(1) "American Indian and Alaska Native" means an American Indian, Alaska Native, or other individual who is eligible for health services through the Indian Health Service, tribes and tribal organizations, or urban Indian organizations.

(2) "Certification" means attestation of compliance with or exemption from community engagement activities. A participant's certification may be included as part of the Medicaid application or provided separately with a dated signature electronically, telephonically, or by mail.

(3) "Community engagement activity" means any qualifying activity identified in ARM 37.84.118 as counting towards the community engagement participation requirements outlined in ARM 37.84.116.

(4) "Department" means the Montana Department of Public Health and Human Services.

(5) "Federal poverty level (FPL)" means the poverty income guidelines published annually in the Federal Register by the U.S. Department of Health and Human Services.

(6) "Health and Economic Livelihood Partnership (HELP) program" means a Medicaid coverage program for persons as authorized at Title 53, chapter 6, part 13, MCA, and Title 39, chapter 12, part 1, MCA, and as implemented in accordance with that part, 53-2-215, MCA, 42 U.S.C. 1315 (2015), 42 U.S.C. 1396d(y) (2015), and other applicable state and federal authorities for those persons who are eligible for the HELP Program as authorized under 42 U.S.C. 1396a(a)(10)(A)(i)(VIII) (2015).

(7) "Medicaid alternative benefit plan" means covered services available to HELP members that is equivalent to the Medicaid services described in ARM Title 37.

(8) "Medically frail" means individuals defined in 42 CFR 440.315(f) (2015).

(9) "Member" means an individual enrolled in the Montana Medicaid Program under 53-6-131, MCA, or receiving Medicaid-funded services under 53-6-1304, MCA.

(10) "Modified adjusted gross income (MAGI)" means income determined in accordance with 42 U.S.C. 1396a(e)(14) and 42 CFR 435.603 (2015).

(11) "Participant" means a member with a modified adjusted gross income at or below 138% of the federal poverty level and enrolled in Medicaid under the HELP program.

(12) "Premium" means a fee owed by an individual as a participant in the HELP Program.

(13) "Reporting period" means the required frequency for providing information to the department on community engagement activity participation. The reporting period is every six months.

(14) "Workforce program" means a program developed and administered by the Department of Labor and Industry that includes employment assessment and workforce development opportunities to members.  


History: 53-2-215, 53-6-113, 53-6-1309, 53-6-1318, MCA; IMP, 53-2-215, 53-6-101, 53-6-113, 53-6-1304, 53-6-1305, 53-6-1306, 53-6-1307, 53-6-1308, 53-6-1309, MCA; NEW, 2015 MAR p. 2294, Eff. 1/1/16; AMD, 2017 MAR p. 2326, Eff. 1/1/18; AMD, 2020 MAR p. 2438, Eff. 1/1/21.