Montana Administrative Register Notice 37-952 No. 15   08/06/2021    
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In the matter of the amendment of ARM 37.86.4401 pertaining to licensed marriage and family therapist







TO: All Concerned Persons


            1. On August 26, 2021, at 11:00 a.m., the Department of Public Health and Human Services will hold a public hearing via remote conferencing to consider the proposed amendment of the above-stated rule. Interested parties may access the remote conferencing platform in the following ways: 

            (a) Join Zoom Meeting at: https://mt-gov.zoom.us/j/87456850161; meeting ID: 874 5685 0161; or

            (b) Dial by telephone +1 646 558 8656; meeting ID: 874 5685 0161. Find your local number: https://mt-gov.zoom.us/u/kddmkykDPF.


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 August 20, 2021, to advise us of the nature of the accommodation that you need. Please contact Heidi Clark, Department of Public Health and Human Services, Office of Legal Affairs, P.O. Box 4210, Helena, Montana, 59604-4210; telephone (406) 444-4094; fax (406) 444-9744; or e-mail dphhslegal@mt.gov.


3. The rule as proposed to be amended provides as follows, new matter underlined, deleted matter interlined:


            37.86.4401 RURAL HEALTH CLINICS AND FEDERALLY QUALIFIED HEALTH CENTERS, DEFINITIONS (1) through (7) remain the same.

            (8) "Health professional" means services furnished by a:

            (a) through (g) remain the same.

            (h) licensed marriage and family therapist (LMFT);

            (h) and (i) remain the same but are renumbered (i) and (j).

            (9) through (18) remain the same.


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

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




Licensed marriage and family therapists (LMFT) were added as a service provider type for Montana Medicaid through MAR Notice No. 37-940.


The department now proposes to include LFMT providers as a billable health professional in rural health clinic (RHC) and federally qualified health center (FQHC) settings. By adding LMFT to the list of health professionals, their allowable services can be reimbursed through the RHC and FQHC reimbursement methodology, thereby making these services available to Medicaid members who receive health care at RHCs and FQHCs.


Fiscal Impact


Provider Type

SFY 2022 State Fiscal Impact

SFY 2022 Federal Fiscal Impact

SFY 2022 Total Fiscal Impact

Active Provider Count

Federally Qualified Health Centers





Rural Health Clinics






The department intends for this proposed rule amendment to be effective retroactive to April 1, 2021.


            5. Concerned persons may submit their data, views, or arguments either orally or in writing at the hearing. Written data, views, or arguments may also be submitted to: Heidi Clark, Department of Public Health and Human Services, Office of Legal Affairs, P.O. Box 4210, Helena, Montana, 59604-4210; fax (406) 444-9744; or e-mail dphhslegal@mt.gov, and must be received no later than 5:00 p.m., September 3, 2021.


6. The Office of Legal Affairs, Department of Public Health and Human Services, has been designated to preside over and conduct this hearing.


7. 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 5 above or may be made by completing a request form at any rules hearing held by the department.


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


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


10.  Section 53-6-196, MCA, requires that the department, when adopting by rule proposed changes in the delivery of services funded with Medicaid monies, make a determination of whether the principal reasons and rationale for the rule can be assessed by performance-based measures and, if the requirement is applicable, the method of such measurement.  The statute provides that the requirement is not applicable if the rule is for the implementation of rate increases or of federal law.


The department has determined that the proposed program changes presented in this notice are not appropriate for performance-based measurement and therefore are not subject to the performance-based measures requirement of 53-6-196, MCA.




/s/ Nicholas Domitrovich for                       /s/ Adam Meier                                

Brenda K. Elias                                          Adam Meier, Director

Rule Reviewer                                            Public Health and Human Services



Certified to the Secretary of State July 27, 2021.



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