37.40.331 ITEMS BILLABLE TO RESIDENTS
(1) The department will not pay a provider for any of the following items or services provided by a nursing facility to a resident. The provider may charge these items or services to the nursing facility resident:
(a) gifts purchased by residents;
(b) social events and entertainment outside the scope of the provider's activities program;
(c) cosmetics and grooming items and services in excess of those for which payment is made by Medicare or Medicaid;
(d) personal comfort items, including tobacco products and accessories, notions, novelties, and confections;
(e) personal dry cleaning;
(f) beauty shop services;
(g) television, radio and private telephone rental;
(h) less-than-effective drugs (exclusive of stock items) ;
(i) vitamins, multivitamins, vitamin supplements and calcium supplements;
(j) personal reading materials;
(k) personal clothing;
(l) flowers and plants;
(m) privately hired nurses or aides;
(n) specially prepared or alternative food requested instead of food generally prepared by facility; and
(o) the difference between the cost of items usually reimbursed under the per diem rate and the cost of specific items or brands requested by the resident which are different from that which the facility routinely stocks or provides (e.g., special lotion, powder, diapers) ;
(2) Services provided in private rooms will be reimbursed by the department at the same rate as services provided in a double occupancy room.
(a) A provider must provide a medically necessary private room at no additional charge and may not bill the recipient any additional charge for the medically necessary private room.
(b) A provider may bill a resident for the extra cost of a private room if the private room is not medically necessary and is requested by the resident. The provider must clearly inform the resident that additional payment is strictly voluntary.
History: 53-2-201, 53-6-113, MCA; IMP, 53-6-101, 53-6-113, MCA; NEW, 1991 MAR p. 2050, Eff. 11/1/91; AMD, 1992 MAR p. 1617, Eff. 7/31/92; AMD, 1993 MAR p. 1385, Eff. 10/1/93; AMD, 1998 MAR p. 1749, Eff. 6/26/98; TRANS, from SRS, 2000 MAR p. 489.