BEFORE THE DEPARTMENT OF PUBLIC

HEALTH AND HUMAN SERVICES OF THE

STATE OF MONTANA

 

In the matter of the amendment of ARM 37.79.326 pertaining to Healthy Montana Kids (HMK) dental benefit program procedures updates

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NOTICE OF PUBLIC HEARING ON PROPOSED AMENDMENT

 

TO: All Concerned Persons

 

            1. On June 15, 2017, at 1:30 p.m., the Department of Public Health and Human Services will hold a public hearing in the auditorium of the Department of Public Health and Human Services Building, 111 North Sanders, Helena, Montana, to consider the proposed amendment of the above-stated rule.

 

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 the Department of Public Health and Human Services no later than 5:00 p.m. on June 7, 2017, to advise us of the nature of the accommodation that you need. Please contact Kenneth Mordan, 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 rule as proposed to be amended provides as follows, new matter underlined, deleted matter interlined:

 

            37.79.326 DENTAL BENEFITS (1) remains the same.

            (2) Providers must bill for services using the procedure codes and modifiers set forth, and according to the definitions contained in the American Dental Association Manual of Current Dental Terminology (CDT 2016 2017).

            (3) Effective January 1, 2016 July 1, 2017, only the dental procedures listed at http://dphhs.mt.gov/hmk.aspx are benefits of the HMK coverage group Dental Program.

            (4) through (6) remain the same.

 

AUTH:  53-4-1004, 53-4-1005, 53-4-1009, 53-4-1105, MCA

IMP:  53-4-1003, 53-4-1004, 53-4-1005, 53-4-1009, 53-4-1104, 53-4-1105, MCA

 

            4. STATEMENT OF REASONABLE NECESSITY

 

The Department of Public Health and Human Services (department) proposes to amend ARM 37.79.326, which describes the state's Healthy Montana Kids (HMK) (formerly the Children's Health Insurance Program (CHIP)) dental benefits. The proposed amendment would update the Current Dental Terminology (CDT) reference material the department utilizes for procedure codes and descriptions from the 2016 to the 2017 version of the CDT.

 

The proposed update of the CDT reference is necessary because the federal Centers for Medicare and Medicaid Services' (CMS) approved state plan for HMK dental benefits utilizes the State of Montana Employee Dental Benefit as a benchmark.  The provider of that benefit, Delta Dental, adopted use of the 2017 CDT in January 2017, which includes procedure code updates, code additions and deletions, or changes to existing code descriptions from the 2016 CDT. The department subsequently examined the 2017 CDT and recommends adoption of the same in order to maintain compliance with the CMS-approved state plan for HMK dental benefits. The HMK/CHIP dental benefit plan will include ABCD codes for qualified providers. Failure of the department to timely adopt the 2017 CDT may adversely impact the department's federal funding requirements and its operation of the HMK dental benefit program.

 

FISCAL IMPACT

 

The department does not anticipate any fiscal impact resulting from the amendment to ARM 37.79.326. The proposed rule changes may affect an estimated 506 dental providers and 19,191 HMK members.

 

            5. Concerned persons may submit their data, views, or arguments either orally or in writing at the hearing. Written data, views, or arguments may also be submitted to: Kenneth Mordan, Department of Public Health and Human Services, Office of Legal Affairs, P.O. Box 4210, Helena, Montana, 59604-4210; fax (406) 444-9744; or e-mail [email protected], and must be received no later than 5:00 p.m., June 23, 2017.

 

6. The Office of Legal Affairs, Department of Public Health and Human Services, has been designated to preside over and conduct this hearing.

 

7. 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.

 

8. 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 the 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.

 

9. The bill sponsor contact requirements of 2-4-302, MCA, do not apply.

 

10. With regard to the requirements of 2-4-111, MCA, the department has determined that the amendment of the above-referenced rule will not significantly and directly impact small businesses.

 

11. Section 53-6-196, MCA, requires that the department, when adopting by rule proposed changes in the delivery of services funded with Medicaid monies, make a determination of whether the principal reasons and rationale for the rule can be assessed by performance-based measures and, if the requirement is applicable, the method of such measurement. The statute provides that the requirement is not applicable if the rule is for the implementation of rate increases or of federal law.

 

The department has determined that the proposed program changes presented in this notice are not appropriate for performance-based measurement and therefore are not subject to the performance-based measures requirement of 53-6-196, MCA.

 

 

 

/s/ Brenda K. Elias                                       /s/ Sheila Hogan                                         

Brenda K. Elias                                            Sheila Hogan, Director

Rule Reviewer                                             Public Health and Human Services

 

 

Certified to the Secretary of State May 15, 2017.