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Rule Title: PROVIDER REQUIREMENTS
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Department: PUBLIC HEALTH AND HUMAN SERVICES
Chapter: DEPARTMENT PROCEDURES
Subchapter: State Reimbursement Rate for Health Care Providers
 
Latest version of the adopted rule presented in Administrative Rules of Montana (ARM):

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37.2.1103    PROVIDER REQUIREMENTS

(1) Except for the administrative rules listed in (2), the provider requirements of ARM Title 37, chapter 85, subchapter 4, "Provider Requirements," apply to the delivery of health care services provided to an individual identified in 53-6-1312, MCA. For purposes of this subchapter, a reference to "Montana Medicaid" or "Medicaid" in ARM Title 37, chapter 85, subchapter 4 is understood to mean payments made under 53-6-1312, MCA.

(2) The following administrative rules do not apply to providers receiving payment for services provided to an individual identified in 53-6-1312, MCA:

(a) ARM 37.85.407, Third Party Liability;

(b) ARM 37.85.411, Provider Rights;

(c) ARM 37.85.415, Medical Assistance Medicaid Payment; and

(d) ARM 37.85.416, Statistical Sampling Audits.

(3) A provider who disputes a payment is entitled to an administrative hearing on the matter according to the procedures of the department responsible for payment. A provider who is aggrieved by a final written decision is entitled to a judicial review of the decision. 

History: 53-6-1318, MCA; IMP, 53-6-1312, MCA; NEW, 2015 MAR p. 2313, Eff. 1/1/16.


 

 
MAR Notices Effective From Effective To History Notes
37-731 1/1/2016 Current History: 53-6-1318, MCA; IMP, 53-6-1312, MCA; NEW, 2015 MAR p. 2313, Eff. 1/1/16.
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