Administrative Rules of Montana
Department 37 - PUBLIC HEALTH AND HUMAN SERVICES
Chapter 37.90 - MENTAL HEALTH MEDICAID FUNDED 1115 AND 1915 WAIVERS
Subchapter 37.90.4 - Home and Community-Based Services Waiver for Adults With Severe and Disabling Mental Illness
Rule 37.90.449 - HOME AND COMMUNITY-BASED SERVICES FOR ADULTS WITH SEVERE AND DISABLING MENTAL ILLNESS: SPECIALIZED MEDICAL EQUIPMENT AND SUPPLIES

Universal Citation: MT Admin Rules 37.90.449

Current through Register Vol. 18, September 20, 2024

(1) Specialized medical equipment and supplies service is the provision of items of medical equipment and supplies to an enrolled member for the purpose of maintaining and improving the enrolled member's ability to reside at home and to function in the community.

(2) Specialized medical equipment and supplies must:

(a) be functionally necessary and relate specifically to the enrolled member's disability;

(b) substantively meet the enrolled member's needs for accessibility, independence, health, or safety;

(c) be likely to improve the enrolled member's functional ability or the ability of a caregiver or service provider to maintain the enrolled member in the enrolled member's home; and

(d) be the most cost-effective item that can meet the needs of the enrolled member.

(3) Specialized medical equipment and supplies service does not include:

(a) items used for leisure and recreational purposes only;

(b) items of clothing;

(c) basic household furniture;

(d) educational items including computers, software, and books unless such items are purchased in conjunction with an environmental control unit; or

(e) coverage for dentistry or dental-related procedures, services, equipment or supplies. This includes any 'D' procedure code definitions identified in the current American Medical Association's Common Procedural Terminology (CPT) manual or identified as dental pursuant to Medicare, the American Dental Association, and/or Montana Medicaid.

(4) Specialized medical equipment and supplies service includes service animals as defined in ARM 37.90.463.

(5) Certain items of medical equipment or supplies for short term use, as specified by the department, may be leased or rented instead of purchased.

(6) The department may require a consultation prior to the purchase of certain equipment and supplies.

AUTH: 53-2-201, 53-6-402, MCA; IMP: 53-6-402, MCA

Disclaimer: These regulations may not be the most recent version. Montana may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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