Administrative Rules of Montana
Department 37 - PUBLIC HEALTH AND HUMAN SERVICES
Chapter 37.55 - END STAGE RENAL DISEASE (ESRD)
Subchapter 37.55.5 - Services and Supplies
Rule 37.55.505 - NON-ELIGIBLE SERVICES
Universal Citation: MT Admin Rules 37.55.505
Current through Register Vol. 18, September 20, 2024
(1) The cost of the following services and supplies is not eligible for payment from ESRD:
(a) attendant or back-up person;
(b) drugs not specifically listed in ARM
37.55.502 as eligible
medications;
(c) transportation for
anyone other than a cadaveric transplant patient;
(d) out-of-state dialysis care unless the
care is directly related to a kidney transplant or a medical referral has been
made by the patient's managing Montana nephrologist;
(e) any transportation for living related
donor;
(f) services provided which
are not related to kidney condition, e.g., epistaxis, otitis media, diabetes,
eye examinations, and heart evaluations;
(g) medicare premiums;
(h) hospital in-patient care of over 60 days
unless specifically justified as ESRD-related (e.g., not due to chronic
debilitating disease other than renal disease);
(i) access-site surgery prior to initiation
of dialysis treatments; and
(j)
medicaid copayments or medicaid deductibles.
Sec. 50-44-102 and 53-6-202, MCA; IMP, Sec. 50-44-102 and 53-6-202, MCA;
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