reglab/housing_qa huggingface dataset:
MT Code § 53-6-104 (2021)
2021 Montana Code Annotated|Title 53. Social Services and Institutions|Chapter 6. Health Care Services|Part 1. Medical Assistance -- Medicaid|53-6-104. Freedom of doctors to treat recipients of medical assistance -- freedom to select doctor

  53-6-104. Freedom of doctors to treat recipients of medical assistance -- freedom to select doctor. (1) The department of public health and human services shall provide for professional freedom of those licensed practitioners who provide medical assistance under this part and provide reasonable freedom of choice to recipients of medical aid to select the vendor or provider of medical care, services, or prescribed drugs.   (2) This section may not be construed to prohibit the department from imposing conditions on the payment of provider services and the receipt of medical assistance, as provided for under 53-6-111 and 53-6-113 through 53-6-116.   History: En. Sec. 4, Ch. 325, L. 1967; R.C.M. 1947, 71-1514; amd. Sec. 1, Ch. 475, L. 1985; amd. Sec. 3, Ch. 711, L. 1989; amd. Sec. 1, Ch. 31, Sp. L. November 1993; amd. Sec. 439, Ch. 546, L. 1995.
MT Code § 53-6-105 (2021)
2021 Montana Code Annotated|Title 53. Social Services and Institutions|Chapter 6. Health Care Services|Part 1. Medical Assistance -- Medicaid|53-6-105. Discrimination prohibited

  53-6-105. Discrimination prohibited. No discrimination shall be practiced or asserted against any applicant for or recipient of care and services under this part on the basis of race, color, or national origin, and the furnishing of care and services under this part to any applicant or recipient thereof shall not be delayed or denied on the basis of race, color, or national origin.   History: En. Sec. 16, Ch. 325, L. 1967; R.C.M. 1947, 71-1526.
MT Code § 53-6-106 (2021)
2021 Montana Code Annotated|Title 53. Social Services and Institutions|Chapter 6. Health Care Services|Part 1. Medical Assistance -- Medicaid|53-6-106. Health care facility standards -- definitions

  53-6-106. Health care facility standards -- definitions. (1) For purposes of 53-6-106 through 53-6-108, the following definitions apply:   (a) "Department" means the department of public health and human services.   (b) "Health care facility" means a health care facility as defined in 50-5-101 and includes a public health center as defined in 7-34-2102.   (2) The department may enter into agreements with appropriate federal agencies for the purpose of certifying health care facilities for the Montana medicaid program.   (3) The department may adopt rules as necessary to prescribe minimum standards for the maintenance and operation of health care facilities. Standards for the quality of care provided by those facilities receiving reimbursement under the Montana medicaid program must be consistent with those requirements imposed upon health care facilities by Title XIX of the federal Social Security Act, 42 U.S.C. 1396, et seq., as may be amended, and by the implementing regulations contained in Title 42 of the Code of Federal Regulations, as may be amended. The authority to prescribe standards and adopt rules under 53-6-106 through 53-6-108 is in addition to the authority granted to the department pursuant to Title 50, chapter 5.   (4) Standards adopted by the department may include but are not limited to requirements in the following areas: staffing, fire protection, health and safety, food and nutrition, environmental and sanitation, administration, admission policies, patient care planning, training, medication, health services, rehabilitation services, and social services and activities.   History: En. Sec. 4(1) thru (4), Ch. 711, L. 1989; amd. Sec. 12, Ch. 354, L. 1995; amd. Sec. 158, Ch. 418, L. 1995; amd. Sec. 440, Ch. 546, L. 1995; amd. Sec. 17, Ch. 93, L. 1997.
MT Code § 53-6-107 (2021)
2021 Montana Code Annotated|Title 53. Social Services and Institutions|Chapter 6. Health Care Services|Part 1. Medical Assistance -- Medicaid|53-6-107. Sanctions -- penalties

  53-6-107. Sanctions -- penalties. (1) The department may suspend, terminate, or refuse to renew an agreement with a health care facility that has failed to meet the requirements for certification for or participation in the Montana medicaid program under 53-6-106 through 53-6-108 or other applicable law. The department may also impose sanctions in the form of denial of medicaid payments for new admissions or other penalties or sanctions, as described in 53-6-111 or Title XIX of the Social Security Act, 42 U.S.C. 1396, et seq., as may be amended, and any implementing federal regulations.   (2) The department may impose a civil monetary penalty, with interest not to exceed 12% a year, for each day that a facility is substantially out of compliance with standards or participation requirements provided by applicable state or federal laws, regulations, or rules, including but not limited to standards adopted by the department under the authority of Title 50, chapter 5, or 53-6-106 through 53-6-108. Penalties must be collected by the department and may be applied to the protection of the health and property of residents of health care facilities that the department finds deficient, including but not limited to payment for the costs of relocation of residents to other facilities, operation of a facility pending correction of deficiencies or closure, and reimbursement of residents for personal funds lost.   (3) The department may appoint temporary management personnel to oversee the operation of the facility and to ensure the health and safety of the facility's residents if there is a need for temporary management because:   (a) an orderly closure of the facility is necessary; or   (b) improvements are being made to bring the facility into compliance with applicable standards.   (4) The department shall, in the case of an emergency, close the facility or transfer residents in the facility to other facilities, or both.   History: En. Sec. 4(5) thru (8), Ch. 711, L. 1989; amd. Sec. 13, Ch. 354, L. 1995; amd. Sec. 159, Ch. 418, L. 1995; amd. Sec. 441, Ch. 546, L. 1995; amd. Sec. 1, Ch. 346, L. 2001.
MT Code § 53-6-108 (2021)
2021 Montana Code Annotated|Title 53. Social Services and Institutions|Chapter 6. Health Care Services|Part 1. Medical Assistance -- Medicaid|53-6-108. Rules governing sanctions or remedies

  53-6-108. Rules governing sanctions or remedies. The department shall adopt rules governing the application of sanctions or remedies imposed under 53-6-107, the amounts of any fines, and the severity of each of these sanctions or remedies. The rules must be designed for the imposition of incrementally more severe fines for repeated or uncorrected deficiencies. The civil penalty for violation of the applicable standards imposed by state or federal laws, regulations, or rules may not exceed $10,000 for each day that the deficiency remains uncorrected. A health care facility aggrieved by an action of the department may request a hearing pursuant to Title 2, chapter 4, part 6.   History: En. Sec. 4(9), Ch. 711, L. 1989; amd. Sec. 14, Ch. 354, L. 1995; amd. Sec. 160, Ch. 418, L. 1995; amd. Sec. 442, Ch. 546, L. 1995; amd. Sec. 2, Ch. 346, L. 2001.
MT Code § 53-6-110 (2021)
2021 Montana Code Annotated|Title 53. Social Services and Institutions|Chapter 6. Health Care Services|Part 1. Medical Assistance -- Medicaid|53-6-110. Report and recommendations on medicaid funding

  53-6-110. Report and recommendations on medicaid funding. (1) As a part of the information required in 17-7-111, the department of public health and human services shall submit a report concerning medicaid funding for the next biennium. This report must include at least the following elements:  (a) analysis of past and present funding levels for the various categories and types of health services eligible for medicaid reimbursement;   (b) projected increased medicaid funding needs for the next biennium. These projections must identify the effects of projected population growth and demographic patterns on at least the following elements:   (i) trends in unit costs for services, including inflation;   (ii) trends in use of services;   (iii) trends in medicaid recipient levels; and   (iv) the effects of new and projected long-term care facilities and services for which a need has been identified in the state long-term care facilities plan.   (2) As an integral part of the report, the department of public health and human services shall present a recommendation of funding levels for the medicaid program. The recommendation need not be consistent with the state health care facilities plan.   (3) In making its appropriations for medicaid funding, the legislature shall specify the portions of medicaid funding anticipated to be allocated to specific categories and types of health care services.   (4) Beginning November 15 of each year through June 15 of the following year, the department of public health and human services shall provide to the legislative fiscal analyst monthly reports containing estimates of the cost for medicaid services and a budget status report for all department programs. The department shall also provide a fiscal yearend summary of medicaid costs and the department budget status report prior to the first legislative finance committee meeting following the end of the fiscal year. The reports must be presented in a format mutually agreed to by the legislative fiscal analyst and the department. The department shall provide the yearend summaries to the legislature in accordance with 5-11-210.   History: En. Sec. 8, Ch. 329, L. 1983; amd. Sec. 39, Ch. 112, L. 1991; amd. Sec. 35, Ch. 349, L. 1993; (5)En. Sec. 1, Ch. 14, Sp. L. November 1993; amd. Sec. 161, Ch. 418, L. 1995; amd. Sec. 443, Ch. 546, L. 1995; amd. Sec. 238, Ch. 42, L. 1997; amd. Sec. 18, Ch. 93, L. 1997; amd. Sec. 1, Ch. 380, L. 2005; amd. Sec. 15, Ch. 120, L. 2013; amd. Sec. 88, Ch. 261, L. 2021; amd. Sec. 8, Ch. 477, L. 2021.
MT Code § 53-6-112 (2021)
2021 Montana Code Annotated|Title 53. Social Services and Institutions|Chapter 6. Health Care Services|Part 1. Medical Assistance -- Medicaid|53-6-112. Department to print and distribute copies of part and certain forms

  53-6-112. Department to print and distribute copies of part and certain forms. The department shall have printed and shall distribute copies of this part to all local offices of public assistance and shall prescribe the form of and print and supply to the local offices of public assistance blanks of applications, reports, and other forms that may be necessary in relation to medical assistance.   History: En. Sec. 1, Ch. 325, L. 1967; amd. Secs. 47 and 48, Ch. 121, L. 1974; R.C.M. 1947, 71-1511(4); amd. Sec. 445, Ch. 546, L. 1995; amd. Sec. 35, Ch. 571, L. 2001.
MT Code § 53-6-114 (2021)
2021 Montana Code Annotated|Title 53. Social Services and Institutions|Chapter 6. Health Care Services|Part 1. Medical Assistance -- Medicaid|53-6-114. Rules of department binding

  53-6-114. Rules of department binding. All rules of the department made under this part are binding upon the local offices of public assistance.   History: En. Sec. 1, Ch. 325, L. 1967; amd. Secs. 47 and 48, Ch. 121, L. 1974; R.C.M. 1947, 71-1511(5); amd. Sec. 447, Ch. 546, L. 1995; amd. Sec. 36, Ch. 571, L. 2001.
MT Code § 53-6-115 (2021)
2021 Montana Code Annotated|Title 53. Social Services and Institutions|Chapter 6. Health Care Services|Part 1. Medical Assistance -- Medicaid|53-6-115. Contracts with other agencies

  53-6-115. Contracts with other agencies. The department of public health and human services may by suitable rules provide for contracting with any state or private agency for processing and payment of claims under the program of medical assistance, and the department may contract with one or more private or state agencies to provide any or all of the enumerated medical services.   History: En. Sec. 5, Ch. 325, L. 1967; amd. Sec. 49, Ch. 121, L. 1974; R.C.M. 1947, 71-1515; amd. Sec. 448, Ch. 546, L. 1995.
MT Code § 53-6-116 (2021)
2021 Montana Code Annotated|Title 53. Social Services and Institutions|Chapter 6. Health Care Services|Part 1. Medical Assistance -- Medicaid|53-6-116. Medicaid managed care -- capitated health care

  53-6-116. Medicaid managed care -- capitated health care. (1) The department of public health and human services, in its discretion, may develop managed care and capitated health care systems for medicaid recipients.  (2) The department may contract with one or more persons for the management of comprehensive physical health services and the management of comprehensive mental health services for medicaid recipients. The department may contract for the provision of these services by means of a fixed monetary or capitated amount for each recipient.   (3) A managed care system is a program organized to serve the medical needs of medicaid recipients in an efficient and cost-effective manner by managing the receipt of medical services for a geographical or otherwise defined population of recipients through appropriate health care professionals.   (4) The provision of medicaid services through managed care and capitated health care systems is not subject to the limitations provided in 53-6-104. The managed care or capitated health care system that is provided to a defined population of recipients may be based on one or more of the medical assistance services provided for in 53-6-101.   (5) The proposed systems, referred to in subsection (1), must be submitted to the legislative finance committee. The legislative finance committee shall review the proposed systems at its next regularly scheduled meeting and shall provide any comments concerning the proposed systems to the department. The department shall provide a copy of any reports made to the legislative finance committee concerning the proposed systems to the legislature in accordance with 5-11-210.   (6) A managed care or capitated health care system, except for a primary care case management service, that requires for implementation a waiver from the centers for medicare and medicaid is subject to the provisions of Title 53, chapter 6, part 7.   History: En. Sec. 1, Ch. 460, L. 1991; amd. Sec. 2, Ch. 31, Sp. L. November 1993; amd. Sec. 449, Ch. 546, L. 1995; amd. Sec. 2, Ch. 466, L. 2001; amd. Sec. 5, Ch. 351, L. 2011; amd. Sec. 89, Ch. 261, L. 2021.
MT Code § 53-6-117 (2021)
2021 Montana Code Annotated|Title 53. Social Services and Institutions|Chapter 6. Health Care Services|Part 1. Medical Assistance -- Medicaid|53-6-117. Participation requirements

  53-6-117. Participation requirements. (1) The department of public health and human services may require medicaid recipients to participate in a managed care system.   (2) Recipients who are required by the department to participate in a managed care system shall participate as required in order to remain eligible for medicaid.   (3) The department may require the participation of medicaid recipients in managed care systems based upon geographical, financial, social, medical, and other factors as the department may determine are relevant to the development and efficient management of managed care systems.   History: En. Sec. 2, Ch. 460, L. 1991; amd. Sec. 450, Ch. 546, L. 1995.
MT Code § 53-6-118 (2021)
2021 Montana Code Annotated|Title 53. Social Services and Institutions|Chapter 6. Health Care Services|Part 1. Medical Assistance -- Medicaid|53-6-118. through 53-6-120 reserved

  53-6-118 through 53-6-120 reserved.
MT Code § 53-6-121 (2021)
2021 Montana Code Annotated|Title 53. Social Services and Institutions|Chapter 6. Health Care Services|Part 1. Medical Assistance -- Medicaid|53-6-121. Local administration of medical assistance

  53-6-121. Local administration of medical assistance. The local offices of public assistance are charged with the local administration and supervision of medical assistance, including medicaid, subject to the powers, duties, rules, and overall supervision of the department.   History: En. Sec. 1, Ch. 325, L. 1967; amd. Secs. 47 and 48, Ch. 121, L. 1974; R.C.M. 1947, 71-1511(2); amd. Sec. 37, Ch. 571, L. 2001.
MT Code § 53-6-122 (2021)
2021 Montana Code Annotated|Title 53. Social Services and Institutions|Chapter 6. Health Care Services|Part 1. Medical Assistance -- Medicaid|53-6-122. Telehealth services -- requirements -- limitations

  53-6-122. Telehealth services -- requirements -- limitations. (1) Providers enrolled in the medicaid program may provide medically necessary services by means of telehealth if the service:  (a) is clinically appropriate for delivery by telehealth as specified by the department by rule or policy;   (b) comports with the guidelines of the applicable medicaid provider manual; and   (c) is not specifically required in the applicable provider manual to be provided in a face-to-face manner.   (2) A provider shall:   (a) ensure an enrollee receiving telehealth services has the same rights to confidentiality and security as provided for traditional office visits;   (b) follow consent and patient information protocols consistent with the protocols followed for in-person visits; and   (c) comply with recordkeeping requirements established by the department by rule.   (3) Telehealth services:   (a) may be provided using secure portal messaging, secure instant messaging, telephone communication, or audiovisual communication;   (b) may not be provided in a setting or manner not otherwise authorized by law; and   (c) must be reimbursed at the same rate of payment as services delivered in person.   (4) An enrollee's residence is not reimbursable as an enrolled originating site provider.   (5) The department shall adopt rules for the provision of telehealth services, including but not limited to:   (a) billing procedures for enrolled providers;   (b) the services considered clinically appropriate for telehealth purposes;   (c) recordkeeping requirements for providers, including originating site providers; and   (d) other requirements for originating site providers, including allowable provider types, reimbursement rates, and requirements for the secure technology to be used at originating sites.   (6) Nothing in this section may be construed as altering the scope of practice of any enrolled provider delivering services by means of telehealth.   History: En. Sec. 2, Ch. 497, L. 2021.
MT Code § 53-6-123 (2021)
2021 Montana Code Annotated|Title 53. Social Services and Institutions|Chapter 6. Health Care Services|Part 1. Medical Assistance -- Medicaid|53-6-123. reserved

  53-6-123 reserved.
MT Code § 53-6-124 (2021)
2021 Montana Code Annotated|Title 53. Social Services and Institutions|Chapter 6. Health Care Services|Part 1. Medical Assistance -- Medicaid|53-6-124. Definitions

  53-6-124. Definitions. As used in 53-6-125, 53-6-127, and this section, the following definitions apply:   (1) "Conversion factor" means the dollar value that is multiplied by the appropriate relative value unit to calculate a price for a service provided by a physician.   (2) "Department" means the department of public health and human services.   (3) "Medicaid" means the Montana medical assistance program established under Title 53, chapter 6.   (4) "Physician" has the meaning provided in 37-3-102.   (5) "Policy adjuster" means a factor by which the fee determined under 53-6-125 is multiplied to increase the fee paid by medicaid for certain categories of services.   (6) "Relative value unit" means a numerical value assigned in the resource-based relative value scale to each procedure code used to bill for services provided by a physician.   (7) "Resource-based relative value scale" means the medicare resource-based relative value scale contained in the physician's medicare fee schedule adopted by the centers for medicare and medicaid services of the U.S. department of health and human services.   History: En. Sec. 1, Ch. 414, L. 2007; amd. Sec. 1, Ch. 397, L. 2011.
MT Code § 53-6-125 (2021)
2021 Montana Code Annotated|Title 53. Social Services and Institutions|Chapter 6. Health Care Services|Part 1. Medical Assistance -- Medicaid|53-6-125. Physician services reimbursement

  53-6-125. Physician services reimbursement. (1) The fee for a covered service provided by a physician under the medicaid program is determined by multiplying the conversion factor times the relative value unit for that service times any applicable policy adjusters.  (2) (a) For fiscal years 2018 and 2019, the conversion factor must be increased, at a minimum, by the same numerical inflation factor calculated in accordance with 20-9-326.   (b) For each subsequent fiscal year, the conversion factor must be increased, at a minimum, by the same percentage increase as the consumer price index for medical care for the previous year, as calculated by the bureau of labor statistics of the United States department of labor.   History: En. Sec. 2, Ch. 414, L. 2007; amd. Sec. 2, Ch. 397, L. 2011; amd. Sec. 6, Ch. 364, L. 2017; amd. Sec. 8, Ch. 393, L. 2019.
MT Code § 53-6-126 (2021)
2021 Montana Code Annotated|Title 53. Social Services and Institutions|Chapter 6. Health Care Services|Part 1. Medical Assistance -- Medicaid|53-6-126. Repealed

  53-6-126. Repealed. Sec. 3, Ch. 397, L. 2011.   History: En. Sec. 3, Ch. 414, L. 2007.
MT Code § 53-6-127 (2021)
2021 Montana Code Annotated|Title 53. Social Services and Institutions|Chapter 6. Health Care Services|Part 1. Medical Assistance -- Medicaid|53-6-127. Rulemaking -- policy adjusters

  53-6-127. Rulemaking -- policy adjusters. The department may by rule adopt policy adjusters for certain categories of service. A policy adjuster may not be less than 1.   History: En. Sec. 4, Ch. 414, L. 2007.
MT Code § 53-6-128 (2021)
2021 Montana Code Annotated|Title 53. Social Services and Institutions|Chapter 6. Health Care Services|Part 1. Medical Assistance -- Medicaid|53-6-128. through 53-6-130 reserved

  53-6-128 through 53-6-130 reserved.
MT Code § 53-6-132 (2021)
2021 Montana Code Annotated|Title 53. Social Services and Institutions|Chapter 6. Health Care Services|Part 1. Medical Assistance -- Medicaid|53-6-132. Application for assistance -- exception

  53-6-132. Application for assistance -- exception. (1) Subject to subsection (2), application for assistance under this part may be made in any local office of public assistance. The application must be presented in the manner and on the form prescribed by the department. All individuals wishing to apply must have the opportunity to do so.   (2) Notwithstanding the provisions of subsection (1), the department may designate an entity other than the local office of public assistance to determine eligibility for medicaid managed care services.   History: En. Sec. 8, Ch. 325, L. 1967; R.C.M. 1947, 71-1518; amd. Sec. 452, Ch. 546, L. 1995; amd. Sec. 9, Ch. 590, L. 1995; amd. Secs. 39, 42, Ch. 465, L. 2001; amd. Sec. 38, Ch. 571, L. 2001.