(1) A payor that has a medical home or patient-centered medical home component in its provider contracts or in insurance contracts issued to Montana residents shall submit a letter to the commissioner describing its method of compensating providers no later than January 1 of each year, if there are changes from the prior year.

(2) A payor that is new to the Montana patient-centered medical home program shall submit a letter of intent describing its proposed method of compensating providers no later than 30 days before beginning participation in the program.

(3) The payor letters described in (1) and (2) must conform to the provisions of Title 33, chapter 40, MCA, applicable Administrative Rules of Montana, and any additional instructions concerning the content and detail of the letter prescribed by the commissioner.

(4) A payor may not participate in the Montana patient-centered medical home program until the commissioner approves the payor as meeting the requirements of this rule. The commissioner shall approve, disapprove, or request additional information no later than 30 days after receipt of the letter of intent.

(5) The commissioner shall maintain copies of the payor letters. After approval, these letters are available to the public, and posted on the commissioner's web site. If the commissioner determines that a payor letter contains trade secret information as defined in 30-14-402(4), MCA, the commissioner shall redact or otherwise withhold such information from the public.

(6) Payment models must support enhanced primary care and promote the development of patient-centered medical home practices, according to the goals expressed in 33-40-103(4), MCA. Payment methods may include the following:

(a) payment for practice transformation and achieving patient-centered medical home recognition status;

(b) reimbursement for patient-centered medical home services such as:

(i) care coordination services;

(ii) care management services;

(iii) disease management services;

(iv) population management services;

(v) behavior health specialist services; and

(vi) clinical pharmacist services.

(c) payment for improvement in quality metrics;

(d) shared savings incentives;

(e) block grants to enhance patient-centered medical home capabilities of primary care practices; and

(f) any other type of payment method that the commissioner approves as supporting the goals of the Montana patient-centered medical home program.