53-6-124. Definitions. As used in 53-6-125, 53-6-127, and this section, the following definitions apply:
(1) "Conversion factor" means the dollar value that is multiplied by the appropriate relative value unit to calculate a price for a service provided by a physician.
(2) "Department" means the department of public health and human services.
(3) "Medicaid" means the Montana medical assistance program established under Title 53, chapter 6.
(4) "Physician" has the meaning provided in 37-3-102.
(5) "Policy adjuster" means a factor by which the fee determined under 53-6-125 is multiplied to increase the fee paid by medicaid for certain categories of services.
(6) "Relative value unit" means a numerical value assigned in the resource-based relative value scale to each procedure code used to bill for services provided by a physician.
(7) "Resource-based relative value scale" means the medicare resource-based relative value scale contained in the physician's medicare fee schedule adopted by the centers for medicare and medicaid services of the U.S. department of health and human services.
History: En. Sec. 1, Ch. 414, L. 2007; amd. Sec. 1, Ch. 397, L. 2011.
Structure Montana Code Annotated
Title 53. Social Services and Institutions
Chapter 6. Health Care Services
Part 1. Medical Assistance -- Medicaid
53-6-101. Montana medicaid program -- authorization of services
53-6-104. Freedom of doctors to treat recipients of medical assistance -- freedom to select doctor
53-6-105. Discrimination prohibited
53-6-106. Health care facility standards -- definitions
53-6-107. Sanctions -- penalties
53-6-108. Rules governing sanctions or remedies
53-6-109. Consistent regulation of long-term care facilities -- rulemaking authority -- timeframes
53-6-110. Report and recommendations on medicaid funding
53-6-112. Department to print and distribute copies of part and certain forms
53-6-113. Department to adopt rules
53-6-114. Rules of department binding
53-6-115. Contracts with other agencies
53-6-116. Medicaid managed care -- capitated health care
53-6-117. Participation requirements
53-6-118. through 53-6-120 reserved
53-6-121. Local administration of medical assistance
53-6-122. Telehealth services -- requirements -- limitations
53-6-125. Physician services reimbursement
53-6-127. Rulemaking -- policy adjusters
53-6-128. through 53-6-130 reserved
53-6-131. Eligibility requirements
53-6-132. Application for assistance -- exception
53-6-133. Eligibility determination
53-6-135. through 53-6-138 reserved
53-6-140. Account not to be treated as asset for purposes of eligibility
53-6-142. Periodic review of assistance
53-6-143. Medical assistance liens and recoveries
53-6-144. Relative's responsibility
53-6-145. Agencies to adopt rules governing personal assistant services
53-6-148. Indian health services federal revenue account
53-6-149. State special revenue fund account -- administration
53-6-151. Medicaid reserve account
53-6-152. through 53-6-154 reserved
53-6-156. Medicaid fraud control unit
53-6-157. Powers and duties of medicaid fraud control unit
53-6-158. Cooperation of governmental agencies with medicaid fraud control unit
53-6-159. Permitted disclosure of information obtained in medicaid fraud control unit investigations
53-6-160. Truthfulness, completeness, and accuracy of submissions to medicaid agencies
53-6-167. Recovery of medicaid benefits after recipient's death
53-6-168. Payment of certain funds of deceased recipient to department
53-6-169. Payment of excess burial funds or assets to department
53-6-171. Department lien upon real property of certain medicaid recipients -- conditions
53-6-172. Notice of intent to impose lien -- opportunity for hearing
53-6-173. Contents of lien document -- scope of obligation secured
53-6-174. Filing of lien -- effect of filing -- priority -- renewal -- dissolution of lien
53-6-176. Notice of application -- proof of notice -- request for issuance of writ of execution
53-6-177. Action to challenge issuance of writ of execution
53-6-178. Department right of recovery -- limitations
53-6-179. Payment of amount due -- periodic payments -- substitute security
53-6-180. Waiver of recovery in cases of undue hardship -- rulemaking
53-6-181. Delay in recovery -- sale subject to lien
53-6-182. Spouse's limited exemption from lien
53-6-183. Issuance of writ of execution by clerk of court
53-6-184. Effect of sale -- title acquired
53-6-185. Disposition of sale proceeds -- application of recovered medical assistance
53-6-187. Time for filing of application
53-6-188. Coordination of lien with other medical assistance recoveries
53-6-189. Rulemaking authority
53-6-190. Receipt of transferred assets for less than fair market value -- fine