(1) Authorization for the reimbursement of a provider for the delivery of particular services and items to an individual consumer is based on the implementation of an individual cost plan (ICP) for the consumer. Absent an approved ICP for a consumer, reimbursement is not available for services and items delivered to the consumer.

(2) Services and items delivered to a consumer may not be reimbursed unless authorized in the consumer's ICP prior to the delivery of those services and items.

(3) Reimbursement for the delivered services and items may not exceed the sums designated as available for those services in the consumer's ICP. Nor may total reimbursement for the delivered services and items exceed the total of the sums designated as available for those services in the consumer's ICP.

(4) An ICP is developed by the consumer's case manager for submission to the DDP regional office for review and approval. For services reimbursed on time units the case manager estimates the levels of service delivery based on a reasonable assessment of the direct care staff time necessary to meet the health and safety needs of the consumer. The case manager uses the standardized reimbursement rates and any specified rates of reimbursement for particular services and items to calculate the amount of monies necessary to fund the services and items to be provided to the consumer.

(5) All new proposed ICPs or proposed amendments to ICPs must be reviewed and authorized by the DDP's regional manager.

(6) Neither the Montana resource allocation tool nor the plan of care may be used to authorize reimbursement for services or items.