Administrative Rules of Montana
Department 37 - PUBLIC HEALTH AND HUMAN SERVICES
Chapter 37.106 - HEALTH CARE FACILITIES
Subchapter 37.106.2 - Community Benefit and Financial Assistance Standards for Nonprofit Hospitals, Critical Access Hospitals, and Rural Emergency Hospitals
Rule 37.106.203 - COMMUNITY BENEFIT AND FINANCIAL ASSISTANCE REQUIREMENTS

Universal Citation: MT Admin Rules 37.106.203

Current through Register Vol. 18, September 20, 2024

(1) The duty of nonprofit hospitals, critical access hospitals, and rural emergency hospitals to provide community benefits and financial assistance is established in 50-5-121, MCA. To satisfy the requirements, a nonprofit hospital, critical access hospital, or rural emergency hospital shall comply with the standards and requirements set forth in this subchapter.

(2) Each nonprofit hospital, critical access hospital, or rural emergency hospital shall:

(a) have in writing a community benefits plan, a community benefits policy; and a financial assistance policy;

(b) adhere to its written community benefit policy and financial assistance policy; and

(c) make its written community benefit and financial assistance policies available to the public, including posting the policies in a prominent location on its website.

(3) With respect to nonprofit hospitals:

(a) the community benefits policy must be consistent with federal standards and the standards established in this subchapter; and

(b) the financial assistance policy must be consistent with federal standards and the standards established in this subchapter, applicable to the area the nonprofit hospital serves.

(4) To establish community benefit and financial assistance standards, the department will do the following:

(a) The department will collect baseline data for a two-year period and utilize existing 2023 data to formulate standards after baseline data is validated/aggregated and a three-year average determined.

(b) The department shall consider the following factors when developing the standards:
(i) hospital size;

(ii) community size and location;

(iii) net patient revenue;

(iv) patient care expenses;

(v) payor mix.

(c) The department may consider other factors when developing the standards, including:
(i) bad debt;

(ii) community health needs assessments; and

(iii) other factors to allow for a level which is reasonable in relation to community needs and the available resources of the hospital.

(d) The department shall consider whether to adopt numerical standards, narrative standards, or a combination of numerical and narrative standards, for community benefit and financial assistance.

(e) Under the standards, the community benefit requirement, including financial assistance, will be set at the beginning of the calendar year.

(5) A nonprofit hospital with operating losses in its fiscal year shall not be required to meet community benefit (including financial assistance) requirements established under the standards for that year.

AUTH: 50-5-106, 50-5-121, MCA; IMP: 50-5-106, 50-5-121, MCA

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