HOME    SEARCH    ABOUT US    CONTACT US    HELP   
           
Montana Administrative Register Notice 37-693 No. 20   10/23/2014    
Prev Next

 

BEFORE THE DEPARTMENT OF PUBLIC

HEALTH AND HUMAN SERVICES

OF THE STATE OF MONTANA

 

In the matter of the amendment of ARM 37.40.402, 37.40.406, 37.40.420, and 37.40.422 pertaining to updating the hospital swing-bed direct care wage to the current fiscal year

)

)

)

)

)

)

NOTICE OF PROPOSED AMENDMENT

 

 

NO PUBLIC HEARING CONTEMPLATED

 

TO: All Concerned Persons

 

1. On November 22, 2014, the Department of Public Health and Human Services proposes to amend 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 the Department of Public Health and Human Services no later than 5:00 p.m. on November 13, 2014, 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 MT 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:

 

            37.40.402 SWING-BED HOSPITALS, PROVIDER PARTICIPATION REQUIREMENTS (1) To participate and be reimbursed as a swing-bed hospital service provider in the Montana Medicaid program, a hospital must meet all of the following requirements:

            (a) through (g) remain the same.

            (h) The hospital meets the requirements of (2) ARM 37.40.416(1).

            (i) remains the same.

 

AUTH: 53-2-201, 53-6-113, MCA

IMP:     53-2-201, 53-6-101, 53-6-111, 53-6-113, 53-6-141, MCA

 

            37.40.406 SWING-BED HOSPITALS, REIMBURSEMENT (1) through (3) remain the same.

            (4) Providers must bill for all services and supplies in accordance with the provisions of ARM 37.85.406. The department's fiscal agent will pay a provider on a monthly basis the amount determined under these rules upon receipt of an appropriate billing which reports the number of patient days of swing-bed hospital services provided to authorized Medicaid recipients during the billing period.

            (5) remains the same.

 

AUTH: 2-4-201, 53-2-201, 53-6-113, MCA

IMP:     2-4-201, 53-2-201, 53-6-101, 53-6-111, 53-6-113, 53-6-141, MCA

 

            37.40.420 RESIDENT TRANSFER AND DISCHARGE RIGHTS (1) through (5) remain the same.

            (6) The written notice of transfer or discharge must include the following:

            (a) through (d) remain the same.

            (e) the name, address, and telephone number of the state of Montana long term care ombudsman in the Governor's Office on Aging, Senior and Long Term Care Division; and

            (f) and (7) remain the same.

 

AUTH: 53-6-113, MCA

IMP:     53-6-101, 53-6-113, MCA

 

37.40.422 DIRECT CARE AND ANCILLARY SERVICES WORKERS' WAGE REPORTING/ADDITIONAL PAYMENTS INCLUDING LUMP SUM PAYMENTS FOR DIRECT CARE AND ANCILLARY SERVICES WORKERS' WAGE AND BENEFIT INCREASES (1) Effective for the period January 1, 2010 January 1, 2015 through December 31, 2010 December 31, 2015, swing-bed hospitals must report to the department actual hourly wage and benefit rates paid for all direct care and ancillary services workers or the lump sum amounts paid for all direct care and ancillary services workers that will receive the benefit of a direct care and ancillary workers' wage and benefit increase.

(2) remains the same.

(3) The department will pay Medicaid certified swing-bed hospitals located in Montana, in accordance with this rule, lump sum payments in addition to the reimbursement rate to be used only for wage and benefit increases or lump sum payments for direct care or ancillary services workers in swing-bed hospitals.

(a) The department will determine lump sum payments commencing January 1, 2010 January 1, 2015, and again six months from that date as a pro rata share of appropriated funds allocated for increases in direct care and ancillary services workers' wages and benefits or lump sum payments to direct care and ancillary services workers.

(b) through (4) remain the same.

 

AUTH: 53-2-201, 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 37.40.402, 37.40.406, 37.40.420, and 37.40.422.

 

ARM 37.40.402

 

The proposed amendment is necessary to amend an incorrect citation to an administrative rule.

 

ARM 37.40.406

 

The proposed amendment is necessary to delete the wording "on a monthly basis" since providers can also bill on a weekly basis.

 

ARM 37.40.420

 

The proposed amendment is necessary to correct the contact information for the "long term care ombudsman" who is located in the Office on Aging within the Senior and Long Term Care Division, not the Governor's office.

 

ARM 37.40.422

 

The proposed amendment is necessary to correct an oversight and update the "lump sum payments for direct-care workers wage increases" to the correct fiscal year.

 

Fiscal Impact

 

There is one hospital and 44 critical access hospitals (CAHs) that participate in the Medicaid swing-bed program.  Thirteen of the providers will participate in the FY 2015 Direct Care Wage payment in the amount of $160,080, based on previous historical utilization.  We are continuing the methodology for Medicaid swing-bed providers that incorporates the calendar year average nursing facility payment rate methodology for calculation of swing-bed rates for SFY 2015.

 

5. The department intends to adopt these rule amendments effective January 1, 2015.

 

6. Concerned persons may submit their data, views, or arguments concerning the proposed action in writing to: Kenneth Mordan, Office of Legal Affairs, Department of Public Health and Human Services, P.O. Box 4210, Helena MT 59604-4210, no later than 5:00 p.m. on November 20, 2014. Comments may also be faxed to (406) 444-9744 or e-mailed to dphhslegal@mt.gov.

 

7. If persons who are directly affected by the proposed action wish to express their data, views, or arguments orally or in writing at a public hearing, they must make written request for a hearing and submit this request along with any written comments to Kenneth Mordan at the above address no later than 5:00 p.m., November 20, 2014.

 

8. If the agency receives requests for a public hearing on the proposed action from either 10 percent or 25, whichever is less, of the persons directly affected by the proposed action; from the appropriate administrative rule review committee of the Legislature; from a governmental subdivision or agency; or from an association having not less than 25 members who will be directly affected, a hearing will be held at a later date. Notice of the hearing will be published in the Montana Administrative Register. Ten percent of the forty-five hospital Medicaid swing bed providers directly affected has been determined to be 13 facilities based on the number of hospital Medicaid swing-bed days.

 

9. 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.

 

10. 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 this 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.

 

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

 

12. With regard to the requirements of 2-4-111, MCA, the department has determined that the amendment of the above-referenced rules will not significantly and directly impact small businesses.

 

 

/s/ Valerie Bashor                                        /s/ Mary E. Dalton acting for                      

Valerie Bashor, Attorney                              Richard H. Opper, Director

Rule Reviewer                                            Public Health and Human Services

 

Certified to the Secretary of State October 14, 2014.

 

 

Home  |   Search  |   About Us  |   Contact Us  |   Help  |   Disclaimer  |   Privacy & Security