Administrative Rules of Montana
Department 37 - PUBLIC HEALTH AND HUMAN SERVICES
Chapter 37.86 - MEDICAID PRIMARY CARE SERVICES
Subchapter 37.86.34 - Case Management Services for High Risk Pregnant Women
Rule 37.86.3405 - TARGETED CASE MANAGEMENT SERVICES FOR HIGH RISK PREGNANT WOMEN, COVERAGE
Universal Citation: MT Admin Rules 37.86.3405
Current through Register Vol. 6, March 22, 2024
(1) Reimbursable targeted case management services for high risk pregnant women are:
(a) comprehensive assessment and periodic
reassessment;
(b) care plan
development;
(c) care coordination
and referral for other services; and
(d) monitoring and follow up.
(2) Face-to-face comprehensive assessments must occur at least monthly during the pregnancy.
(3) Two post-partum reassessments must occur after delivery prior to the last day of the month in which the 60th day following delivery occurs.
(4) Monitoring must include at least one annual monitoring to determine if the following conditions are met:
(a) services
are being furnished in accordance with the member's care plan;
(b) services in the care plan are adequate;
and
(c) changes in the needs or
status of the member are reflected in the care plan.
AUTH: 53-6-113, MCA; IMP: 53-6-101, MCA
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