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Montana Administrative Register Notice 37-584 No. 8   04/26/2012    
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BEFORE THE DEPARTMENT OF PUBLIC

HEALTH AND HUMAN SERVICES OF THE

STATE OF MONTANA

 

In the matter of the amendment of ARM 37.87.733, 37.87.809, 37.87.901, and 37.87.2233 pertaining to updating the Children's Mental Health Bureau (CMHB) fee schedule

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NOTICE OF PUBLIC HEARING ON PROPOSED AMENDMENT

 

TO:  All Concerned Persons

 

            1.  On May 17, 2012, at 9:00 a.m., the Department of Public Health and Human Services will hold a public hearing in Room 207 of the Department of Public Health and Human Services Building, 111 North Sanders, Helena, Montana, to consider the proposed amendment of the above-stated rules.

 

2.  The Department of Public Health and Human Services will make reasonable accommodations for persons with disabilities who wish to participate in this rulemaking process or need an alternative accessible format of this notice.  If you require an accommodation, contact Department of Public Health and Human Services no later than 5:00 p.m. on May 9, 2012, to advise us of the nature of the accommodation that you need.  Please contact Kenneth Mordan, Department of Public Health and Human Services, Office of Legal Affairs, P.O. Box 4210, Helena, Montana, 59604-4210; telephone (406) 444-4094; fax (406) 444-9744; or e-mail dphhslegal@mt.gov.

 

3.  The rules as proposed to be amended provide as follows, new matter underlined, deleted matter interlined:

 

            37.87.733  MENTAL HEALTH CENTER SERVICES FOR YOUTH WITH SERIOUS EMOTIONAL DISTURBANCE (SED), REIMBURSEMENT  (1)  Medicaid reimbursement for mental health center services shall be the lowest lesser of:

            (a)  the provider's actual (submitted) charge for the service; or

            (b)  the rate established in the department's Medicaid Mental Health and Mental Health Services Plan, Individuals Under 18 Years of Age Fee Schedule fee schedule, as adopted in ARM 37.87.901.

            (2)  For day treatment services, the department will not reimburse a mental health center provider for more than one fee per treatment day per youth.  This does not apply to mental health professional services to the extent such services are separately billed in accordance with these rules or targeted case management services for youth with serious emotional disturbance.

 

AUTH:  53-2-201, 53-6-101, 53-6-113, MCA

IMP:     53-2-201, 53-6-101, 53-6-111, MCA

 

            37.87.809  TARGETED CASE MANAGEMENT SERVICES FOR YOUTH WITH SERIOUS EMOTIONAL DISTURBANCE, REIMBURSEMENT  (1) remains the same.

            (2)  The department will pay providers of targeted case management services for youth with SED the lesser of:

            (a) remains the same.

            (b)  the amount specified the rate established in the department's Medicaid Mental Health and Mental Health Services Plan, Individuals Under 18 Years of Age Fee Schedule fee schedule, as adopted at in ARM 37.87.901.

            (3) through (5) remain the same.

 

AUTH:  53-2-201, 53-6-113, MCA

IMP:     53-1-601, 53-1-602, 53-1-603, 53-2-201, MCA

 

            37.87.901  MEDICAID MENTAL HEALTH SERVICES FOR YOUTH, REIMBURSEMENT  (1)  Medicaid reimbursement for mental health services shall be the lowest of:

            (a)  the provider's actual (submitted) charge for the service; or

            (b)  the rate established in the department's fee schedule.  The department adopts and incorporates by reference the department's Medicaid Youth Mental Health and Mental Health Services Plan, Individuals Under 18 Years of Age Fee Schedule dated August 1, 2011 July 1, 2012.  A copy of the fee schedule may be obtained from the Department of Public Health and Human Services, Developmental Services Division, Children's Mental Health Bureau, 111 Sanders, P.O. Box 4210, Helena, MT 59604 or at www.mt.medicaid.org.

 

AUTH:  53-2-201, 53-6-113, MCA

IMP:     53-2-201, 53-6-101, 53-6-111, MCA

 

            37.87.2233  MENTAL HEALTH SERVICES FOR YOUTH WITH SERIOUS EMOTIONAL DISTURBANCE (SED) RESPITE CARE SERVICES, PROVIDER REIMBURSEMENT  (1) and (2) remain the same.

            (3)  Reimbursement for respite care services is as provided in the department's Medicaid Mental Health and Mental Health Services Plan, Individuals Under 18 Years of Age Fee Schedule fee schedule, as adopted in ARM 37.87.901.

            (4)  Providers of respite care services must accept the amounts payable under this rule as payment in full for the respite care services provided to youth with SED.

 

AUTH:  53-2-201, 53-6-101, 53-6-113, MCA

IMP:     53-2-201, 53-6-101, 53-6-111, MCA

 

            4.  STATEMENT OF REASONABLE NECESSITY

 

The Department of Public Health and Human Services (the department) is proposing amendments to ARM 37.87.901.

 

This rule adopts and incorporates the "Medicaid Mental Health and Mental Health Services Plan, Individuals Under 18 years of Age Fee Schedule."  The department proposes to amend the title to "Medicaid Youth Mental Health Services Fee Schedule," to accurately reflect current Children's Mental Health Bureau (CMHB) services included in the fee schedule and to update the effective date of the fee schedule from August 1, 2011 to July 1, 2012.  The fee schedule references rates set by Montana Medicaid's resource based relative value scale (RBRVS) reimbursement method for psychologists, social workers, and professional counselors.  The RBRVS is located in ARM 37.85.212 and is revised annually.

 

Additional amendments to the proposed fee schedule add language to provide clarity and improve readability.  The department recognized areas in which information provided in the current fee schedule was also available in more suitable venues, such as the Children's Mental Health Bureau's Provider Manual and Clinical Guidelines for Utilization Management.  The department proposes to remove the language that is redundant.  To provide consistency throughout the fee schedule, the department reformatted the headings for select tables.

 

Furthermore, the department is proposing to add the Comprehensive School and Community Treatment (CSCT) fee to the fee schedule.  The department transferred the CSCT program from the Health Resources Division to the Developmental Services Division in order to ensure coordination with various children's mental health services.  This transfer began on January 1, 2012.  The Children's Mental Health Bureau will begin administering the CSCT program effective July 1, 2012. CSCT is a Medicaid funded program, therefore it is appropriate to amend the fee schedule to include this fee. This will provide a consistent point of reference for mental health providers and serve to better coordinate the efforts across children's mental health services.

 

The department is also proposing the same amendments to ARM 37.87.733, 37.87.809, and 37.87.2233.

 

These rules reference the "Medicaid Mental Health Services Plan, Individuals under 18 years of age, Fee Schedule", adopted and incorporated in ARM 37.87.901.  ARM 37.87.901 is being amended effective July 1, 2012; part of the proposed amendment is to rename the fee schedule "Medicaid Youth Mental Health Services Fee Schedule".  The department proposes to update references to the fee schedule in these rules to ensure the department's rules remain consistent.

 

            5.  The department intends the proposed rule changes to be applied effective July 1, 2012.

 

            6.  Concerned persons may submit their data, views, or arguments either orally or in writing at the hearing.  Written data, views, or arguments may also be submitted to: Kenneth Mordan, Department of Public Health and Human Services, Office of Legal Affairs, P.O. Box 4210, Helena, Montana, 59604-4210; fax (406) 444-9744; or e-mail dphhslegal@mt.gov, and must be received no later than 5:00 p.m., May 24, 2012.

 

7.  The Office of Legal Affairs, Department of Public Health and Human Services, has been designated to preside over and conduct this hearing.

 

8.  The department maintains a list of interested persons who wish to receive notices of rulemaking actions proposed by this agency.  Persons who wish to have their name added to the list shall make a written request that includes the name, e-mail, and mailing address of the person to receive notices and specifies for which program the person wishes to receive notices.  Notices will be sent by e-mail unless a mailing preference is noted in the request.  Such written request may be mailed or delivered to the contact person in 6 above or may be made by completing a request form at any rules hearing held by the department.

 

9.  An electronic copy of this proposal notice is available through the Secretary of State's web site at http://sos.mt.gov/ARM/Register.  The Secretary of State strives to make the electronic copy of the notice conform to the official version of the notice, as printed in the Montana Administrative Register, but advises all concerned persons that in the event of a discrepancy between the official printed text of the notice and the electronic version of the notice, only the official printed text will be considered.  In addition, although the Secretary of State works to keep its web site accessible at all times, concerned persons should be aware that the web site may be unavailable during some periods, due to system maintenance or technical problems.

 

10.  The bill sponsor contact requirements of 2-4-302, MCA, do not apply.

 

 

/s/ John Koch                                               /s/ Anna Whiting Sorrell                            

Rule Reviewer                                             Anna Whiting Sorrell, Director

                                                                        Public Health and Human Services

           

Certified to the Secretary of State April 16, 2012.

 

 

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