BEFORE THE DEPARTMENT OF PUBLIC
HEALTH AND HUMAN SERVICES OF THE
STATE OF MONTANA
In the matter of the amendment of ARM 37.79.326 pertaining to HMK Dental procedure codes
NOTICE OF PUBLIC HEARING ON PROPOSED AMENDMENT
TO: All Concerned Persons
1. On May19, 2022, at 9:00 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/89719778682?pwd=UExvWGMwdDhMYVdQNEJtbHU5NHlNZz09 meeting ID: 897 1977 8682 and password 252418 or
(b) Dial by telephone +1 646 558 8656 meeting ID: 897 1977 8682. Find your local number: https://mt-gov.zoom.us/u/kgesI8x0.
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 May 5, 2022, to advise us of the nature of the accommodation that you need. Please contact Valerie St. Clair, Department of Public Health and Human Services, Office of Legal Affairs, P.O. Box 4210, Helena, Montana, 59604-4210; telephone (406) 444-6863; fax (406) 444-9744; or e-mail email@example.com.
3. The rule as proposed to be amended provides as follows, new matter underlined, deleted matter interlined:
37.79.326 DENTAL BENEFITS (1) remains the same.
(2) Providers must bill for services using the procedure codes and modifiers set forth, and according to the definitions contained in the American Dental Association Manual of Current Dental Terminology (CDT
July 1, 2020 July 1, 2022, only the dental procedures listed at http://dphhs.mt.gov/hmk .aspx are benefits of the HMK coverage group Dental Program.
(4) through (6) remain the same.
AUTH: 53-4-1004, 53-4-1005, 53-4-1009, 53-4-1105, MCA
IMP: 53-4-1003, 53-4-1004, 53-4-1005, 53-4-1009, 53-4-1104, 53-4-1105, MCA
4. STATEMENT OF REASONABLE NECESSITY
The Department of Public Health and Human Services (department) is proposing to amend ARM 37.79.326(2) and (3) pertaining to updating the HMK Dental fee schedule, effective dates, and the Current Dental Terminology (CDT) codebook reference date.
The proposed amendments are explained below, with reference to the specific sections of ARM 37.79.326.
ARM 37.79.326 Dental Benefits
The department proposes to update the HMK Dental fee schedule to align with the state employee benchmark plan changes and reflect new procedure code updates, additions or deletions, and changes to existing code descriptions.
The department proposes to update the Current Dental Terminology (CDT) codebook reference from 2020 to 2022.
The department proposes to update the effective date of the covered dental procedures list from July 1, 2020, to July 1, 2022.
The link to the list of the dental procedures was invalid; accordingly, the department proposes to update it with a valid link.
There is no expected fiscal impact.
The department intends these amendments to be effective July 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: Valerie St. Clair, 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 firstname.lastname@example.org, and must be received no later than 5:00 p.m., May 27, 2022.
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, does 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 April 19, 2022.