an approximate 2% provider increase for allied services, mental health services, and anesthesia services. The conversion factor amounts for physician services, allied services, mental health services, and anesthesia services will be determined by modeling data.
The payment-to-charge ratio is determined by dividing the amount that is reimbursed for services by the amount billed for the services. For SFY 2015 the department has determined the payment-to-charge ratio is 44%.
It is necessary for the department to provide these updates to reflect the most current provider rate increases as funded by HB2, and to reference the most current information regarding fee schedules, effective dates, conversion factors, and percentages where applicable for each service.
Summary of Proposed Amendments - Physician Services
The following describes the proposed rule amendments to ARM 37.85.105(2) pertaining to Physician Services:
(a) – update the reference to the Federal Register regarding the RBRVS to include the effective date, and add new language stating that procedure codes created after January 1, 2014, will be reimbursed using the relative value units from the Medicare Physician Fee Schedule in place at the time the procedure code is created;
(b) – revise the effective date regarding RBRVS fee schedules to July 1, 2014; and update the conversion factor for physician services from $34.32 to $35.86, allied services from $23.08 to $24.33, mental health services from $24.29 to $23.87, and anesthesia services from $28.10 to $28.66;
(c) – revise the effective date regarding policy adjustors to July 1, 2014 and maintain the policy adjustor percentage for maternity at 112%, family planning at 105%, and psychological testing for youth at 145%;
(d) – remove the language regarding the "by report rate" and replace it with language regarding the "payment-to-charge ratio," revise the effective date regarding the "payment-to-charge ratio" to July 1, 2014, and maintain the "payment-to-charge ratio" of the provider's usual and customary charges at 44%;
(e) – revise the effective date regarding the specific percents for modifiers adopted by the department to July 1, 2014;
(f) – revise the effective date regarding the rate of reimbursement for psychiatrists to July 1, 2014 and maintain the reimbursement rate at 112% of the physician reimbursement rate;
(g) – revise the effective date regarding the rate of reimbursement for mid-level practitioners to July 1, 2014 and maintain the reimbursement rate of 90% of the physician reimbursement rate; and
(h) – revise the effective date regarding reimbursement of optometric services to July 1, 2014.
The fiscal impact and number of providers affected can be found within the "fiscal impact" section of this document.
Statement of Reasonable Necessity - Hospital Services
Outpatient hospital services are reimbursed on a predetermined rate per service basis. These services are classified according to a list of Ambulatory Payment Classification (APC) groups published annually in the Code of Federal Regulations. APC group reimbursement is based on the Current Procedural Terminology (CPT) or the Healthcare Common Procedural Coding System (HCPCS) code associated with the service.
The department uses a conversion factor to establish an outpatient rate that is less than the rate established by Medicare's outpatient conversion factor. This conversion factor is an average base rate used to translate APC relative weights into payment rates and is the same for all APC groups. The APC payment equals the Medicare specific weight for each APC, multiplied by the Medicaid conversion factor. Currently, the conversion factor for outpatient services is $50.61. This rate will be updated to $55.53 with an effective date of July 1, 2014.
The department's All Patient Refined – Diagnosis Related Groups (APR-DRG) prospective payment system for inpatient hospital services is based on the classification of inpatient hospital discharges to APR-DRGs. The department assigns an APR-DRG to each Medicaid member discharge in accordance with the current APR grouper program version as developed by 3M Health Information Systems. The current grouper version is version 29 which will be updated to version 31 with an effective date of July 1, 2014.
The Centers for Medicare and Medicaid Services (CMS) is requiring that the Medicaid composite rate for dialysis clinics be adjusted to reflect the current Medicare rate. Therefore, effective July 1, 2014, the current Medicaid composite rate of $267.24 will be reduced to the current Medicare composite rate of $252.00. This change in dialysis rates is necessary to allow Medicaid to stay within the clinic upper payment level (UPL) as required by CMS.
It is necessary for the department to provide these updates to reflect the most current provider rate increases as funded by HB2, and to reference the most current information regarding fee schedules, effective dates, conversion factors, and percentages where applicable for each service.
Summary of Proposed Amendments - Hospital Services
The following describes the proposed rule amendments to ARM 37.85.105(3) pertaining to Hospital Services:
(a)(i) – revise the effective date regarding the inpatient hospital fee schedule to July 1, 2014;
(a)(ii) – revise the effective date regarding the APR-DRG Table of Weights and Thresholds to July 1, 2014, and update the APR-DRG grouper version from version 29 to version 31;
(b)(ii) – increase the conversion factor for outpatient services from $50.61 to $55.53, and revise the effective date to July 1, 2014;
(b)(iii) – update the outpatient statewide average cost-to-charge ratio from 44.5% to 46.3%; and
(b)(iv) – update the composite rate for dialysis clinics from $267.24 to $252.00; and revise the effective date to July 1, 2014.
The fiscal impact and number of providers affected can be found within the "fiscal impact" section of this document.
Statement of Reasonable Necessity – Allied Health Services
It is necessary for the department to provide these updates to reflect the most current provider rate increases as funded by HB2, and to reference the most current information regarding fee schedules, effective dates, conversion factors, and percentages where applicable for each service.
The following describes the proposed rule amendments to ARM 37.85.105(3) pertaining to Allied Health Services:
(c) – revise the effective date of the hearing aid services fee schedule to July 1, 2014;
(d) – revise the Relative Value for Dentists publish date to 2014; update the dental conversion factor from $31.89 to $32.53, and revise the effective date to July 1, 2014;
(e) – revise the effective date of the dental/denturist provider manual to July 1, 2014;
(f) – revise the effective date of the outpatient drug reimbursement dispensing fee range to July 1, 2014;
(f)(ii) – update the maximum dispensing fee for preferred brand name and generic drugs and generic drugs not identified on the preferred list to a maximum of $6.65;
(h) – update the vaccine administration fees from $21.32 for the first vaccine and $13.38 for each additional administered vaccine to $21.32 for the first vaccine and $12.68 for each additional vaccine; and revise the effective date to July 1, 2014;
(k) – revise the effective date of the home infusion therapy services fee schedule to July 1, 2014;
(m) – revise the effective date regarding the Early Periodic Screening, Diagnostic, and Treatment (EPSDT) fee schedule for private duty nursing, nutrition and orientation, and mobility specialists to July 1, 2014;
(n) – revise the effective date regarding the transportation and per diem fee schedule to July 1, 2014;
(p) – revise the effective date regarding the ambulance services fee schedule to July 1, 2014; and
(q) – add new language that indicates the effective date for the audiology services fee schedule is July 1, 2014.
The fiscal impact and number of providers affected can be found within the "fiscal impact" section of this document.
Fiscal Impact for Human Resources Division
The proposed amendments as funded in HB2 to the above-mentioned rules regarding services provided through the Health Resources Division will increase the Medicaid budget by approximately 2% for state fiscal year (SFY) 2015. The following amounts are the budget figures reflecting this increase:
SFY 2015 Allied Health Services $838,440 Hospital Services $2,265,503 Clinic Services ($15,900) Indian Health Pharmacy $3,856 Physician/Mid-level Services $1,125,607 Breast and Cervical $92,402 HMK Pharmacy $8,987 Acute Pharmacy $117,152 Total $4,436,047
This increase in Medicaid funding will have a positive impact upon 372 hospitals; 32 audiologists; 24 hearing aid dispensers; 277 pharmacy providers; 11 home infusion therapy providers; 169 optometric providers; 12 private duty nursing providers; 7 nutrition providers; 92 chiropractic providers; 360 school-based services providers; 4 orientation and mobility specialists; 14 transportation providers; 103 ambulance providers; 373 dental providers; 9,341 physicians; 2,428 mid-level practitioners; 64 podiatrists; 86 occupational therapists; 322 physical therapists; 77 speech therapists; 45 public health clinics; 24 Independent Diagnostic Testing Facilities (IDTF) providers; 133 lab and x-ray providers; and 15 family planning clinics. This increase in funding will maintain access to Medicaid services for 114,746 members within Montana.
STATEMENT OF REASONABLE NECESSITY- ADDICTIVE AND MENTAL DISORDERS DIVISION
The Addictive and Mental Disorders Division (AMDD) of the Department of Public Health and Human Services (the department) is proposing amendments to ARM 37.85.104 and 37.85.105 for the purpose of implementing an approximate 2% increase in Medicaid fees to providers and reference to updating the fee schedules effective July 1, 2014. The increase is necessary to maintain Medicaid provider rates at a level consistent with efficiency, economy, quality of care, and to ensure the continued participation of providers.
The proposed amendments as funded by HB2 to the above-mentioned rules regarding services provided through the AMDD will increase the Medicaid and the Mental Health Services Plan (MHSP) budget by approximately 2% for State Fiscal Year (SFY) 2015. The increase will have a positive impact for providers with mental health centers, mental health waiver programs, mental health and substance abuse programs, MHSP, and the 72-Hour Presumptive Crisis Stabilization program.
Summary of Proposed Amendments - Mental Health Services
ARM 37.85.104
The department is proposing changing the effective date in (1)(a) and (b) from July 1, 2013 to July 1, 2014.
ARM 37.85.105
The department is proposing changing the effective date in (5)(a), (b), (c), and (d) from July 1, 2013 to July 1, 2014.
Fiscal Impact
The AMDD is proposing to update the reimbursement pages for the approximate 2% provider rate increase for Medicaid and general fund adult mental health programs. The proposed provider rate increase, as funded by HB2, will increase the Medicaid and MHSP budget by approximately 2% for FY 2015. The following budget amounts reflect the increase.
SFY 2015 Mental Health Centers $747,125 Chemical Dependency Case Management $75,603 Mental Health Case Management $422,183 SDMI HCBS Waiver Program $154,224 72-Hour Presumptive Program $58,806 Mental Health Services Plan $272,930 Total $1,730,871
The increase in Medicaid and MHSP funding will have a positive impact among the chemical dependency providers, mental health centers, home and community-based waiver providers, and six hospitals providing 72-hour presumptive crisis stabilization.
STATEMENT OF REASONABLE NECESSITY- SENIOR AND LONG-TERM CARE DIVISION
The Senior and Long-Term Care Division of the Department of Public Health and Human Services (the department) is proposing amendments to ARM 37.85.105 regarding an approximate 2% increase in Medicaid fees to providers for three of its programs; Home and Community Services (HCBS), Home Health Services, and Personal Assistance Services (PAS). This increase is funded by House Bill 2 (HB2) of the 63rd Montana Legislature. The purpose of the proposed rule amendments is to update and set provider rates to take into consideration the provider rate increase funding. The increase is necessary to maintain Medicaid provider rates at a level consistent with efficiency, economy, quality of care, and to ensure the continued participation of providers.
Fiscal Impact
HCBS Services: The fee schedule will include a 1.94% increase in provider rates which has been appropriated at $746,160 in total funds by the Legislature in HB2. This funding will impact all Medicaid HCBS individuals and providers who utilize this service. The anticipated number of individuals who will receive HCBS services in SFY 2014 is approximately 2,500.
Home Health Services: The fee schedule will include a 1.9% increase in provider rates which has been appropriated at $6,655 in total funds by the Legislature in HB2. This funding will impact all Medicaid Home Health individuals and Home Health providers who utilize this service. The anticipated number of individuals who will receive home health services in SFY 2014 is approximately 400.
Personal Assistance Services: The fee schedule will include a 1.83% increase in provider rates, which has been appropriated at $752,015 in total funds by the Legislature in HB2. This funding will impact all Medicaid personal assistance service and self-directed personal assistance service individuals and providers. The anticipated number of recipients who will receive personal assistance and self-directed personal assistance services in SFY 2014 is approximately 3,600.
STATEMENT OF REASONABLE NECESSITY- DEVELOPMENTAL SERVICES DIVISION - CHILDREN'S MENTAL HEALTH BUREAU
The Children's Mental Health Bureau of the Department of Public Health and Human Services (the department) is proposing to amend ARM 37.85.104 and 37.85.105, for the purpose of implementing an approximate 2% rate increase in Medicaid fees to providers. The rate increase is necessary to implement HB2 of the 2013 Montana Legislature, which appropriated approximately $2.8 million for the biennium for rate increases, of which approximately $1.4 million remains for the state fiscal year 2015 rate increase. The department is also defining how it intends to price new Current Procedural Terminology (CPT) codes that do not have assigned Relative Value Units (RVU). The calculated rate percentage increases are determined using RBRVS rate modeling for those services priced using RBRVS; and for services from the fee schedule, the rate increases are determined using current and projected expenditures with the available appropriation amount.
Summary of Proposed Amendments - Children's Mental Health Bureau
ARM 37.85.104
The department proposes to amend the rates established in the Medicaid Youth Mental Health Services Fee Schedule, Individuals Under 18 Years of Age, fee schedule to implement an appropriated rate increase in non-Medicaid fees to providers of respite and update the effective date to July 1, 2014. The increase is necessary to implement HB2 of the 2013 Montana Legislature which funded the increase. The proposed increases are necessary to maintain Medicaid rates at a level consistent with efficiency, economy, quality of care, and to ensure the continued participation of providers.
ARM 37.85.105
The department proposes to amend the rates established in the Medicaid Youth Mental Health Services Fee Schedule, Individuals Under 18 Years of Age, fee schedule to implement a rate increase in Medicaid fees to providers and update the effective date to July 1, 2014.
The department proposes to amend rates established in the 1915(i) HCBS State Plan Program for Youth with Serious Emotional Disturbance Fee Schedule and 1915 (c) HCBS Bridge Waiver to implement a rate increase in Medicaid fees to providers and update the effective date to July 1, 2014.
Fiscal Impact
The funding source of the rate increase is Medicaid match for Children's Mental Health Services. 15,500 youth and 1,800 providers are affected by this proposed rate increase. Total funds appropriated for the rate increase are approximately $1.4 million for state fiscal year (SFY) 2015. CSCT also receives an increase which increases the federal expenditure for SFY 2015 by $575,000.
5. The department intends to adopt these rule amendments effective July 1, 2014.
6. Concerned persons may submit their data, views, or arguments either orally or in writing at the hearing. Written data, views, or arguments may also be submitted to: Kenneth Mordan, Department of Public Health and Human Services, Office of Legal Affairs, P.O. Box 4210, Helena, Montana, 59604-4210; fax (406) 444-9744; or e-mail [email protected], and must be received no later than 5:00 p.m., May 22, 2014.
7. The Office of Legal Affairs, Department of Public Health and Human Services, has been designated to preside over and conduct this hearing.
8. The department maintains a list of interested persons who wish to receive notices of rulemaking actions proposed by this agency. Persons who wish to have their name added to the list shall make a written request that includes the name, e-mail, and mailing address of the person to receive notices and specifies for which program the person wishes to receive notices. Notices will be sent by e-mail unless a mailing preference is noted in the request. Such written request may be mailed or delivered to the contact person in 6 above or may be made by completing a request form at any rules hearing held by the department.
9. An electronic copy of this proposal notice is available through the Secretary of State's web site at http://sos.mt.gov/ARM/Register. The Secretary of State strives to make the electronic copy of the notice conform to the official version of the notice, as printed in the Montana Administrative Register, but advises all concerned persons that in the event of a discrepancy between the official printed text of the notice and the electronic version of the notice, only the official printed text will be considered. In addition, although the Secretary of State works to keep its web site accessible at all times, concerned persons should be aware that the web site may be unavailable during some periods, due to system maintenance or technical problems.
10. The bill sponsor contact requirements of 2-4-302, MCA, do not apply.
11. With regard to the requirements of 2-4-111, MCA, the department has determined that the amendment of the above-referenced rules will not significantly and directly impact small businesses.
/s/ John C. Koch /s/ Richard H. Opper John C. Koch Richard H. Opper, Director Rule Reviewer Public Health and Human Services
Certified to the Secretary of State April 14, 2014.
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A directory of state agencies is available online at http://www.mt.gov/govt/agencylisting.asp.
For questions about the organization of the ARM or this web site, contact [email protected].
