reglab/housing_qa huggingface dataset:
MT Code § 53-6-1101 (2021)
2021 Montana Code Annotated|Title 53. Social Services and Institutions|Chapter 6. Health Care Services|Part 11. Prevention and Stabilization Account|53-6-1101. Prevention and stabilization account -- allocation of proceeds

  53-6-1101. Prevention and stabilization account -- allocation of proceeds. (1) There is a prevention and stabilization account in the state special revenue fund provided for in 17-2-102. Money in the account must be used by the department of public health and human services to finance, administer, and provide health and human services.   (2) (a) Funds in the prevention and stabilization account must be used for the following programs in order of priority:   (i) prescription drugs for adults with a serious and disabling mental illness eligible for programs initiated pursuant to 53-21-702(2) and (3);   (ii) child care for low-income families;   (iii) the Montana initiative for the abatement of mortality in infants administered pursuant to 50-19-301;   (iv) independent living;   (v) extended employment;   (vi) child support enforcement state matching funds;   (vii) stabilization of rates for medicaid mental health services;   (viii) medicaid hospice services;   (ix) home health therapy services;   (x) poison control; and   (xi) AIDS funds.   (b) Funds remaining after allocations to the priorities in subsection (2)(a) may be expended for other programs as directed in 17-6-606(1).   (c) Appropriations from the prevention and stabilization account for programs listed in subsection (2)(a) are restricted for the use specified and may not be transferred to other programs pursuant to 17-7-139.   History: (1)En. Sec. 14, Ch. 531, L. 2003; en. Sec. 2, Ch. 608, L. 2003.
MT Code § 53-6-1301 (2021)
2021 Montana Code Annotated|Title 53. Social Services and Institutions|Chapter 6. Health Care Services|Part 13. Montana Health and Economic Livelihood Partnership (HELP) Act|53-6-1301. Short title

  53-6-1301. (Temporary) Short title. This part, along with Title 39, chapter 12, and 25-3-106, may be cited as the "Montana Health and Economic Livelihood Partnership (HELP) Act". (Terminates June 30, 2025--sec. 38, Ch. 415, L. 2019.)   History: En. Sec. 1, Ch. 368, L. 2015.
MT Code § 53-6-1303 (2021)
2021 Montana Code Annotated|Title 53. Social Services and Institutions|Chapter 6. Health Care Services|Part 13. Montana Health and Economic Livelihood Partnership (HELP) Act|53-6-1303. Definitions

  53-6-1303. (Temporary) Definitions. As used in this part, the following definitions apply:   (1) "Community engagement" means participation in the activities specified in 53-6-1308 as a means to improve a program participant's well-being and opportunities for self-sufficiency.   (2) "Department" means the department of public health and human services provided for in 2-15-2201.   (3) "HELP Act" or "act" means the Montana Health and Economic Livelihood Partnership Act provided for in Title 39, chapter 12, and this part.   (4) "Member" means an individual enrolled in the Montana medicaid program pursuant to 53-6-131 or receiving medicaid-funded services pursuant to 53-6-1304.   (5) "Program participant" or "participant" means an individual enrolled in the Montana Health and Economic Livelihood Partnership Act program established in Title 39, chapter 12, and this part. (Terminates June 30, 2025--secs. 38, 48, Ch. 415, L. 2019.)   History: En. Sec. 3, Ch. 368, L. 2015; amd. Sec. 31, Ch. 415, L. 2019.
MT Code § 53-6-1304 (2021)
2021 Montana Code Annotated|Title 53. Social Services and Institutions|Chapter 6. Health Care Services|Part 13. Montana Health and Economic Livelihood Partnership (HELP) Act|53-6-1304. Montana HELP Act program -- eligibility for coverage of health care services -- exceptions

  53-6-1304. (Temporary) Montana HELP Act program -- eligibility for coverage of health care services -- exceptions. (1) An individual is eligible for coverage of health care services provided pursuant to this part if the individual meets the requirements of 42 U.S.C. 1396a(a)(10)(A)(i)(VIII).   (2) The department may serve individuals who are eligible for medicaid-funded services pursuant to this part through the medical assistance program established in Title 53, chapter 6, part 1, if the individuals would be served more appropriately because the individuals:   (a) have exceptional health care needs, including but not limited to medical, mental health, or developmental conditions;   (b) live in a geographical area, including an Indian reservation, that would not be effectively or efficiently served through this part;   (c) need continuity of care that would not be available or cost-effective through this part;   (d) are exempt under the waiver implementing this part as of July 1, 2019; or   (e) are otherwise exempt under federal law. (Terminates June 30, 2025--secs. 38, 48, Ch. 415, L. 2019.)   History: En. Sec. 4, Ch. 368, L. 2015; amd. Sec. 32, Ch. 415, L. 2019.
MT Code § 53-6-1305 (2021)
2021 Montana Code Annotated|Title 53. Social Services and Institutions|Chapter 6. Health Care Services|Part 13. Montana Health and Economic Livelihood Partnership (HELP) Act|53-6-1305. Montana HELP Act program -- delivery of health care services -- third-party administrator -- rulemaking

  53-6-1305. (Temporary) Montana HELP Act program -- delivery of health care services -- third-party administrator -- rulemaking. (1) The department may contract as provided in Title 18, chapter 4, with one or more third-party administrators to assist in administering the delivery of health care services to members eligible under 53-6-1304, including but not limited to:   (a) establishing networks of health care providers;   (b) paying claims submitted by health care providers;   (c) collecting the premiums provided for in 53-6-1307;   (d) coordinating care;   (e) helping to administer the program; and   (f) helping to administer the medicaid program reforms as specified in 53-6-1311.   (2) If the department decides to contract with a third-party administrator, the department shall determine the basic health care services to be provided through the arrangement with the third-party administrator.   (3) (a) The department may exempt certain individuals who are eligible for medicaid-funded services pursuant to 53-6-1304 from receiving health care services through an arrangement with a third-party administrator if the individuals would be served more appropriately through the medical assistance program established in Title 53, chapter 6, part 1.   (b) If the department contracts with a third-party administrator, the department shall:   (i) adopt rules establishing criteria for determining whether a member is exempt from receiving health care services through an arrangement with the third-party administrator;   (ii) provide coverage for exempted individuals through the medical assistance program established in Title 53, chapter 6, part 1; and   (iii) for members participating in the arrangement with a third-party administrator, directly cover any service required under federal or state law that is not available through the arrangement with the third-party administrator.   (4) The department may contract with a third-party administrator for the services allowed under subsections (1)(a) through (1)(f) only upon receipt of a federal waiver allowing a third-party administrator to provide services in accordance with this part. (Terminates June 30, 2025--secs. 38, 48, Ch. 415, L. 2019.)   History: En. Sec. 5, Ch. 368, L. 2015; amd. Sec. 33, Ch. 415, L. 2019.
MT Code § 53-6-1306 (2021)
2021 Montana Code Annotated|Title 53. Social Services and Institutions|Chapter 6. Health Care Services|Part 13. Montana Health and Economic Livelihood Partnership (HELP) Act|53-6-1306. Prohibition on copayments

  53-6-1306. (Temporary) Prohibition on copayments. The department may not require a program participant to make a copayment, to pay a coinsurance amount, or to meet a deductible amount for any service covered under this part. (Terminates June 30, 2025--secs. 38, 48, Ch. 415, L. 2019.)   History: En. Sec. 6, Ch. 368, L. 2015; amd. Sec. 2, Ch. 21, L. 2019; amd. Sec. 34, Ch. 415, L. 2019.
MT Code § 53-6-1309 (2021)
2021 Montana Code Annotated|Title 53. Social Services and Institutions|Chapter 6. Health Care Services|Part 13. Montana Health and Economic Livelihood Partnership (HELP) Act|53-6-1309. Community engagement -- reporting -- suspension -- audit

  53-6-1309. (Temporary) Community engagement -- reporting -- suspension -- audit. (1) The department shall adopt rules establishing:   (a) requirements for reporting community engagement requirements;   (b) requirements for obtaining an exemption from the community engagement requirements as allowed under 53-6-1308; and   (c) a program to audit information provided by program participants to the department to ensure compliance with the requirements of 53-6-1308.   (2) The department shall notify a program participant who is not in compliance with the community engagement requirements that:   (a) the participant has 180 days to come into compliance; and   (b) failure to comply within the 180-day period will be considered a voluntary suspension from the program unless the participant attests and the department confirms that the participant is exempt from the community engagement requirements as allowed under 53-6-1308.   (3) A participant who is suspended from the program for noncompliance may be reinstated 180 days after the date of suspension or upon a determination by the department that the program participant:   (a) is exempt from the community engagement requirements; or   (b) has been in compliance with the requirements for 30 days. A participant reinstated pursuant to this subsection (3)(b) must remain under heightened monitoring by the department during the remainder of the suspension period.   (4) (a) If suspensions for noncompliance with community engagement requirements reach a level exceeding 5% of program participants, the department shall notify the legislative audit committee. Upon consideration of recommendations by the legislative auditor, the legislative audit committee shall select an independent third-party auditor to conduct an audit of the participants who were subject to suspension using statistically valid methods.   (b) (i) The audit must be completed within 90 days and the report made available to the legislative audit committee.   (ii) If the audit is not completed within 90 days, the department shall immediately cease suspensions until the audit is complete and the legislative audit committee has received the audit report.   (c) If the audit finds that more than 10% of the participants in the audit sample were suspended erroneously, the department shall cease further suspensions until the conclusion of the next general legislative session.   (d) If the audit finds that 10% or fewer of the participants in the audit sample were suspended erroneously, the department shall continue to suspend the enrollment of program participants who fail to meet the community engagement requirements.   (e) The cost of any audit under this section performed at the direction of the legislative audit committee must be paid by the department. (Terminates June 30, 2025, on occurrence of contingency--sec. 48, Ch. 415, L. 2019.)   History: En. Sec. 2, Ch. 415, L. 2019.
MT Code § 53-6-1310 (2021)
2021 Montana Code Annotated|Title 53. Social Services and Institutions|Chapter 6. Health Care Services|Part 13. Montana Health and Economic Livelihood Partnership (HELP) Act|53-6-1310. Health risk analysis

  53-6-1310. (Temporary) Health risk analysis. (1) Within 1 year of a program participant's enrollment in the program, the department shall use available claims data and other information collected directly from the participant to assess whether the participant would be better served in a coordinated care or other treatment model approved by the department.   (2) Coordinated care models may include but are not limited to a:   (a) medicaid health home;   (b) patient-centered or advanced primary care medical home;   (c) substance use disorder or mental health treatment or other treatment or prevention programs;   (d) care coordination program;   (e) tribal health improvement program; or   (f) primary care case management arrangement.   (3) The department is not required to complete a separate analysis for a participant who:   (a) is already being served through a coordinated care model listed in subsection (2); or   (b) has received primary care or preventative care services within the last 12 months. (Terminates June 30, 2025, on occurrence of contingency--sec. 48, Ch. 415, L. 2019.)   History: En. Sec. 3, Ch. 415, L. 2019.
MT Code § 53-6-1311 (2021)
2021 Montana Code Annotated|Title 53. Social Services and Institutions|Chapter 6. Health Care Services|Part 13. Montana Health and Economic Livelihood Partnership (HELP) Act|53-6-1311. Medicaid program reforms

  53-6-1311. (Temporary) Medicaid program reforms. (1) To ensure that the Montana medicaid program is administered efficiently and effectively, the department shall strengthen existing programs that manage the way members obtain approval for medical services and shall establish additional programs designed to reduce costs and improve medical outcomes. The efforts may include but are not limited to:   (a) establishing by rule requirements designed to strengthen the relationship between physicians and members enrolled in existing primary care case management programs;   (b) strengthening data-sharing arrangements with providers to reduce inappropriate use of emergency room services and overuse of other services;   (c) expanding to additional members any existing programs in which case managers and providers work with members with high-risk medical conditions to provide preventive care and advice and to make referrals for medical services;   (d) establishing, within existing funds, one or more pilot programs to improve the health of members, including but not limited to efforts to increase pain management, decrease emergency department overuse, and prevent drug or alcohol addiction or abuse;   (e) reviewing existing primary care case management programs to evaluate and improve their effectiveness; and   (f) engaging members with chronic or other medical or behavioral health conditions in coordinated care models that more closely monitor and manage a member's health to reduce costs or improve medical outcomes. These coordinated care models may include but are not limited to:   (i) patient-centered medical homes;   (ii) accountable care organizations;   (iii) managed care organizations as defined in 42 CFR 438.2;   (iv) health improvement programs;   (v) health homes for behavioral health or other chronic conditions; and   (vi) changes to current service delivery methods.   (2) The department shall work to reduce fraud, waste, and abuse in the medicaid program before, during, and after enrollment by enhancing technology system support to provide knowledge-based authentication for verifying the identity and financial status of individuals seeking benefits, including the use of public records to confirm identity and flag changes in demographics.   (3) The department may ask a third-party administrator under contract with the department to assist in efforts undertaken pursuant to subsections (1) and (2) when the activity can appropriately be handled by a third-party administrator.   (4) A care coordination entity used to deliver medicaid services shall meet all state standards for operation, including but not limited to solvency, consumer protection, nondiscrimination, network adequacy, care model design, and fraud and abuse standards. (Terminates June 30, 2025--secs. 38, 48, Ch. 415, L. 2019.)   History: En. Sec. 8, Ch. 368, L. 2015; amd. Sec. 36, Ch. 415, L. 2019.
MT Code § 53-6-1312 (2021)
2021 Montana Code Annotated|Title 53. Social Services and Institutions|Chapter 6. Health Care Services|Part 13. Montana Health and Economic Livelihood Partnership (HELP) Act|53-6-1312. Health care services payment schedules

  53-6-1312. Health care services payment schedules. (1) The department of corrections and the department of public health and human services shall reimburse health care service for individuals identified in subsection (2) at the rates adopted by the department for the medicaid program under Title 53, chapter 6, part 1, if the health care services are not otherwise covered by medicaid, medicare, a health insurer, or another private or governmental program that pays for health care costs.   (2) This section applies to individuals:   (a) in the custody of the department of corrections; or   (b) who are residents, by commitment or otherwise, of the Montana state hospital, the Montana mental health nursing care center, the Montana chemical dependency center, the state facility at Galen, or the Montana developmental center.   History: En. Sec. 9, Ch. 368, L. 2015; amd. Sec. 15, Ch. 456, L. 2019.
MT Code § 53-6-1313 (2021)
2021 Montana Code Annotated|Title 53. Social Services and Institutions|Chapter 6. Health Care Services|Part 13. Montana Health and Economic Livelihood Partnership (HELP) Act|53-6-1313. Reduction in federal medical assistance percentage

  53-6-1313. (Temporary) Reduction in federal medical assistance percentage. If the federal medical assistance percentage for medical services provided to individuals eligible for medicaid-funded services pursuant to 53-6-1304 is set below the levels established in 42 U.S.C. 1396d(y)(1) on the effective date of this section, the continuation of coverage under this part is contingent on:   (1) the appropriation of additional state general fund or other action by the legislature;   (2) the ability of the department to increase premiums assessed under 53-6-1307 to pay the difference; or   (3) a combination of legislative action and premium increases as necessary to provide for the increased state match obligation. (Terminates June 30, 2025--sec. 38, Ch. 415, L. 2019.)   History: En. Sec. 10, Ch. 368, L. 2015.
MT Code § 53-6-1314 (2021)
2021 Montana Code Annotated|Title 53. Social Services and Institutions|Chapter 6. Health Care Services|Part 13. Montana Health and Economic Livelihood Partnership (HELP) Act|53-6-1314. Disenrollment for failure to report change in circumstances

  53-6-1314. (Temporary) Disenrollment for failure to report change in circumstances. (1) (a) A program participant shall report to the department a permanent increase in income that would affect the participant's eligibility for the program. The change must be reported within 30 days of the change in income.   (b) A short-term increase in income that is caused by overtime pay or other nonregular payments and that will not be sustained over time does not qualify as a permanent increase in income for the purposes of this section.   (2) Disenrollment may occur only after the state conducts an administrative review and determines the participant is ineligible for medicaid coverage under any eligibility category. (Terminates June 30, 2025, on occurrence of contingency--sec. 48, Ch. 415, L. 2019.)   History: En. Sec. 4, Ch. 415, L. 2019.
MT Code § 53-6-1315 (2021)
2021 Montana Code Annotated|Title 53. Social Services and Institutions|Chapter 6. Health Care Services|Part 13. Montana Health and Economic Livelihood Partnership (HELP) Act|53-6-1315. Montana HELP Act special revenue account

  53-6-1315. (Temporary) Montana HELP Act special revenue account. (1) There is a Montana HELP Act account in the state special revenue fund to the credit of the department.   (2) Money from the following sources must be deposited in the account:   (a) the taxpayer integrity fees provided for in 15-30-2660;   (b) the outpatient hospital utilization fee provided for in 15-66-102(3)(b);   (c) the health service corporation fee provided for in 33-2-714; and   (d) premiums paid by members pursuant to 53-6-1307.   (3) Money in the account must be used to pay for:   (a) the state share of costs, including benefits and administrative costs, of providing health care services under this part; and   (b) grants made under the HELP Act employer grant program provided for in 39-12-106.   (4) Money from the account must be used for the benefits and administrative costs of providing health care services under this part before any general fund is expended on the costs. (Terminates June 30, 2025, on occurrence of contingency--sec. 48, Ch. 415, L. 2019.)   History: En. Sec. 5, Ch. 415, L. 2019.
MT Code § 53-6-1316 (2021)
2021 Montana Code Annotated|Title 53. Social Services and Institutions|Chapter 6. Health Care Services|Part 13. Montana Health and Economic Livelihood Partnership (HELP) Act|53-6-1316. Repealed

  53-6-1316. Repealed. Sec. 3, Ch. 21, L. 2019; sec. 39, Ch. 415, L. 2019.   History: En. Sec. 11, Ch. 368, L. 2015.
MT Code § 53-6-1317 (2021)
2021 Montana Code Annotated|Title 53. Social Services and Institutions|Chapter 6. Health Care Services|Part 13. Montana Health and Economic Livelihood Partnership (HELP) Act|53-6-1317. Repealed

  53-6-1317. Repealed. Sec. 3, Ch. 21, L. 2019.   History: En. Sec. 12, Ch. 368, L. 2015.
MT Code § 53-6-1318 (2021)
2021 Montana Code Annotated|Title 53. Social Services and Institutions|Chapter 6. Health Care Services|Part 13. Montana Health and Economic Livelihood Partnership (HELP) Act|53-6-1318. Rulemaking authority

  53-6-1318. (Temporary) Rulemaking authority. (1) The department may adopt rules as necessary to carry out this part.   (2) The department and the department of labor and industry may, in coordination, adopt rules as necessary for the implementation of the employment and reemployment assessments and workforce development activities provided for in Title 39, chapter 12. (Terminates June 30, 2025--sec. 38, Ch. 415, L. 2019.)   History: En. Sec. 13, Ch. 368, L. 2015.
MT Code § 53-6-1319 (2021)
2021 Montana Code Annotated|Title 53. Social Services and Institutions|Chapter 6. Health Care Services|Part 13. Montana Health and Economic Livelihood Partnership (HELP) Act|53-6-1319. through 53-6-1324 reserved

  53-6-1319 through 53-6-1324 reserved.
MT Code § 53-6-1325 (2021)
2021 Montana Code Annotated|Title 53. Social Services and Institutions|Chapter 6. Health Care Services|Part 13. Montana Health and Economic Livelihood Partnership (HELP) Act|53-6-1325. Report to legislature

  53-6-1325. (Temporary) Report to legislature. (1) The department shall report the following information to the legislative finance committee and the children, families, health, and human services interim committee quarterly:  (a) the number of individuals who were determined eligible for medicaid-funded services pursuant to 53-6-1304;   (b) demographic information on program participants;   (c) the average length of time that participants remained eligible for medical assistance;   (d) the number of participants subject to the fees provided for in 15-30-2660 and the total amount of fees collected;   (e) the amount of money deposited in the Montana HELP Act special revenue account, by source of funding;   (f) the level of participant engagement in wellness activities or incentives offered under this part;   (g) the number of participants who took part in community engagement activities, the number whose program participation was suspended for failure to take part in community engagement activities, and the number who were disenrolled from the program for failure to report a change in circumstances;   (h) the number of participants who reduced their dependency on the HELP Act program, either voluntarily or because of increased income levels; and   (i) the total cost of providing services under this part, including related administrative costs.   (2) A compilation of reports received during the interim must be provided to the legislature in accordance with 5-11-210.(Terminates June 30, 2025, on occurrence of contingency--sec. 48, Ch. 415, L. 2019.)   History: En. Sec. 37, Ch. 415, L. 2019; amd. Sec. 91, Ch. 261, L. 2021.