Montana Administrative Register Notice 37-993 No. 9   05/13/2022    
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In the matter of the amendment of ARM 37.34.3005 pertaining to developmental disabilities waiver programs reimbursement







TO: All Concerned Persons


           1.  On June 2, 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/86440818807?pwd=aHRTb25vcmdBeG5laFlhUTAvMXRlUT09, meeting ID:  864 4081 8807 and password 855877; or

            (b) Dial by telephone +1 646 558 8656, meeting ID: 864 4081 8807.  Find your local number: https://mt-gov.zoom.us/u/kdwtS4ixnf.


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 27, 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 dphhslegal@mt.gov.


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



            (2)  The department adopts and incorporates by this reference the rates of reimbursement for and the delivery of services and items available through each Home and Community-Based Services Waiver Program as specified in the Montana Developmental Disabilities Program Services Manual, effective July 1, 2021 July 1, 2022. A copy of the manual may be obtained through the Department of Public Health and Human Services, Developmental Services Behavioral Health and Developmental Disabilities Division, Developmental Disabilities Program, 111 N. Sanders, P.O. Box 4210, Helena, MT 59604-4210 and at

http://dphhs.mt.gov/dsd/developmentaldisabililities/DDPratesinf https://dphhs.mt.gov/dsd/developmentaldisabilities/ddpratesinf.


AUTH: 53-2-201, 53-6-402, MCA

IMP: 53-2-201, 53-6-402, MCA




The Department of Public Health and Human Services (department) is proposing to amend ARM 37.34.3005 pertaining to reimbursement rates in the Montana Developmental Disabilities Program Services Manual. 


The rule amendment would adopt and incorporate the updated version of the manual, dated July 1, 2022, to include a waiver definition update to remote monitoring, the allowance of retainer days for day supports and activities, and changes in billing and reimbursement of services provided to persons who are recipients of developmental disabilities services through the Medicaid programs.


Based on legislative appropriations in the 2021 legislative session, the Developmental Disabilities Program proposes to implement a 1.9% average provider rate increase to provider rates, and through increased rates apply money appropriated by the 2021 Legislative Session for workers who provide direct care to people with developmental disabilities.  These rate adjustments are reflected in the proposed manual, dated July 1, 2022. 


ARM 37.34.3005(2)

The proposed amendment would give an approximate 1.9% increase to Medicaid waiver services and distribute an additional $990,290 to waiver services through rate setting for recruitment and retention of direct care workers, with an effective date of July 1, 2022. The combined weighted average increase for waiver services is estimated at 2.7%.


The proposed amendment would apply both increases to all waiver services except:


Individual Goods and Services

Remote Monitoring Equipment

Specialized Medical Equipment and Supplies

Environmental Modifications

Personal Emergency Response System

Community Transition Services


The following Extended State Plan services will receive updates per their established Medicaid State Plan rate methodologies:


Private Duty Nursing (Medicaid State Plan) LPN

Private Duty Nursing (Medicaid State Plan) RN

Psychological Services

Physical Therapy (Medicaid State Plan)

Occupational Therapy (Medicaid State Plan)

Speech Therapy (Medicaid State Plan)

Nutritionist Services (Medicaid State Plan)


The proposed Montana Developmental Disabilities Program Services Manual dated July 1, 2022, can be found at



Fiscal Impact


Waiver rate increases - The provider rate increases are projected to have the following fiscal impact:


1.9% provider rate increase:


SFY 2023

General Fund Increase

SFY 2023

Federal Fund Increase

SFY 2023

Total Fund Increase





Direct care recruitment and retention increase:


SFY 2023

General Fund Increase

SFY 2023

Federal Fund Increase

SFY 2023

Total Fund Increase





The department intends for the proposed amendments to be effective retroactive to 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 dphhslegal@mt.gov, and must be received no later than 5:00 p.m., June 10, 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, 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 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/ Aleea Sharp___                                      /s/ Adam Meier______________             

Aleea Sharp                                                  Adam Meier, Director

Rule Reviewer                                              Public Health and Human Services



Certified to the Secretary of State May 3, 2022.


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