Current through Register Vol. 18, September 20, 2024
(1) The department
will pay Medicaid Personal Assistance Services and Community First Choice
Services (CFCS) providers located in Montana, who submit an approved request to
the department, an add-on payment in addition to the reimbursement fee as
provided in ARM 37.40.1026, 37.40.1027,
37.40.1105,
37.85.105. The add-on payment is
to be used only to cover health insurance payments for direct-care workers who
spend a majority of their time serving Medicaid personal care members.
(a) The department will determine the add-on
payments, commencing July 1, 2014, as a pro rata share of appropriated funds
allocated for health care for health care worker coverage. A provider agency is
eligible to receive a portion of the total funds based on their percentage of
total utilization of personal assistance services and CFCS over the previous
fiscal year.
(b) To receive the
health care for health care worker payment, a provider must submit for approval
an application request to the department stating how the health care for health
care worker add-on payment will be spent to comply with the application's
requirements. The provider must submit all of the information required on a
department-approved form in order to continue to receive subsequent add-on
payment amounts for the entire year.
(c) A provider must submit an application
request for the funds distributed under (1)(b). The request must include all
required information, within the deadlines established by the department.
Providers who do not submit the application request or do not wish to
participate in the add-on funding may not be entitled to their pro rata share
of the funds available for health care for health care worker
coverage.
(2) A provider
that receives funds under this rule must maintain appropriate records
documenting the expenditures of these funds. This documentation must be
maintained and made available to authorized governmental entities and their
agencies to the same extent as other required records and documentation under
applicable Medicaid record requirements.
(a)
Effective for the period beginning July 1, 2014, personal assistance services
or CFCS providers must submit quarterly reports to the department. The report
must include the names of eligible direct-care workers receiving health
insurance coverage, the monthly cost of the insurance plan, and the total cost
to the agency to provide health insurance coverage.
53-2-201,
MCA; IMP:
53-2-201,
53-6-113,
MCA
