Administrative Rules of Montana
Department 20 - CORRECTIONS
Chapter 20.15 - CLINICAL SERVICES
Subchapter 20.15.1 - Payment of Provider Claims at Medicaid Rate for Patients in Department of Corrections Custody
Rule 20.15.103 - PROVIDER REQUIREMENTS

Universal Citation: MT Admin Rules 20.15.103

Current through Register Vol. 18, September 20, 2024

(1) Except for the administrative rules listed in (2), the provider requirements of ARM Title 37, chapter 85, subchapter 4, "Provider Requirements," apply to the delivery of health care services provided to an individual identified in 53-6-1312, MCA. For the purposes of this subchapter, a reference to "Montana Medicaid" or "Medicaid" in ARM Title 37, chapter 85, subchapter 4 is understood to mean payments made under 53-6-1312, MCA.

(2) The following administrative rules do not apply to providers receiving payment for services provided to an individual identified in 53-6-1312, MCA:

(a) ARM 37.85.407, Third Party Liability;

(b) ARM 37.85.411, Provider Rights;

(c) ARM 37.85.415, Medical Assistance Medicaid Payment; and

(d) ARM 37.85.416, Statistical Sampling Audits.

(3) A provider who disputes a payment is entitled to an administrative hearing on the matter according to the procedures of the department responsible for payment. A provider who is aggrieved by a final written decision is entitled to a judicial review of the decision.

AUTH: 53-1-203, 53-6-1318, MCA; IMP: 53-6-1312, MCA

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