BEFORE THE DEPARTMENT OF PUBLIC

HEALTH AND HUMAN SERVICES OF THE

STATE OF MONTANA

 

In the matter of the amendment of ARM 37.86.2405, 37.86.2505, and 37.86.2605 pertaining to Medicaid transportation reimbursement for mileage

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NOTICE OF PROPOSED AMENDMENT   NO PUBLIC HEARING CONTEMPLATED

 

TO:  All Concerned Persons

 

1.  On January 23, 2009, the Department of Public Health and Human Services proposes to amend the above-stated rules.

 

2.  The Department of Public Health and Human Services will make reasonable accommodations for persons with disabilities who wish to participate in this rulemaking process or need an alternative accessible format of this notice.  If you require an accommodation, contact Department of Public Health and Human Services no later than 5:00 p.m. on January 5, 2009, to advise us of the nature of the accommodation that you need.  Please contact Rhonda Lesofski, Department of Public Health and Human Services, Office of Legal Affairs, P.O. Box 4210, Helena, Montana, 59604-4210; telephone (406) 444-4094; fax (406) 444-9744; or e-mail [email protected].

 

            3.  The rules as proposed to be amended provide as follows, new matter underlined, deleted matter interlined:

 

            37.86.2405  TRANSPORTATION AND PER DIEM, REIMBURSEMENT

            (1)  The department pays the lower of the following reimbursement rates for transportation services:

            (a) remains the same.

            (b)  the department's Personal and Commercial Transportation and Per Diem Fee Schedule adopted in this rule.

            (2)  The department adopts and incorporates by reference the department's Personal Transportation Fee Schedule effective July 2008 which Montana Medicaid Fee Schedule, Personal and Commercial Transportation dated October 2008 that sets forth the reimbursement rates for transportation, per diem, and other Medicaid services.  A copy of the department's fee schedule is posted at the Montana Medicaid provider web site at http://medicaidprovider.hhs.mt.gov.  A copy of the fee schedule may also be obtained from the Department of Public Health and Human Services, Health Resources Division, 1400 Broadway, P.O. Box 202951, Helena, MT 59620-2951.

            (3) and (4) remain the same.

            (5)  Mileage for transportation in a personally owned vehicle is reimbursed at the rate provided in the department's personal and commercial transportation fee schedule.

 

AUTH:  53-2-201, 53-6-113, MCA

IMP:  53-6-101, 53-6-113, 53-6-141, MCA

 

            37.86.2505  SPECIALIZED NONEMERGENCY MEDICAL TRANSPORTATION, REIMBURSEMENT  (1) through (1)(b) remain the same.

            (2)  The department adopts and incorporates by reference the department's fee schedule dated July October 2008 which sets forth the reimbursement rates for specialized nonemergency medical transportation services and other Medicaid services.  A copy of the fee schedule is posted at the Montana Medicaid provider web site at http://medicaidprovider.hhs.mt.gov.  A copy of the department's fee schedule may be obtained from the Department of Public Health and Human Services, Health Resources Division, 1400 Broadway, P.O. Box 202951, Helena, MT 59620-2951.

 

AUTH:  53-2-201, 53-6-113, MCA

IMP:  53-6-101, 53-6-113, 53-6-141, MCA

 

            37.86.2605  AMBULANCE SERVICES, REIMBURSEMENT  (1) through (1)(b) remain the same.

            (2)  The department adopts and incorporates by reference the department's Ambulance Montana Medicaid Fee Schedule, Ambulance effective July dated October 2008.  A copy of the fee schedule is posted at the Montana Medicaid provider web site at http://medicaidprovider.hhs.mt.gov.  A copy of the department's fee schedule may be obtained from the Department of Public Health and Human Services, Health Resources Division, 1400 Broadway, P.O. Box 202951, Helena, MT 59620-2951.

            (3) through (4) remain the same.

 

AUTH:  53-2-201, 53-6-113, MCA

IMP:  53-6-101, 53-6-113, 53-6-141, MCA

 

            4.  The Department of Public Health and Human Services (the department) is proposing the amendment of ARM 37.86.2405, 37.86.2505, and 37.86.2605 pertaining to Medicaid transportation reimbursement for mileage, including ambulance mileage.  The proposed changes would increase the mileage reimbursement amount for personal medical transportation from $0.25 to $0.33 per mile, commercial and specialized nonemergency from $0.79 to $1.04 and would also increase the ambulance ground transportation rate from $2.79 to $3.68 per mile.  The increased mileage rates would be applied retroactively to October 1, 2008.

 

The proposed amendments are necessary to compensate for rising fuel costs.  The increased mileage rates are intended to preserve health care access for Montana Medicaid recipients.

 

If the department did not amend these rules to increase mileage rates, rising fuel costs will eventually make it too expensive for transportation providers and Medicaid recipients to travel to distant locations for medically necessary services.  Montana is a geographically large state with a relatively small population.  Medical services are concentrated in a few of the largest population centers.  The department is concerned that Medicaid recipients' access to medically necessary services could be restricted by rising fuel costs.  The proposed changes in mileage rates are the best way to keep fuel costs from becoming a barrier to medically necessary travel.

 

Fiscal effects

 

The department estimates that in State Fiscal Year (SFY) 2008, the proposed amendments will increase Montana Medicaid expenditures a total of $355,792.  Estimated federal and state general fund cost increases for the proposed rule changes would be:

 

SFY 2009                   PROGRAM                            FEDERAL     STATE           TOTAL

 

ARM 37.86.2405      Transportation/Per Diem     $238,909       $112,221       $351,130

 

ARM 37.86.2505      Specialized Nonemergency

                                    Transportation                              $742               $349             $1,091

 

ARM 37.86.2605      Ambulance                                 $2,429            $1,141             $3,571

 

Number of persons affected

 

The proposed rule changes could affect an estimated 102,400 Medicaid recipients, 33 commercial and nonemergency transportation providers, and 119 ambulance providers.

 

The department intends to apply the transportation rate increases retroactively to October 1, 2008.  No detrimental effects to affected persons would result from retroactive application.

 

            5.  Concerned persons may submit their data, views, or arguments concerning the proposed action in writing to: Rhonda Lesofski, Department of Public Health and Human Services, Office of Legal Affairs, P.O. Box 4210, Helena, Montana, 59604-4210; telephone (406) 444-4094; fax (406) 444-9744; or e-mail [email protected], and must be received no later than 5:00 p.m., January 21, 2009.

 

6.  If persons who are directly affected by the proposed action wish to express their data, views, or arguments orally or in writing at a public hearing, they must make written request for a hearing and submit this request along with any written comments to Rhonda Lesofski at the above address no later than 5:00 p.m., January 21, 2009.

 

7.  If the agency receives requests for a public hearing on the proposed action from either 10% or 25, whichever is less, of the persons directly affected by the proposed action; from the appropriate administrative rule review committee of the Legislature; from a governmental subdivision or agency; or from an association having not less than 25 members who will be directly affected, a hearing will be held at a later date.  Notice of the hearing will be published in the Montana Administrative Register.  Ten percent of those directly affected has been determined to be 25 persons based on 102,552 Medicaid recipients and providers.

 

8.  The department maintains a list of interested persons who wish to receive notices of rulemaking actions proposed by this agency. Persons who wish to have their name added to the list shall make a written request that includes the name, e-mail, and mailing address of the person to receive notices and specifies for which program the person wishes to receive notices.  Notices will be sent by e-mail unless a mailing preference is noted in the request.  Such written request may be mailed or delivered to the contact person in 5 above or may be made by completing a request form at any rules hearing held by the department.

 

9.  An electronic copy of this Proposal Notice is available through the Secretary of State's web site at http://sos.mt.gov/ARM/Register. The Secretary of State strives to make the electronic copy of this Notice conform to the official version of the Notice, as printed in the Montana Administrative Register, but advises all concerned persons that in the event of a discrepancy between the official printed text of the Notice and the electronic version of the Notice, only the official printed text will be considered. In addition, although the Secretary of State works to keep its web site accessible at all times, concerned persons should be aware that the web site may be unavailable during some periods, due to system maintenance or technical problems.

 

10.  The bill sponsor notice requirements of 2-4-302, MCA, do not apply.

 

 

 

/s/  John Koch                                                /s/  Anna Whiting Sorrell                              

Rule Reviewer                                               Anna Whiting Sorrell, Acting Director

                                                                        Public Health and Human Services

 

Certified to the Secretary of State December 15, 2008.