Administrative Rules of Montana
Department 37 - PUBLIC HEALTH AND HUMAN SERVICES
Chapter 37.34 - DEVELOPMENTAL DISABILITIES PROGRAM
Subchapter 37.34.9 - 0208 Medicaid Home and Community-Based Services Program
Rule 37.34.946 - 0208 MEDICAID HOME AND COMMUNITY-BASED SERVICES PROGRAM: INDIVIDUAL GOODS AND SERVICES

(1) Individual goods and services are services, supports, or goods that enhance opportunities to achieve outcomes related to living arrangements, relationships, and inclusion in the community as identified and documented in the plan of care.

(2) Individual goods and services must fall into one of the following categories:

(3) Individual goods and services must be:

(4) The service, equipment, or supply must meet the person's medical needs or provide support in order to be independent in daily activities and must meet one of the following criteria:

(5) The cost of the service, equipment, or supply must not compromise the person's health or safety by depleting their individual cost plan to the extent they cannot receive services that provide for their health and safety.

(6) Service, equipment, or supplies which are experimental will not be reimbursed.

(7) A person or the person's delegate self-directing services with employer authority using the financial management service (FMS) option must purchase goods and services in accordance with the requirements set forth by the Developmental Disabilities Program (DDP) and receive reimbursement from the fiscal management service.

(8) Individual goods and services expected to exceed a $2,000 annual aggregate limit require prior approval by the DDP regional manager.