53-6-133. Eligibility determination. (1) The local office of public assistance shall promptly determine the eligibility of each applicant under this part in accordance with the rules of the department. Each applicant must be informed of the right to a fair hearing and of the confidential nature of the information given. The department, through the local office of public assistance, shall, after the hearing, determine whether or not the applicant is eligible for assistance under this part, and aid must be furnished promptly to eligible persons. Each applicant must receive written notice of the decision concerning the applicant's application, and the right of appeal is secured to the applicant under the procedures of 53-2-606.
(2) The local office of public assistance and the department may accept the federal social security administration's determination of eligibility for supplemental security income, Title XVI of the Social Security Act, as qualifying the eligible individuals to receive medical assistance under this part.
(3) (a) The department shall verify the information provided on an application for medicaid under part 13 or under this part, using data sources allowed under federal law or regulation and Montana department of revenue information as required under subsection (3)(b), to confirm an applicant's eligibility for the program before authorizing payment of benefits under the program.
(b) The department shall request income tax and wage income from the department of revenue as allowed under 15-30-2618 and 15-31-511 to verify the income information provided by applicants who may be eligible for coverage pursuant to 53-6-1304.
(4) The department shall establish by rule the documents to be used to verify that an applicant is a Montana resident. (Subsections (3) and (4) terminate June 30, 2025, on occurrence of contingency--sec. 48, Ch. 415, L. 2019.)
History: En. Sec. 10, Ch. 325, L. 1967; amd. Sec. 1, Ch. 181, L. 1974; amd. Sec. 1, Ch. 327, L. 1977; R.C.M. 1947, 71-1520; amd. Sec. 2, Ch. 310, L. 1989; amd. Sec. 453, Ch. 546, L. 1995; amd. Sec. 39, Ch. 571, L. 2001; amd. Sec. 27, Ch. 415, L. 2019.
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