37.86.5112    PASSPORT TO HEALTH PROGRAM: REIMBURSEMENT

(1) Reimbursement for primary care case management services is as follows:

(a) $3.00 per enrollee per month for individuals categorically eligible for Aged, Blind, Disabled and Medically Frail Medicaid; or

(b) $1.00 per enrollee per month for all others who are members of Passport eligible populations.

(2) A primary care provider may be reimbursed for primary care case management for an enrollee for a month during which case management or medical care was not provided to the enrollee if the primary care provider is otherwise in compliance with the agreement with the program.

(3) Medicaid services authorized or provided by a primary care provider are reimbursed as provided in ARM Title 37, chapters 40, 82, 83, 85, 86, and 88.

(4) Services requiring Passport referral are not reimbursable unless referral is provided by a Passport enrollee's primary care provider.

 

History: 53-2-201, 53-6-113, MCA; IMP, 53-6-116, MCA; NEW, 1992 MAR p. 2288, Eff. 10/16/92; AMD, 1996 MAR p. 2193, Eff. 8/9/96; TRANS, from SRS, 2000 MAR p. 481; AMD, 2013 MAR p. 1447, Eff. 8/9/13; AMD, 2018 MAR p. 650, Eff. 4/1/18.