BEFORE THE Department of Public

health and human services of the

STATE OF MONTANA

 

In the matter of the amendment of ARM 37.82.701 pertaining to the update of federal poverty level and health coverage status when determining Plan First Program eligibility

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NOTICE OF AMENDMENT

 

TO: All Concerned Persons

 

1. On July 24, 2014, the Department of Public Health and Human Services published MAR Notice No. 37-682 pertaining to the proposed amendment of the above-stated rule at page 1575 of the 2014 Montana Administrative Register, Issue Number 14.

 

2. The department has amended the above-stated rule as proposed.

 

3. The department has thoroughly considered the comments and testimony received. A summary of the comments received and the department's responses are as follows:

 

COMMENT #1: One commenter stated allowing claims to be submitted to third party coverage "would exclude participation in the program by women with third party insurance coverage," and "if services are not covered by third party health coverage, coordination of benefits would not be necessary."

 

RESPONSE #1: The proposed amendment now allows women with other health coverage to participate in the Plan First Program. All third party plans are not comprehensive, especially grandfathered plans. For instance, if the woman's plan does not cover intrauterine devices (IUDs), the Plan First Program would cover this service. The department believes that allowing women with third party liability to participate in the Plan First Program only enhances the plans they already have. The Plan First Program is not comprehensive insurance and only offers limited family planning services and supplies. Medicaid is required to coordinate third party liability benefits.

 

            4. The department intends to apply this rule amendment retroactively to July 1, 2014. A retroactive application of the rule does not result in a negative impact to any affected party.

 

 

/s/ Susan Callaghan                                               /s/ Richard H. Opper                                   

Susan Callaghan                                                   Richard H. Opper, Director

Rule Reviewer                                                      Public Health and Human Services

 

Certified to the Secretary of State September 8, 2014.