Montana Code Annotated
Title 53. Social Services and Institutions
Chapter 6. Health Care Services

53-6-104. Freedom of doctors to treat recipients of medical assistance -- freedom to select doctor - 53-6-104. Freedom of doctors to treat recipients of medical assistance...

53-6-105. Discrimination prohibited - 53-6-105. Discrimination prohibited. No discrimination shall be practiced or asserted...

53-6-106. Health care facility standards -- definitions - 53-6-106. Health care facility standards -- definitions. (1) For purposes...

53-6-107. Sanctions -- penalties - 53-6-107. Sanctions -- penalties. (1) The department may suspend, terminate,...

53-6-108. Rules governing sanctions or remedies - 53-6-108. Rules governing sanctions or remedies. The department shall adopt...

53-6-109. Consistent regulation of long-term care facilities -- rulemaking authority -- timeframes - 53-6-109. Consistent regulation of long-term care facilities -- rulemaking authority...

53-6-110. Report and recommendations on medicaid funding - 53-6-110. Report and recommendations on medicaid funding. (1) As a...

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

53-6-112. Department to print and distribute copies of part and certain forms - 53-6-112. Department to print and distribute copies of part and...

53-6-113. Department to adopt rules - 53-6-113. Department to adopt rules. (1) The department shall adopt...

53-6-114. Rules of department binding - 53-6-114. Rules of department binding. All rules of the department...

53-6-115. Contracts with other agencies - 53-6-115. Contracts with other agencies. The department of public health...

53-6-116. Medicaid managed care -- capitated health care - 53-6-116. Medicaid managed care -- capitated health care. (1) The...

53-6-117. Participation requirements - 53-6-117. Participation requirements. (1) The department of public health and...

53-6-118. through 53-6-120 reserved - 53-6-118 through 53-6-120 reserved.

53-6-121. Local administration of medical assistance - 53-6-121. Local administration of medical assistance. The local offices of...

53-6-122. Telehealth services -- requirements -- limitations - 53-6-122. Telehealth services -- requirements -- limitations. (1) Providers enrolled...

53-6-123. reserved - 53-6-123 reserved.

53-6-124. Definitions - 53-6-124. Definitions. As used in 53-6-125, 53-6-127, and this section,...

53-6-125. Physician services reimbursement - 53-6-125. Physician services reimbursement. (1) The fee for a covered...

53-6-126. Repealed - 53-6-126. Repealed. Sec. 3, Ch. 397, L. 2011. History: En....

53-6-127. Rulemaking -- policy adjusters - 53-6-127. Rulemaking -- policy adjusters. The department may by rule...

53-6-128. through 53-6-130 reserved - 53-6-128 through 53-6-130 reserved.

53-6-131. Eligibility requirements - 53-6-131. (Temporary) Eligibility requirements. (1) Medical assistance under the Montana...

53-6-132. Application for assistance -- exception - 53-6-132. Application for assistance -- exception. (1) Subject to subsection...

53-6-133. Eligibility determination - 53-6-133. Eligibility determination. (1) The local office of public assistance...

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

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

53-6-139. Terminated - 53-6-139. Terminated. Sec. 9, Ch. 616, L. 1989. History: En....

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

53-6-141. Repealed - 53-6-141. Repealed. Sec. 8, Ch. 711, L. 1989. History: En....

53-6-142. Periodic review of assistance - 53-6-142. Periodic review of assistance. All medical assistance cases approved...

53-6-143. Medical assistance liens and recoveries - 53-6-143. Medical assistance liens and recoveries. (1) Except as provided...

53-6-144. Relative's responsibility - 53-6-144. Relative's responsibility. Except as otherwise provided in 53-6-167 through...

53-6-145. Agencies to adopt rules governing personal assistant services - 53-6-145. Agencies to adopt rules governing personal assistant services. (1)...

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 - 53-6-146. Protection of tribal and Indian health service facilities from...

53-6-147. reserved - 53-6-147 reserved.

53-6-148. Indian health services federal revenue account - 53-6-148. Indian health services federal revenue account. (1) There is...

53-6-149. State special revenue fund account -- administration - 53-6-149. State special revenue fund account -- administration. (1) There...

53-6-150. Donated funds - 53-6-150. Donated funds. The department of public health and human...

53-6-151. Medicaid reserve account - 53-6-151. Medicaid reserve account. There is a medicaid reserve account...

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

53-6-155. Definitions - 53-6-155. Definitions. As used in this part, unless expressly provided...

53-6-156. Medicaid fraud control unit - 53-6-156. Medicaid fraud control unit. (1) There is a medicaid...

53-6-157. Powers and duties of medicaid fraud control unit - 53-6-157. Powers and duties of medicaid fraud control unit. (1)...

53-6-158. Cooperation of governmental agencies with 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 - 53-6-159. Permitted disclosure of information obtained in medicaid fraud control...

53-6-160. Truthfulness, completeness, and accuracy of submissions to medicaid agencies - 53-6-160. Truthfulness, completeness, and accuracy of submissions to medicaid agencies....

53-6-161. Terminated - 53-6-161. Terminated. Sec. 8, Ch. 614, L. 1991. History: En....

53-6-162. Terminated - 53-6-162. Terminated. Sec. 8, Ch. 614, L. 1991. History: En....

53-6-163. Terminated - 53-6-163. Terminated. Sec. 8, Ch. 614, L. 1991. History: En....

53-6-164. Terminated - 53-6-164. Terminated. Sec. 8, Ch. 614, L. 1991. History: En....

53-6-165. Definitions - 53-6-165. Definitions. As used in this part, unless expressly provided...

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 - 53-6-166. Period of ineligibility for medical assistance when assets disposed...

53-6-167. Recovery of medicaid benefits after recipient's death - 53-6-167. Recovery of medicaid benefits after recipient's death. (1) Except...

53-6-168. Payment of certain funds of deceased recipient to department - 53-6-168. Payment of certain funds of deceased recipient to department....

53-6-169. Payment of excess burial funds or assets to department - 53-6-169. Payment of excess burial funds or assets to department....

53-6-170. Terminated - 53-6-170. Terminated. Sec. 18, Ch. 577, L. 1999. History: En....

53-6-171. Department lien upon real property of certain medicaid recipients -- conditions - 53-6-171. Department lien upon real property of certain medicaid recipients...

53-6-172. Notice of intent to impose lien -- opportunity for hearing - 53-6-172. Notice of intent to impose lien -- opportunity for...

53-6-173. Contents of lien document -- scope of obligation secured - 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 - 53-6-174. Filing of lien -- effect of filing -- priority...

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

53-6-176. Notice of application -- proof of notice -- request for issuance of writ of execution - 53-6-176. Notice of application -- proof of notice -- request...

53-6-177. Action to challenge issuance of writ of execution - 53-6-177. Action to challenge issuance of writ of execution. A...

53-6-178. Department right of recovery -- limitations - 53-6-178. Department right of recovery -- limitations. (1) Except as...

53-6-179. Payment of amount due -- periodic payments -- substitute security - 53-6-179. Payment of amount due -- periodic payments -- substitute...

53-6-180. Waiver of recovery in cases of undue hardship -- rulemaking - 53-6-180. Waiver of recovery in cases of undue hardship --...

53-6-181. Delay in recovery -- sale subject to lien - 53-6-181. Delay in recovery -- sale subject to lien. (1)...

53-6-182. Spouse's limited exemption from lien - 53-6-182. Spouse's limited exemption from lien. (1) Subject to Title...

53-6-183. Issuance of writ of execution by clerk of court - 53-6-183. Issuance of writ of execution by clerk of court....

53-6-184. Effect of sale -- title acquired - 53-6-184. Effect of sale -- title acquired. The purchaser of...

53-6-185. Disposition of sale proceeds -- application of recovered medical assistance - 53-6-185. Disposition of sale proceeds -- application of recovered medical...

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

53-6-187. Time for filing of application - 53-6-187. Time for filing of application. Except as provided in...

53-6-188. Coordination of lien with other medical assistance recoveries - 53-6-188. Coordination of lien with other medical assistance recoveries. The...

53-6-189. Rulemaking authority - 53-6-189. Rulemaking authority. The department may adopt rules to implement...

53-6-190. Receipt of transferred assets for less than fair market value -- fine - 53-6-190. Receipt of transferred assets for less than fair market...

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

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

53-6-196. Performance-based rulemaking -- privacy exemption - 53-6-196. Performance-based rulemaking -- privacy exemption. (1) Except for rules...

Part 2. Renal Disease Treatment Program (Renumbered)

53-6-201. Renumbered 50-44-101 - 53-6-201. Renumbered 50-44-101. Code Commissioner, 1991.

53-6-202. Renumbered 50-44-102 - 53-6-202. Renumbered 50-44-102. Code Commissioner, 1991.

Part 3. Montana State Hospital (Renumbered and Repealed)

53-6-301. Renumbered 53-21-601 - 53-6-301. Renumbered 53-21-601. Code Commissioner, 1991.

53-6-302. Repealed - 53-6-302. Repealed. Sec. 1, Ch. 80, L. 1987. History: En....

53-6-303. Renumbered 53-21-602 - 53-6-303. Renumbered 53-21-602. Code Commissioner, 1991.

53-6-304. Renumbered 53-21-603 - 53-6-304. Renumbered 53-21-603. Code Commissioner, 1991.

Part 4. Home and Community-Based Long-Term Care Medicaid Services

53-6-401. Definitions - 53-6-401. Definitions. As used in this part, the following definitions...

53-6-402. Medicaid-funded home and community-based services -- waivers -- funding limitations -- populations -- services -- providers -- long-term care preadmission screening -- powers and duties of department -- rulemaking authority - 53-6-402. Medicaid-funded home and community-based services -- waivers -- funding...

53-6-403. Home and community-based services waivers -- legislative findings and intent - 53-6-403. Home and community-based services waivers -- legislative findings and...

53-6-404. Use of waiver funding - 53-6-404. Use of waiver funding. (1) The department shall use...

53-6-405. Fraud prevention education -- department responsibilities - 53-6-405. Fraud prevention education -- department responsibilities. (1) In an...

53-6-406. Fiscal accountability for home and community-based services - 53-6-406. Fiscal accountability for home and community-based services. (1) (a)...

53-6-407. Notification required before termination of waiver participation - 53-6-407. Notification required before termination of waiver participation. (1) The...

53-6-408. through 53-6-412 reserved - 53-6-408 through 53-6-412 reserved.

53-6-413. Substantive changes to waiver provisions -- rulemaking requirements -- definition - 53-6-413. Substantive changes to waiver provisions -- rulemaking requirements --...

Part 5. Traumatic Brain Injury -- Services

53-6-501. Traumatic brain injury defined - 53-6-501. Traumatic brain injury defined. (1) (a) As used in...

53-6-502. Traumatic brain injury trust fund established -- source of funds -- uses - 53-6-502. Traumatic brain injury trust fund established -- source of...

Part 6. Long-Term Care Reform

53-6-601. Short title - 53-6-601. Short title. This part may be cited as the...

53-6-602. Purpose -- policy - 53-6-602. Purpose -- policy. (1) The legislature finds that in...

53-6-603. Long-term care service development -- coordination -- delivery - 53-6-603. Long-term care service development -- coordination -- delivery. (1)...

Part 7. Medicaid Managed Care

53-6-701. Policy of medicaid managed care -- system for integrated health care services - 53-6-701. Policy of medicaid managed care -- system for integrated...

53-6-702. Definitions - 53-6-702. Definitions. As used in this part, the following definitions...

53-6-703. Repealed - 53-6-703. Repealed. Sec. 11, Ch. 351, L. 2011. History: En....

53-6-704. Different benefit packages - 53-6-704. Different benefit packages. (1) The department may by rule...

53-6-705. Requirements for managed health care entities - 53-6-705. Requirements for managed health care entities. (1) A managed...

53-6-706. Requirements relating to enrollees - 53-6-706. Requirements relating to enrollees. (1) All individuals enrolled in...

53-6-707. Payment reductions and adjustments -- freedom to contract - 53-6-707. Payment reductions and adjustments -- freedom to contract. (1)...

53-6-708. Waiver - 53-6-708. Waiver. The department may seek and obtain any necessary...

53-6-709. Legislative auditor -- oversight - 53-6-709. Legislative auditor -- oversight. (1) In order to prevent,...

53-6-710. Advisory council -- duties - 53-6-710. Advisory council -- duties. (1) There is an advisory...

53-6-711. Requests for proposals and contracts -- review requirements -- public notice and comment - 53-6-711. Requests for proposals and contracts -- review requirements --...

Part 8. Long-Term Care Insurance Partnerships

53-6-801. Purpose - 53-6-801. Purpose. The purpose of this part and the long-term...

53-6-802. Definitions - 53-6-802. Definitions. As used in this part, unless the context...

53-6-803. Long-term care insurance partnerships authorized - 53-6-803. Long-term care insurance partnerships authorized. (1) The commissioner and...

53-6-804. Rulemaking and certification of policies by commissioner and department - 53-6-804. Rulemaking and certification of policies by commissioner and department....

53-6-805. Department to make rules - 53-6-805. Department to make rules. The department shall adopt rules...

Part 9. Medicaid Medical Savings Account Pilot Project (Terminated)

53-6-901. Terminated - 53-6-901. Terminated. Sec. 1, Ch. 28, L. 1999. History: En....

53-6-902. Terminated - 53-6-902. Terminated. Sec. 1, Ch. 28, L. 1999. History: En....

53-6-903. Terminated - 53-6-903. Terminated. Sec. 1, Ch. 28, L. 1999. History: En....

53-6-904. Terminated - 53-6-904. Terminated. Sec. 1, Ch. 28, L. 1999. History: En....

53-6-905. Terminated - 53-6-905. Terminated. Sec. 1, Ch. 28, L. 1999. History: En....

53-6-906. Terminated - 53-6-906. Terminated. Sec. 1, Ch. 28, L. 1999. History: En....

53-6-907. Terminated - 53-6-907. Terminated. Sec. 1, Ch. 28, L. 1999. History: En....

53-6-908. Terminated - 53-6-908. Terminated. Sec. 1, Ch. 28, L. 1999. History: En....

53-6-909. Terminated - 53-6-909. Terminated. Sec. 1, Ch. 28, L. 1999. History: En....

53-6-910. Terminated - 53-6-910. Terminated. Sec. 1, Ch. 28, L. 1999. History: En....

Part 10. Prescription Drug Plus Discount Program

53-6-1001. Definitions - 53-6-1001. Definitions. As used in this part, unless the context...

53-6-1002. Prescription drug plus discount program -- rules - 53-6-1002. Prescription drug plus discount program -- rules. (1) The...

53-6-1003. Eligibility -- income determination - 53-6-1003. Eligibility -- income determination. To be eligible for the...

53-6-1004. State pharmacy access program - 53-6-1004. State pharmacy access program. (1) The department shall administer...

53-6-1005. Department administration -- pharmacy access - 53-6-1005. Department administration -- pharmacy access. The department shall administer...

53-6-1006. Prescription drug consumer information and technical assistance program -- education outreach for consumers and professionals - 53-6-1006. Prescription drug consumer information and technical assistance program --...

53-6-1007. through 53-6-1009 reserved - 53-6-1007 through 53-6-1009 reserved.

53-6-1010. Specifications for administration of program - 53-6-1010. Specifications for administration of program. (1) The department shall...

53-6-1011. Appeals - 53-6-1011. Appeals. An eligibility determination made by the department based...

53-6-1012. Obligations of department - 53-6-1012. Obligations of department. The department shall establish simplified procedures...

53-6-1013. Contracting - 53-6-1013. Contracting. The department may contract for the administration of...

53-6-1014. through 53-6-1019 reserved - 53-6-1014 through 53-6-1019 reserved.

53-6-1020. Contingency on expenditure - 53-6-1020. Contingency on expenditure. This part may not be construed...

Part 11. Prevention and Stabilization Account

53-6-1101. Prevention and stabilization account -- allocation of proceeds - 53-6-1101. Prevention and stabilization account -- allocation of proceeds. (1)...

Part 12. Health and Medicaid Initiatives Account

53-6-1201. Special revenue fund -- health and medicaid initiatives - 53-6-1201. Special revenue fund -- health and medicaid initiatives. (1)...

Part 13. Montana Health and Economic Livelihood Partnership (HELP) Act

53-6-1301. Short title - 53-6-1301. (Temporary) Short title. This part, along with Title 39,...

53-6-1302. Montana HELP Act program -- legislative findings and purpose - 53-6-1302. (Temporary) Montana HELP Act program -- legislative findings and...

53-6-1303. Definitions - 53-6-1303. (Temporary) Definitions. As used in this part, the following...

53-6-1304. Montana HELP Act program -- eligibility for coverage of health care services -- exceptions - 53-6-1304. (Temporary) Montana HELP Act program -- eligibility for coverage...

53-6-1305. Montana HELP Act program -- delivery of health care services -- third-party administrator -- rulemaking - 53-6-1305. (Temporary) Montana HELP Act program -- delivery of health...

53-6-1306. Prohibition on copayments - 53-6-1306. (Temporary) Prohibition on copayments. The department may not require...

53-6-1307. Premiums -- collection of overdue premiums -- nonpayment as voluntary disenrollment -- reenrollment -- exemptions - 53-6-1307. (Temporary) Premiums -- collection of overdue premiums -- nonpayment...

53-6-1308. Community engagement requirements -- countable activities -- exemptions -- self-attestation - 53-6-1308. (Temporary) Community engagement requirements -- countable activities -- exemptions...

53-6-1309. Community engagement -- reporting -- suspension -- audit - 53-6-1309. (Temporary) Community engagement -- reporting -- suspension -- audit....

53-6-1310. Health risk analysis - 53-6-1310. (Temporary) Health risk analysis. (1) Within 1 year of...

53-6-1311. Medicaid program reforms - 53-6-1311. (Temporary) Medicaid program reforms. (1) To ensure that the...

53-6-1312. Health care services payment schedules - 53-6-1312. Health care services payment schedules. (1) The department of...

53-6-1313. Reduction in federal medical assistance percentage - 53-6-1313. (Temporary) Reduction in federal medical assistance percentage. If the...

53-6-1314. Disenrollment for failure to report change in circumstances - 53-6-1314. (Temporary) Disenrollment for failure to report change in circumstances....

53-6-1315. Montana HELP Act special revenue account - 53-6-1315. (Temporary) Montana HELP Act special revenue account. (1) There...

53-6-1316. Repealed - 53-6-1316. Repealed. Sec. 3, Ch. 21, L. 2019; sec. 39,...

53-6-1317. Repealed - 53-6-1317. Repealed. Sec. 3, Ch. 21, L. 2019. History: En....

53-6-1318. Rulemaking authority - 53-6-1318. (Temporary) Rulemaking authority. (1) The department may adopt rules...

53-6-1319. through 53-6-1324 reserved - 53-6-1319 through 53-6-1324 reserved.

53-6-1325. Report to legislature - 53-6-1325. (Temporary) Report to legislature. (1) The department shall report...

Part 14. Medicaid Overpayment Audits

53-6-1401. Definitions - 53-6-1401. Definitions. As used in this part, unless expressly provided...

53-6-1402. Overpayment audit procedures -- provider records -- limitations on record requests and reviews -- onsite audits - 53-6-1402. Overpayment audit procedures -- provider records -- limitations on...

53-6-1403. Extrapolation and statistical sampling prohibited -- exceptions - 53-6-1403. Extrapolation and statistical sampling prohibited -- exceptions. (1) Except...

53-6-1404. Peer review of overpayment findings - 53-6-1404. Peer review of overpayment findings. (1) (a) A provider's...

53-6-1405. Audit completion -- notice of overpayment determination -- opportunity to resubmit claim - 53-6-1405. Audit completion -- notice of overpayment determination -- opportunity...

53-6-1406. Publication of audit results - 53-6-1406. Publication of audit results. At least once a year...

53-6-1407. Audit education and training - 53-6-1407. Audit education and training. In order to carry out...

53-6-1408. Applicability to auditor -- scope - 53-6-1408. Applicability to auditor -- scope. (1) An auditor performing...

53-6-1409. Auditor evaluation hearings -- adoption of rules - 53-6-1409. Auditor evaluation hearings -- adoption of rules. At least...

53-6-1410. Absorption of costs - 53-6-1410. Absorption of costs. Any cost incurred by the department...

Part 21. Children's Mental Health Services Pilot Project -- Youth Outcome Improvement (Terminated)

53-6-2101. Terminated - 53-6-2101. Terminated. Sec. 7, Ch. 265, L. 2015. History: En....

53-6-2102. Terminated - 53-6-2102. Terminated. Sec. 7, Ch. 265, L. 2015. History: En....

53-6-2103. Terminated - 53-6-2103. Terminated. Sec. 7, Ch. 265, L. 2015. History: En....

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Montana Code Annotated Title 53. Social Services and Institutions Chapter 6. Health Care Services

Montana Code Annotated
Title 53. Social Services and Institutions
Chapter 6. Health Care Services