Montana Administrative Register Notice 37-969 No. 21   11/05/2021    
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In the matter of the amendment of ARM 37.81.304 pertaining to the Big Sky Rx benefit






TO: All Concerned Persons


            1. On November 29, 2021, at 10:00 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/89466934100, meeting ID:  894 6693 4100 or

            (b) Dial by telephone +1 646 558 8656, meeting ID: 894 6693 4100.  Find your local number: https://mt-gov.zoom.us/u/kb9BY5ti9B.


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 November 15, 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:


            37.81.304 AMOUNT OF THE BIG SKY RX BENEFIT (1) An applicant eligible for the Big Sky Rx PDP premium assistance may receive a benefit not to exceed $38.00 $38.90 per month. The benefit amount will not exceed $38.00 $38.90 regardless of the cost of the premium for the PDP the individual chooses.

            (a) If a portion of the applicant's PDP premium is paid through the Extra Help Program, the Big Sky Rx Program will pay the applicant's portion of the PDP premium up to $38.00 $38.90 per month.

            (b) Big Sky Rx does not pay for the cost of an enrollee's drugs or the cost of an enrollee's deductible, coinsurance, or copayments.

            (c) All expenditures are contingent on legislative appropriation. The amount of the monthly benefit, $38.00 $38.90, extends the Social Security Extra Help benefit amount to Montana residents with income up to 200% FPL. The department's total expenditure for the program will be based on appropriation and the number of enrolled applicants.


AUTH: 53-2-201, 53-6-1004, MCA

IMP: 53-2-201, 53-6-1001, 53-6-1004, 53-6-1005, MCA




The Department of Public Health and Human Services (department) Health Resources Division is proposing to amend ARM 37.81.304.


The Big Sky Rx program contributes to the cost of an eligible Montana resident's premium payment in a federally approved Medicare prescription drug plan (PDP). This rule proposal, if adopted, will increase the maximum amount that Big Sky Rx will contribute to pay the eligible enrollee's monthly premium for a PDP program from $38.00 per month to $38.90 per month. The department is proposing this change to match the federally established low income subsidy (LIS) monthly benefit benchmark.


Since the inception of Big Sky Rx, the benefit has mirrored the LIS premium benefit benchmark to ensure a reasonable and prudent monthly benefit for enrolled members.


Fiscal Impact


This rule proposal will affect 1,571 Montanans who will see an increase in the amount of monetary assistance from the Big Sky Rx program for their monthly PDP premium. This rule proposal will increase the state special fund spending by $1,414 per month or $16,968 on an annual basis.


The department intends to apply these proposed amendments effective to January 1, 2022.


            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., December 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/ Brenda K. Elias                                       /s/ Adam Meier                                            

Brenda K. Elias                                            Adam Meier, Director

Rule Reviewer                                              Public Health and Human Services



Certified to the Secretary of State October 26, 2021.



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