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 and 37.86.1807 pertaining to Effective Dates of Montana Medicaid Provider Fee Schedules

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NOTICE OF AMENDMENT

 

TO: All Concerned Persons

 

1. On October 29, 2015, the Department of Public Health and Human Services published MAR Notice No. 37-728 pertaining to the public hearing on the proposed amendment of the above-stated rules at page 1826 of the 2015 Montana Administrative Register, Issue Number 20. On December 24, 2015, the Department of Public Health and Human Services published an Amended Notice of Public Hearing on Proposed Amendment at page 2238 of the 2015 Montana Administrative Register, Issue Number 24.

 

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

 

          37.85.105 Effective dates, CONVERSION FACTORS, POLICY ADJUSTERS, AND COST-TO-CHARGE RATIOS of Montana Medicaid Provider Fee Schedules (1) through (3)(k) remain as proposed.

          (l) Montana Medicaid adopts and incorporates by reference the Region D Supplier Manual, January 2016, 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, 2016. The prosthetic devices, durable medical equipment, and medical supplies fee schedule, as provided in ARM 37.86.1807, is effective February 1, 2016 July 1, 2015.

          (m) through (6) remain as proposed.

 

AUTH: 53-2-201, 53-6-113, MCA

IMP: 53-2-201, 53-6-101, 53-6-402, MCA

 

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: The department received several comments urging the department to delay or not adopt the proposed Medicare fee schedule and a new Medicaid incontinence supply fee schedule in ARM 37.85.105 and 37.86.1807 pertaining to prosthetic devices, durable medical equipment, and medical supplies fee schedule.

 

RESPONSE #1: The department is amending the proposed notice by leaving the original effective date of July 1, 2015 in ARM 37.85.105(3)(l). The department is reviewing the proposed amendment to ARM 37.86.1807 and may file a new proposed rulemaking at a later time.

 

4. The department is not amending ARM 37.86.1807 at this time due to the comments received.

 

          5. The department intends to apply this amendment to ARM 37.85.105 retroactively to January 1, 2016. A retroactive application of the proposed rule amendment does not result in a negative impact to any affected party.

 

 

/s/ Susan Callaghan                              /s/ Richard H. Opper                            

Susan Callaghan, Attorney                    Richard H. Opper, Director

Rule Reviewer                                       Public Health and Human Services

         

Certified to the Secretary of State January 11, 2016