37.86.5002    HEALTH MAINTENANCE ORGANIZATIONS: RECIPIENT ELIGIBILITY

(1) A recipient in any one of the following categories is eligible to enroll with an HMO contracting with the department:

(a) a FAIM or family-related recipient required by ARM 37.86.5103 to participate in a primary care case management program; or

(b) an SSI recipient or SSI-related recipient required by ARM 37.86.5103 to participate in a primary care case management program.

(2) A recipient who is ineligible to participate in a primary care case management program is not eligible to enroll with an HMO contracting with the department.

History: Sec. 53-2-201 and 53-6-113, MCA; IMP, Sec. 53-2-201, 53-6-101, 53-6-113, 53-6-116 and 53-6-117, MCA; NEW, 1995 MAR p. 1974, Eff. 9/29/95; AMD, 1997 MAR p. 503, Eff. 3/11/97; AMD, 1997 MAR p. 1210, Eff. 7/8/97; TRANS, from SRS, 2000 MAR p. 481; AMD, 2000 MAR p. 866, Eff. 3/31/00.