Montana Code Annotated
Part 1. Medical Assistance -- Medicaid
53-6-133. Eligibility determination

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

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

53-6-102. Repealed

53-6-103. Repealed

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

53-6-111. Department charged with administration and supervision of medical assistance program -- overpayment recovery -- sanctions for fraudulent and abusive activities -- adoption of rules

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

53-6-123. reserved

53-6-124. Definitions

53-6-125. Physician services reimbursement

53-6-126. Repealed

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

53-6-134. Extension of eligibility for medical assistance to persons terminated from section 1931 medicaid program

53-6-135. through 53-6-138 reserved

53-6-139. Terminated

53-6-140. Account not to be treated as asset for purposes of eligibility

53-6-141. Repealed

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

53-6-146. Protection of tribal and Indian health service facilities from cost-shifting -- seeking to leverage federal financial participation for state children's health insurance program and medicaid

53-6-147. reserved

53-6-148. Indian health services federal revenue account

53-6-149. State special revenue fund account -- administration

53-6-150. Donated funds

53-6-151. Medicaid reserve account

53-6-152. through 53-6-154 reserved

53-6-155. Definitions

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

53-6-161. Terminated

53-6-162. Terminated

53-6-163. Terminated

53-6-164. Terminated

53-6-165. Definitions

53-6-166. Period of ineligibility for medical assistance when assets disposed of for less than fair market value -- undue hardship exception -- department to adopt rules

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

53-6-170. Terminated

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

53-6-175. Recovery of medical assistance secured by lien -- application for issuance of writ of execution

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

53-6-186. Action by department or other person to preserve property subject to lien -- recovery of costs

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

53-6-191. through 53-6-194 reserved

53-6-195. Medicaid program for workers with disabilities -- purpose -- eligibility -- participant costs

53-6-196. Performance-based rulemaking -- privacy exemption