reglab/housing_qa huggingface dataset:
MT Code § 53-6-710 (2021)
2021 Montana Code Annotated|Title 53. Social Services and Institutions|Chapter 6. Health Care Services|Part 7. Medicaid Managed Care|53-6-710. Advisory council -- duties

  53-6-710. Advisory council -- duties. (1) There is an advisory council to review requests for proposals issued and contracts proposed to be awarded under this part.  (2) The advisory council consists of seven members appointed as follows:   (a) two members appointed by the speaker of the house of representatives, at least one of whom must be a health care provider;   (b) two members appointed by the president of the senate, at least one of whom must be a health care provider; and   (c) three members appointed by the governor, at least one of whom must be a health care provider.   (3) Members shall serve staggered, 3-year terms.   (4) When the department proposes to seek a medicaid waiver for managed care, the council shall conduct the following activities before the department issues a request for proposal and after it has selected a vendor but before a contract is awarded:   (a) hold a public hearing in the geographic area that would be affected by the program or contract in order to:   (i) educate medicaid recipients, health care providers, and the public residing in the area about the provisions of the proposed program or contract and the consumer's options; and   (ii) accept public comment about the proposed program or contract;   (b) submit a report if managed care is in place of its findings related to the public comment process to the children, families, health, and human services interim committee in accordance with 5-11-210, the legislative auditor's office, and the department.   (5) The council shall meet according to a schedule adopted by a majority vote of the council.   (6) The council is attached to the department for administrative purposes only, and members are entitled to reimbursement for travel expenses as provided in 2-18-501 through 2-18-503.   History: En. Sec. 1, Ch. 351, L. 2011; amd. Sec. 90, Ch. 261, L. 2021.
MT Code § 53-6-711 (2021)
2021 Montana Code Annotated|Title 53. Social Services and Institutions|Chapter 6. Health Care Services|Part 7. Medicaid Managed Care|53-6-711. Requests for proposals and contracts -- review requirements -- public notice and comment

  53-6-711. Requests for proposals and contracts -- review requirements -- public notice and comment. (1) Before the department issues a request for proposals or awards a contract for the provision of services through a managed health care entity:   (a) the department shall meet the public notice, legislative presentation, and public comment requirements of 53-2-215;   (b) the legislative auditor's office and the state auditor's office, in consultation with the department, shall analyze the request for proposal and the proposed contract for:   (i) actuarial soundness;   (ii) network adequacy as provided for in Title 33, chapter 36, part 2; and   (iii) consumer choice; and   (c) within 60 days of receipt of the request for proposal and proposed contract, the legislative auditor's office and state auditor's office shall complete their analyses and publish the findings of their analyses.   (2) (a) Before the department may award a contract, it shall seek an independent analysis to verify that the potential vendor is able to comply with the goals of the proposed managed care program.   (b) The vendor shall pay the costs of the analysis.   History: En. Sec. 2, Ch. 351, L. 2011.
MT Code § 53-6-801 (2021)
2021 Montana Code Annotated|Title 53. Social Services and Institutions|Chapter 6. Health Care Services|Part 8. Long-Term Care Insurance Partnerships|53-6-801. Purpose

  53-6-801. Purpose. The purpose of this part and the long-term care insurance partnerships authorized by this part is to encourage individuals to purchase long-term care insurance policies or certificates that will provide for their potential long-term care needs, thereby reducing the amount of money spent by the state of Montana for long-term care under the Montana medicaid program. The purpose of this part is also to provide an incentive for the purchase of the policies or certificates by providing individuals some protection from the requirement that they spend down their resources in order to qualify for medical assistance benefits in the form of payment for long-term care.   History: En. Sec. 2, Ch. 195, L. 1997.
MT Code § 53-6-802 (2021)
2021 Montana Code Annotated|Title 53. Social Services and Institutions|Chapter 6. Health Care Services|Part 8. Long-Term Care Insurance Partnerships|53-6-802. Definitions

  53-6-802. Definitions. As used in this part, unless the context indicates otherwise, the following definitions apply:   (1) "Certificate" means a certificate as defined in 33-22-1107.   (2) "Commissioner" means the commissioner of insurance provided for in 2-15-1903.   (3) "Department" means the department of public health and human services provided for in 2-15-2201.   (4) "Dollar-for-dollar model" means a program in which the amount of resources that is disregarded in determining medical assistance eligibility for an individual is increased by $1 for each dollar paid by an insurer to an insured under the insured's long-term care insurance policy or certificate.   (5) "Long-term care insurance" means an insurance policy or certificate that provides coverage for medically necessary services in a long-term care facility, as defined in 50-5-101, or in the insured's home.   (6) "Long-term care insurance partnership" or "partnership" means a program of collaboration between the commissioner, the department, insurers, and their insureds to create an incentive, through the issuance of insurance policies or certificates certified by the commissioner and the department, for individuals to purchase long-term care insurance.   (7) "Policy" means a policy as defined in 33-22-1107.   History: En. Sec. 1, Ch. 195, L. 1997.
MT Code § 53-6-803 (2021)
2021 Montana Code Annotated|Title 53. Social Services and Institutions|Chapter 6. Health Care Services|Part 8. Long-Term Care Insurance Partnerships|53-6-803. Long-term care insurance partnerships authorized

  53-6-803. Long-term care insurance partnerships authorized. (1) The commissioner and the department may in their discretion establish long-term care insurance partnerships as provided for in federal law under 42 U.S.C. 1396p or if allowed by a waiver of federal law under section 1115 of Title XI of the Social Security Act, 42 U.S.C. 1315.   (2) The department may in its discretion collaborate with private insurers to implement long-term care insurance partnerships that will allow individuals who have resources in excess of the resource limit for receipt of medical assistance under the Montana medicaid program to receive medical assistance benefits if those individuals are eligible for or require the level of care provided by a long-term care facility and meet the other program requirements in accordance with federal law or an approved waiver in order to facilitate the enrollment of persons into long-term care insurance plans.   (3) Under partnerships created pursuant to this section, individuals may qualify for special treatment of their resources if they purchase a long-term care insurance policy or certificate certified by the commissioner and the department as provided in 53-6-804 prior to becoming eligible for medical assistance benefits. The department may modify eligibility and other medicaid requirements by administrative rule as provided in 53-6-805 and as allowed by state and federal law to encourage individuals to maintain long-term care insurance.   (4) The long-term care insurance partnerships may in the department's discretion be based on a dollar-for-dollar model or any other model that is cost-neutral.   History: En. Sec. 3, Ch. 195, L. 1997; amd. Sec. 1, Ch. 406, L. 2005.
MT Code § 53-6-804 (2021)
2021 Montana Code Annotated|Title 53. Social Services and Institutions|Chapter 6. Health Care Services|Part 8. Long-Term Care Insurance Partnerships|53-6-804. Rulemaking and certification of policies by commissioner and department

  53-6-804. Rulemaking and certification of policies by commissioner and department. (1) The commissioner and the department may by rule adopt requirements for certification of long-term care insurance policies and certificates. These requirements may include but are not limited to:   (a) minimum levels and durations of benefits;   (b) mandatory inflation protection;   (c) mandatory home and community care coverage;   (d) case management; and   (e) procedures for the insured to appeal a denial of benefits.   (2) The commissioner and the department shall review long-term care insurance policies and certificates to determine whether policies and certificates meet the requirements for certification pursuant to this section.   History: En. Sec. 4, Ch. 195, L. 1997.
MT Code § 53-6-805 (2021)
2021 Montana Code Annotated|Title 53. Social Services and Institutions|Chapter 6. Health Care Services|Part 8. Long-Term Care Insurance Partnerships|53-6-805. Department to make rules

  53-6-805. Department to make rules. The department shall adopt rules necessary for the administration of the partnerships, including but not limited to rules concerning:   (1) the populations and age groups eligible to have resources disregarded for the purposes of qualification for medical assistance benefits under the Montana medicaid program;   (2) the level of care that an individual requires in order to have resources disregarded in determining eligibility for medical assistance benefits;   (3) the amount and type of resources of an individual that will be disregarded in determining eligibility for medical assistance benefits;   (4) requirements for the disregard of resources of an individual in determining eligibility for medical assistance benefits; and   (5) the exemption of protected resources from a lien provided in 53-6-171 through 53-6-189 for the recovery of medical assistance benefits paid by the state.   History: En. Sec. 5, Ch. 195, L. 1997.
MT Code § 53-6-901 (2021)
2021 Montana Code Annotated|Title 53. Social Services and Institutions|Chapter 6. Health Care Services|Part 9. Medicaid Medical Savings Account Pilot Project (Terminated)|53-6-901. Terminated

  53-6-901. Terminated. Sec. 1, Ch. 28, L. 1999.   History: En. Sec. 1, Ch. 380, L. 1997.
MT Code § 53-6-902 (2021)
2021 Montana Code Annotated|Title 53. Social Services and Institutions|Chapter 6. Health Care Services|Part 9. Medicaid Medical Savings Account Pilot Project (Terminated)|53-6-902. Terminated

  53-6-902. Terminated. Sec. 1, Ch. 28, L. 1999.   History: En. Sec. 2, Ch. 380, L. 1997.
MT Code § 53-6-903 (2021)
2021 Montana Code Annotated|Title 53. Social Services and Institutions|Chapter 6. Health Care Services|Part 9. Medicaid Medical Savings Account Pilot Project (Terminated)|53-6-903. Terminated

  53-6-903. Terminated. Sec. 1, Ch. 28, L. 1999.   History: En. Sec. 3, Ch. 380, L. 1997.
MT Code § 53-6-904 (2021)
2021 Montana Code Annotated|Title 53. Social Services and Institutions|Chapter 6. Health Care Services|Part 9. Medicaid Medical Savings Account Pilot Project (Terminated)|53-6-904. Terminated

  53-6-904. Terminated. Sec. 1, Ch. 28, L. 1999.   History: En. Sec. 4, Ch. 380, L. 1997.
MT Code § 53-6-905 (2021)
2021 Montana Code Annotated|Title 53. Social Services and Institutions|Chapter 6. Health Care Services|Part 9. Medicaid Medical Savings Account Pilot Project (Terminated)|53-6-905. Terminated

  53-6-905. Terminated. Sec. 1, Ch. 28, L. 1999.   History: En. Sec. 5, Ch. 380, L. 1997.
MT Code § 53-6-906 (2021)
2021 Montana Code Annotated|Title 53. Social Services and Institutions|Chapter 6. Health Care Services|Part 9. Medicaid Medical Savings Account Pilot Project (Terminated)|53-6-906. Terminated

  53-6-906. Terminated. Sec. 1, Ch. 28, L. 1999.   History: En. Sec. 6, Ch. 380, L. 1997.
MT Code § 53-6-907 (2021)
2021 Montana Code Annotated|Title 53. Social Services and Institutions|Chapter 6. Health Care Services|Part 9. Medicaid Medical Savings Account Pilot Project (Terminated)|53-6-907. Terminated

  53-6-907. Terminated. Sec. 1, Ch. 28, L. 1999.   History: En. Sec. 7, Ch. 380, L. 1997.
MT Code § 53-6-908 (2021)
2021 Montana Code Annotated|Title 53. Social Services and Institutions|Chapter 6. Health Care Services|Part 9. Medicaid Medical Savings Account Pilot Project (Terminated)|53-6-908. Terminated

  53-6-908. Terminated. Sec. 1, Ch. 28, L. 1999.   History: En. Sec. 8, Ch. 380, L. 1997.
MT Code § 53-6-909 (2021)
2021 Montana Code Annotated|Title 53. Social Services and Institutions|Chapter 6. Health Care Services|Part 9. Medicaid Medical Savings Account Pilot Project (Terminated)|53-6-909. Terminated

  53-6-909. Terminated. Sec. 1, Ch. 28, L. 1999.   History: En. Sec. 9, Ch. 380, L. 1997.
MT Code § 53-6-910 (2021)
2021 Montana Code Annotated|Title 53. Social Services and Institutions|Chapter 6. Health Care Services|Part 9. Medicaid Medical Savings Account Pilot Project (Terminated)|53-6-910. Terminated

  53-6-910. Terminated. Sec. 1, Ch. 28, L. 1999.   History: En. Sec. 10, Ch. 380, L. 1997.
MT Code § 53-6-1001 (2021)
2021 Montana Code Annotated|Title 53. Social Services and Institutions|Chapter 6. Health Care Services|Part 10. Prescription Drug Plus Discount Program|53-6-1001. Definitions

  53-6-1001. Definitions. As used in this part, unless the context requires otherwise, the following definitions apply:   (1) "Department" means the department of public health and human services provided for in Title 2, chapter 15, part 22.   (2) "Discounted price" means a price set by the department by rule pursuant to 53-6-1002.   (3) "Manufacturer" means a manufacturer of prescription drugs and includes a subsidiary or affiliate of a manufacturer.   (4) "Participating retail pharmacy" means a retail pharmacy located in this state or another business licensed to dispense prescription drugs in this state that is medicaid-approved.   (5) "Program" means the prescription drug plus discount program provided for in 53-6-1002.   (6) "Secondary discounted price" means the discounted price less any further discounts funded by manufacturer rebates for medication purchased by participants in the program.   History: En. Sec. 1, Ch. 551, L. 2003; amd. Sec. 4, Ch. 287, L. 2005; amd. Sec. 30, Ch. 19, L. 2011.
MT Code § 53-6-1003 (2021)
2021 Montana Code Annotated|Title 53. Social Services and Institutions|Chapter 6. Health Care Services|Part 10. Prescription Drug Plus Discount Program|53-6-1003. Eligibility -- income determination

  53-6-1003. Eligibility -- income determination. To be eligible for the program, an individual must:   (1) reside in a household with an income level less than or equal to 250% of the federal poverty guidelines as adopted by the U.S. department of health and human services; and   (2) lack prescription drug coverage or shall provide documentation that the individual has exceeded the coverage of the individual's prescription drug benefits.   History: En. Sec. 3, Ch. 551, L. 2003; amd. Sec. 6, Ch. 287, L. 2005.
MT Code § 53-6-1004 (2021)
2021 Montana Code Annotated|Title 53. Social Services and Institutions|Chapter 6. Health Care Services|Part 10. Prescription Drug Plus Discount Program|53-6-1004. State pharmacy access program

  53-6-1004. State pharmacy access program. (1) The department shall administer a pharmacy access prescription drug benefit program that contributes to the cost of the premium and, optionally, to the cost of the deductible for the Part D medicare prescription drug benefit as established in Title I of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003.   (2) An individual is eligible for the pharmacy access program if the individual:   (a) has a family income, as adopted by rule, of up to 200% of the federal poverty guidelines set annually by the U.S. department of health and human services and is not eligible for federal low-income assistance under Part D;   (b) submits proof of enrollment in a prescription drug plan for the Part D medicare benefit.   (3) The department shall establish by rule eligibility based upon the applicant's family income within the range provided in subsection (2). The department may adopt rules defining income. In establishing eligibility based upon income, the department shall take into account the amount of funding available for the program.   (4) The department shall set an amount of benefit for the premium and may optionally set a portion of the deductible by rule based on the numbers enrolled and the appropriation.   (5) The department shall open the enrollment of the pharmacy access program at the same time as enrollment commences for the medicare Part D program.   (6) If the department determines that there are excess funds for the pharmacy access program, it may use the funds for the program provided for in 53-6-1002.   History: En. Sec. 1, Ch. 287, L. 2005.
MT Code § 53-6-1005 (2021)
2021 Montana Code Annotated|Title 53. Social Services and Institutions|Chapter 6. Health Care Services|Part 10. Prescription Drug Plus Discount Program|53-6-1005. Department administration -- pharmacy access

  53-6-1005. Department administration -- pharmacy access. The department shall administer the pharmacy access program. The department shall provide for outreach and enrollment in the pharmacy access program. The department shall integrate the enrollment and outreach procedures with other services provided to individuals and families eligible for other related programs.   History: En. Sec. 2, Ch. 287, L. 2005; amd. Sec. 7, Ch. 81, L. 2017.
MT Code § 53-6-1006 (2021)
2021 Montana Code Annotated|Title 53. Social Services and Institutions|Chapter 6. Health Care Services|Part 10. Prescription Drug Plus Discount Program|53-6-1006. Prescription drug consumer information and technical assistance program -- education outreach for consumers and professionals

  53-6-1006. Prescription drug consumer information and technical assistance program -- education outreach for consumers and professionals. (1) There is a prescription drug consumer information and technical assistance program in the department to provide Montana residents with advice on the prudent use of prescription drugs and how to access government and private prescription drug programs and discounts. The program must include consultation by licensed pharmacists with individuals on how to avoid dangerous drug interactions and provide for substitution of more cost-effective drugs with approval by the prescribing health care professional.   (2) The department shall create educational resources, including a website, concerning the costs and benefits of various drugs to inform consumers and medical practitioners on clinically effective and cost-conscious prescription drugs.   History: En. Sec. 3, Ch. 287, L. 2005.
MT Code § 53-6-1007 (2021)
2021 Montana Code Annotated|Title 53. Social Services and Institutions|Chapter 6. Health Care Services|Part 10. Prescription Drug Plus Discount Program|53-6-1007. through 53-6-1009 reserved

  53-6-1007 through 53-6-1009 reserved.
MT Code § 53-6-1010 (2021)
2021 Montana Code Annotated|Title 53. Social Services and Institutions|Chapter 6. Health Care Services|Part 10. Prescription Drug Plus Discount Program|53-6-1010. Specifications for administration of program

  53-6-1010. Specifications for administration of program. (1) The department shall adopt specifications for the administration and management of the program. Specifications may include but are not limited to program objectives, accounting and handling practices, supervisory authority, and an evaluation methodology.   (2) Information disclosed by manufacturers during negotiations and all terms and conditions negotiated between the director and manufacturers and all information requested or required under the program are public information, except for information that the department determines is proprietary information.   (3) The department may use a formulary or other committee to determine preferred drug lists for department programs. The department shall include a representative of consumers on any formulary committee or committee to determine preferred drug lists for purchase by the department or reimbursement of costs. Any formulary or preferred drug list must be based on objective clinical data on safety and effectiveness. If two or more drugs are found to be equally effective and safe for the treatment of the same medical condition, the drug available at the lowest net price, inclusive of discounts and rebates, must be placed on the list. Other drugs for treating the same medical condition may be added to the list if they are therapeutically equivalent and the department determines them to be cost-effective.   (4) The department may negotiate rebates from the prescription drug manufacturers for drugs that will be on any preferred drug list. The department may negotiate price discounts with prescription drug manufacturers for any state-purchased health care programs, including medicaid, the state children's health insurance program, and the program provided for in 53-6-1002.   (5) The department may use the access restrictions and a preferred drug list to negotiate for the most favorable discount prices and rebates for the program.   (6) The department may participate in multistate purchasing pool initiatives for the benefit of the program.   History: En. Sec. 4, Ch. 551, L. 2003; amd. Sec. 7, Ch. 287, L. 2005.
MT Code § 53-6-1011 (2021)
2021 Montana Code Annotated|Title 53. Social Services and Institutions|Chapter 6. Health Care Services|Part 10. Prescription Drug Plus Discount Program|53-6-1011. Appeals

  53-6-1011. Appeals. An eligibility determination made by the department based on information provided by the department of revenue is final, subject to appeal in accordance with the appeal process established in the medicaid program.   History: En. Sec. 5, Ch. 551, L. 2003.
MT Code § 53-6-1012 (2021)
2021 Montana Code Annotated|Title 53. Social Services and Institutions|Chapter 6. Health Care Services|Part 10. Prescription Drug Plus Discount Program|53-6-1012. Obligations of department

  53-6-1012. Obligations of department. The department shall establish simplified procedures for determining eligibility and issuing Montana prescription enrollment cards to qualified individuals under 53-6-1002 and shall undertake outreach efforts to build public awareness of the program and maximize enrollment of qualified individuals. The department may adjust the requirements and terms of the program to accommodate any new federally funded prescription drug programs.   History: En. Sec. 6, Ch. 551, L. 2003.
MT Code § 53-6-1013 (2021)
2021 Montana Code Annotated|Title 53. Social Services and Institutions|Chapter 6. Health Care Services|Part 10. Prescription Drug Plus Discount Program|53-6-1013. Contracting

  53-6-1013. Contracting. The department may contract for the administration of any components of the program, including but not limited to outreach, eligibility, claims, administration, price and rebate negotiations, and drug rebate recovery and redistribution. Any contract to administer any program component must prohibit the contractor from receiving any compensation or other benefit from any drug manufacturer, labeler, or distributor participating in the medicaid or prescription drug plus discount programs.   History: En. Sec. 7, Ch. 551, L. 2003; amd. Sec. 8, Ch. 287, L. 2005.
MT Code § 53-6-1014 (2021)
2021 Montana Code Annotated|Title 53. Social Services and Institutions|Chapter 6. Health Care Services|Part 10. Prescription Drug Plus Discount Program|53-6-1014. through 53-6-1019 reserved

  53-6-1014 through 53-6-1019 reserved.
MT Code § 53-6-1020 (2021)
2021 Montana Code Annotated|Title 53. Social Services and Institutions|Chapter 6. Health Care Services|Part 10. Prescription Drug Plus Discount Program|53-6-1020. Contingency on expenditure

  53-6-1020. Contingency on expenditure. This part may not be construed to require implementation or ongoing operation of the program under 53-6-1201(3)(b) without a line item appropriation in the general appropriations bill included for that purpose.   History: En. Sec. 10, Ch. 287, L. 2005.