(1) Hospitals granted a provider based status by the department may not restrict access to Medicaid clients.

(2) A physician, clinic, or mid-level practitioner who practices primary care and is a provider based entity, except as described in (3) is required to participate in the Passport to Health and Team Care programs (ARM 37.86.5101 through 37.86.5120 and ARM 37.86.5201 through 37.86.5306). The provider:

(a) must sign a Passport to Health contract;

(b) must accept auto-assignment;

(c) must not limit or restrict acceptance of Medicaid clients unless that same limit/restriction applies to non-Medicaid clients;

(d) must accept new Medicaid clients at the same rate non-Medicaid clients are accepted; and

(e) can only disenroll clients from his/her caseload per the Passport to Health agreement and subject to approval by the department.

(3) A physician, clinic, or mid-level practitioner is exempt from the requirement to participate in the Passport to Health program if the following is met:

(a) the provider is not practicing primary care; or

(b) the provider has requested removal from the department and the department has granted approval.

(4) A clinic, physician, or mid-level practitioner who does not practice primary care and is a provider based entity is exempt from the requirement to participate in the Passport to Health program but is required to accept new Medicaid clients at the same rate non-Medicaid clients are accepted.

(5) Clients must be notified that they will be assessed two cost shares for Medicaid and/or two copayment and deductible charges for cross-over claims.

(a) Notices must be clearly posted in all clinics and facilities and the recipient must be provided written notice before the delivery of services as in 42 CFR 413.65(g)(7)(i), (ii), (iii), and (iv).

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