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This is an obsolete version of the rule. Please click on the rule number to view the current version.

6.6.4902    PATIENT-CENTERED MEDICAL HOME QUALIFICATION

(1) After January 1, 2014, health plans and primary care practices as defined in 33-40-103, MCA, self-funded government plans, Medicaid plans, and other health care providers offering medical services as defined in 33-22-140, MCA, may not offer or identify themselves as a patient-centered medical home or "medical home" unless the participating provider groups are qualified by the commissioner, and the health plan or other payer is utilizing healthcare providers who are qualified when offering "medical home" services to covered individuals under the plan.

(2) A primary care practice that is currently operating as a patient-centered medical home must submit an application for qualification by December 1, 2013, if the practice wishes to continue using that designation. Thereafter, any provider seeking to use the patient-centered medical home designation must apply for qualification and receive approval from the commissioner before holding itself out as a patient-centered medical home.

(3) The commissioner may provisionally qualify a patient-centered medical home for up to one year after the submission of an application, if the applicant needs additional time to obtain the necessary accreditation. The commissioner may extend the provisional status for an additional six months, if requested by the patient-centered medical home and for good cause.

(4) A primary care practice must apply for qualified patient-centered medical home qualification in a form prescribed by the commissioner.

(5) The commissioner shall maintain a list of qualified patient-centered medical homes on the agency's web site.

History: 33-40-104, MCA; IMP, 33-40-104, 33-40-105, MCA; NEW, 2013 MAR p. 1686, Eff. 9/20/13; AMD, 2014 MAR p. 3051, Eff. 12/25/14.

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