Montana Administrative Register Notice 37-543 No. 13   07/14/2011    
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In the matter of the amendment of ARM 37.86.2224, 37.87.808, 37.87.901, and 37.87.903 pertaining to Children's Mental Health Bureau rate reduction








TO:  All Concerned Persons


            1.  On May 26, 2011, the Department of Public Health and Human Services published MAR Notice No. 37-543 pertaining to the public hearing on the proposed amendment of the above-stated rules at page 874 of the 2011 Montana Administrative Register, Issue Number 10.  The department held a public hearing on June 15, 2011, and the initial comment period was scheduled to end on June 23, 2011.


            2.  On July 21, 2011, at 1:00 p.m., the Department of Public Health and Human Services will hold a second public hearing in the auditorium of the Department of Public Health and Human Services Building, 111 North Sanders, Helena, Montana, to consider the proposed amendment of the above-stated rules.  This second hearing will supplement the hearing held on June 15, 2011.


            3.  The Department of Public Health and Human Services will make reasonable accommodations for persons with disabilities who need an alternative accessible format of this notice.  If you need to request an accommodation, contact the department no later than 5:00 p.m. on July 18, 2011 to advise us of the nature of the accommodation that you need.  Please contact Kenneth Mordan, 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.


            4. ARM 37.86.2224, 37.87.808, and 37.87.903 remain as proposed.


5.  ARM 37.87.901 remains as proposed, but with the following change to the original proposal notice, new matter underlined, deleted matter interlined:


            37.87.901  MEDICAID MENTAL HEALTH SERVICES FOR YOUTH, REIMBURSEMENT  (1)  Medicaid reimbursement for mental health services shall be the lowest of:

            (a) remains as proposed.

            (b)  the rate established in the department's fee schedule.  The department adopts and incorporates by reference the department's Medicaid Mental Health and Mental Health Services Plan, Individuals Under 18 Years of Age Fee Schedule dated August 1, 2011 September 1, 2011.  A copy of the fee schedule may be obtained from the Department of Public Health and Human Services, Developmental Services Division, Children's Mental Health Bureau, 111 Sanders, P.O. Box 4210, Helena, MT 59604 or at www.mt.medicaid.org.


AUTH:  53-2-201, 53-6-113, MCA

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


6.  REASON:  The proposed rule changes included notification of a draft fee schedule that reflected incorrect rates appearing to reduce mental health rates more than intended by the department.  The department will post a draft of the correct proposed rates at the Children's Mental Health Bureau's web site at www.dphhs.mt.gov/mentalhealth/children/, extend the comment period, and hold a second hearing to allow for public comment.


The proposed rule notice, published on May 26, 2011, omitted the fiscal impact statement.  This proposed amendment notice includes the fiscal impact statement.


            Fiscal Impact


Based on year-to-date (YTD) claims information from state fiscal year (SFY) 2010, about 3,550 youth received case management for a cost of $5 million per year.  Based on YTD claims information from SFY 2010, 6,057 youth received outpatient therapy services for a cost of around $4,375 million per year.  These changes are not expected to have an impact on youth and families receiving targeted case management (TCM) or outpatient therapy services.


The estimated cumulative fiscal impact of the 2% rate reduction of these rules is:

                        Total Cost                  State General Fund              Federal Match


9/1/11 - 6/30/12         ($991,309)                 ($335,162)                             ($656,147)


This rule amendment is estimated to impact 260 Medicaid providers and 10,500 Medicaid youth.


            7.  The department is also extending the time within which to submit written comments.  Written data, views, or arguments may be submitted to Kenneth Mordan at the contact information listed in paragraph 3, and must be received no later than 5:00 p.m. on July 25, 2011.  Persons who testified at the initial hearing, or who submitted comments during the initial comment period, need not testify again or resubmit their comments.  Any such previous testimony and comments will be included in the rulemaking record.


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


9.  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 3 above or may be made by completing a request form at any rules hearing held by the department.


10.  An electronic copy of this Proposal Notice is available through the Secretary of State's web site at http://sos.mt.gov/ARM/Register.  The Secretary of State strives to make the electronic copy of the notice conform to the official version of the notice, as printed in the Montana Administrative Register, but advises all concerned persons that in the event of a discrepancy between the official printed text of the notice and the electronic version of the notice, only the official printed text will be considered.  In addition, although the Secretary of State works to keep its web site accessible at all times, concerned persons should be aware that the web site may be unavailable during some periods, due to system maintenance or technical problems.


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




/s/ John Koch                                     /s/ Hank Hudson for Anna Whiting Sorrell

Rule Reviewer                                   Anna Whiting Sorrell, Director

                                                            Public Health and Human Services


Certified to the Secretary of State July 5, 2011



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