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| Montana Administrative Register Notice 37-758 | No. 15 08/05/2016 | |
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BEFORE THE DEPARTMENT OF PUBLIC HEALTH AND HUMAN SERVICES OF THE STATE OF MONTANA
TO: All Concerned Persons
1. On August 25, 2016, at 2:30 p.m., the Department of Public Health and Human Services will hold a public hearing in Room 207 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 the Department of Public Health and Human Services no later than 5:00 p.m. on August 17, 2016, 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:
37.34.3005 REIMBURSEMENT FOR SERVICES OF MEDICAID FUNDED DEVELOPMENTAL DISABILITIES HOME AND COMMUNITY-BASED SERVICES (HCBS) WAIVER PROGRAMS (1) remains the same. (2) The department adopts and incorporates by this reference the rates of reimbursement for the delivery of services and items available through each Home and Community-Based Services Waiver Program as specified in the Montana Developmental Disabilities Program Manual of Service Rates and Procedures of Reimbursement for Home and Community-Based Services (HCBS) 1915c 0208
37.86.3607 CASE MANAGEMENT SERVICES FOR PERSONS WITH DEVELOPMENTAL DISABILITIES, REIMBURSEMENT (1) Reimbursement for the delivery by provider entities of Medicaid funded targeted case management services to persons with developmental disabilities is provided as specified in the Montana Developmental Disabilities Program Manual of Service Reimbursement Rates and Procedures for Developmental Disabilities Case Management Services for Persons with Developmental Disabilities Who Are 16 Years of Age or Older or Who Reside in a Children's Community Home, dated (2) The department adopts and incorporates by this reference the Montana Developmental Disabilities Program Manual of Service Reimbursement Rates and Procedures for Developmental Disabilities Case Management Services for Persons with Developmental Disabilities Who Are 16 Years of Age or Older or Who Reside in a Children's Community Home, dated
AUTH: 53-6-113, MCA IMP: 53-6-101, MCA
4. STATEMENT OF REASONABLE NECESSITY
The Department of Public Health and Human Services (department) is proposing the amendment of ARM 37.34.3005 and 37.86.3607. These two rules pertain to the reimbursement of services provided to persons who are recipients of developmental disabilities services funded by the State of Montana with Medicaid monies. These proposed amendments are necessary to increase the reimbursement rates to incorporate state fiscal year (SFY) 2017 additional funding appropriated through House Bill 2 (HB2) of the 64th Montana State Legislature. These proposed amendments also are necessary to implement needed changes in the texts of the two manuals that are incorporated by reference in these rules.
ARM 37.34.3005
The proposed rule amendments have two purposes listed below.
1. The first purpose is to change the title of the manual referenced within the rule to the Montana Developmental Disabilities Program Manual of Service Rates and Procedures of Reimbursement for Home and Community-Based Services (HCBS) 1915c 0208 and 0667 Waiver Programs, per notice given to the Centers for Medicare and Medicaid (CMS) of the program's intent to discontinue the 1037 waiver effective September 30, 2015, and CMS's subsequent approval of the discontinuation of that waiver option. The 1037 Supports for Community Working and Living waiver provided day habilitation, homemaker, live-in caregiver, personal care, residential hab, respite, supported employment, personal supports, supports brokerage, adult companion, educational services, environmental mods/adaptive equipment/specialized medical equipment and supplies, health/health maintenance/safety supports, individual goods and services, PERS, private duty nursing, social/leisure and recreational supports, and transportation for individuals w/MR/DD ages 18 - no max age. The department chose to discontinue this waiver and move the recipients of the waiver into the 0208 comprehensive waiver. The termination of the waiver was due to under-utilization of the waiver. The 0208 waiver provides all the same services as the 1037 waiver, and persons transferred to the 0208 waiver experienced no changes or losses in services.
2. The second purpose is to incorporate into the rule this new edition of the manual, to be dated July 1, 2016, which includes changes in the rates of reimbursement and in certain textual provisions that are necessitated by additional legislative appropriations for the reimbursement of the Medicaid funded home and community services and by changes in the waivers available for delivery of the Medicaid funded home and community services entered into with the federal Centers for Medicare and Medicaid Services (CMS).
ARM 37.86.3607
The purpose of this proposed amendment is to incorporate into the rule a new edition of the Montana Developmental Disabilities Program Manual of Service Reimbursement Rates and Procedures for Developmental Disabilities Case Management Services for Persons with Developmental Disabilities Who Are 16 Years of Age or Older or Who Reside in a Children's Community Home, to be dated July 1, 2016. The proposed amendments include a change in the rate of reimbursement that is necessitated by additional legislative appropriations for the reimbursement of the Medicaid funded case management services. This proposed change in reimbursement is only applicable to the provision of case management services that are contracted for by the department and is not applicable to the reimbursement of case management services delivered by state employees.
Amendments to Manuals
"Montana Developmental Disabilities Program Manual of Service Rates and Procedures of Reimbursement for Home and Community-Based Services (HCBS) 1915c 0208, 1037, and 0667 Waiver Programs"
1. The department is proposing to remove references of the 1037 waiver within this manual, per notice given to the Centers for Medicare and Medicaid (CMS) of the program's intent to discontinue that waiver effective September 30, 2015, and CMS's subsequent approval of the discontinuation of that waiver option. This includes removing reference of the 1037 waiver in the name of the manual to the Montana Developmental Disabilities Program Manual of Service Rates and Procedures of Reimbursement for Home and Community-Based Services (HCBS) 1915c 0208 and 0667 Waiver Programs.
2. The proposed effective date of the revised manual is July 1, 2016.
3. The proposed reimbursement fees include the amount appropriated by the 64th Montana State Legislature for provider rate increases.
"Montana Developmental Disabilities Program Manual of Service Reimbursement Rates and Procedures for Developmental Disabilities Case Management Services for Persons with Developmental Disabilities Who Are 16 Years of Age or Older or Who Reside in a Children's Community Home"
1. The proposed effective date of the revised manual is July 1, 2016.
2. The proposed reimbursement fee includes the amount appropriated by the 64th Montana State Legislature for provider rate increases.
Fiscal Impact
The fiscal impact of the proposed changes to ARM 37.34.3005, implementing provider rate increases for DD providers will increase total expenditures to providers for state fiscal year 2016 by the sum of $3,694,445. These increased rates affect approximately 70 corporate providers of services.
The fiscal impact of the proposed change to ARM 37.86.3607, implementing provider rate increases for contracted providers of developmental disabilities case management services will increase total expenditures to those providers for state fiscal year 2017 by the sum of $127,464 in expenditures. These increased rates affect approximately
5. The department intends to apply these rule amendments retroactively to July 1, 2016. A retroactive application of the proposed rule amendments does not result in a negative impact to any affected party.
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., September 2, 2016.
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.
12. Section 53-6-196, MCA, requires that the department, when adopting by rule proposed changes in the delivery of services funded with Medicaid monies, make a determination of whether the principal reasons and rationale for the rule can be assessed by performance-based measures and, if the requirement is applicable, the method of such measurement. The statute provides that the requirement is not applicable if the rule is for the implementation of rate increases or of federal law.
The department has determined that the proposed program changes presented in this notice are not appropriate for performance-based measurement and therefore are not subject to the performance-based measures requirement of 53-6-196, MCA.
/s/ Cary B. Lund /s/ Richard H. Opper Cary B. Lund Richard H. Opper, Director Rule Reviewer Public Health and Human Services
Certified to the Secretary of State July 25, 2016.
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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].
