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Rule Title: HOME INFUSION THERAPY SERVICES, DEFINITIONS
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Department: PUBLIC HEALTH AND HUMAN SERVICES
Chapter: MEDICAID PRIMARY CARE SERVICES
Subchapter: Home Infusion Therapy Services
 
Latest version of the adopted rule presented in Administrative Rules of Montana (ARM):

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37.86.1501    HOME INFUSION THERAPY SERVICES, DEFINITIONS

In ARM 37.86.1501, 37.86.1502, 37.86.1505, and 37.86.1506, the following definitions apply:

(1) "Agency staff services" means all services provided by the home infusion therapy agency's staff, as provided in ARM 37.106.2405, including all professional and nonprofessional employed and contracted individuals. Agency staff services include:

(a) preparation and revision of the plan of care;

(b) coordination of treatment with other health care providers;

(c) recipient and/or care giver training;

(d) clinical monitoring of laboratory values and therapy progression;

(e) reporting clinical information to the recipient's physician and other health care providers;

(f) delivery, pick up, and disposal of equipment, supplies, or drugs;

(g) 24-hour on call status; and

(h) any other services provided by the agency staff related to the recipient's home infusion therapy services.

(2) "Home infusion therapy services" means a comprehensive treatment program for the preparation and administration of parenteral medications or parenteral nutritional services to a recipient who is not receiving infusion therapy as a hospital inpatient or outpatient. Home infusion therapy services include all pharmacist professional services, all agency staff services and all associated medical equipment and supplies for care required at home or an ambulatory infusion suite (AIS). Home infusion therapy services do not include professional physician services or drugs. Drugs are covered under the pharmacy outpatient program.

(3) "Home Nursing Services for Infusion/Specialty Drug Administration" means high-tech registered nurse (RN) services provided by an RN with special education, training and expertise in home administration of drugs via infusion, home/AIS administration of specialty drugs, or home nursing management of disease state and care management programs. Typical services include:

(a) evaluation and assessment;

(b) education and training for the patient or caregiver;

(c) inspection and consultation of aseptic home environment;

(d) catheter insertion/maintenance; and

(e) patient assessment.

(4) "Pharmacist professional services" include:

(a) preparation and revision of the plan of care;

(b) preparation and compounding of drugs;

(c) monitoring of laboratory values and therapy progression;

(d) reporting clinical information to the recipient's physician and other health care providers;

(e) delivery, pick up, and disposal of equipment, supplies and/or, drugs; and

(f) 24-hour on call status.

(5) Other home infusion therapy services include services as provided in ARM 37.106.2411 and the procedure codes included in the department's Home Infusion Therapy Fee Schedule.

History: 53-2-201, 53-6-113, MCA; IMP, 53-6-101, 53-6-113, MCA; NEW, 1996 MAR p. 2599, Eff. 10/4/96; TRANS, from SRS, 2000 MAR p. 481; AMD, 2012 MAR p. 1270, Eff. 7/1/12.


 

 
MAR Notices Effective From Effective To History Notes
37-583 7/1/2012 Current History: 53-2-201, 53-6-113, MCA; IMP, 53-6-101, 53-6-113, MCA; NEW, 1996 MAR p. 2599, Eff. 10/4/96; TRANS, from SRS, 2000 MAR p. 481; AMD, 2012 MAR p. 1270, Eff. 7/1/12.
10/4/1996 7/1/2012 History: Sec. 53-2-201 and 53-6-113, MCA; IMP, Sec. 53-6-101 and 53-6-113, MCA; NEW, 1996 MAR p. 2599, Eff. 10/4/96; TRANS, from SRS, 2000 MAR p. 481.
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