Montana Administrative Register Notice 6-220 No. 24   12/24/2015    
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In the matter of the amendment of ARM 6.6.4907 pertaining to Patient-Centered Medical Homes





TO: All Concerned Persons


1. On October 29, 2015, the Commissioner of Securities and Insurance, Montana State Auditor, published MAR Notice No. 6-220 pertaining to the public hearing on the proposed amendment of the above-stated rule at page 1796 of the 2015 Montana Administrative Register, Issue Number 20.


2. The department has amended ARM 6.6.4907, but with the following changes to the original proposal, stricken matter interlined, new matter underlined:


6.6.4907 PATIENT-CENTERED MEDICAL HOME REPORTING--SPECIFIC QUALITY MEASURES REQUIRED (1) A qualified or provisionally qualified patient-centered medical home (PCMH) shall report annually to the commissioner on its performance related to certain standards and health care quality measures, as prescribed by the commissioner. A PCMH health care provider that provides care to adults only, or both children and adults, shall choose at least three of the five quality measures listed in (3)(a) through (e) to report to the commissioner. A PCMH shall choose four out of five measures for the 2016 reporting year, for the report due in March 2017 and all subsequent years.

(2) A PCMH health care provider that provides care only to children, referred to as a pediatric practice, shall choose at least the child immunization performance measure in (3)(c). Reporting on depression screening in (3)(e) is optional for pediatric practices until the 2017 reporting year, for the report due in March 2018. At that time and for subsequent years, all pediatric clinics shall report on both the depression and immunization measures.

(3) through (5) remain as proposed.

(6) Annually, the data on standards and quality measures are due to the commissioner on March 31 for the previous calendar year. For the initial report, data must be submitted to the commissioner for the reporting period January 1, 2014 through December 31, 2014, by March 31, 2015.

(7) through (10) remain as proposed.


3. The department has thoroughly considered the comments and testimony received. The following comments were received by the December 2, 2015, deadline:


COMMENT NO. 1: One commenter wrote to express their support of the rule and consideration shown to primary care practices with regard to reducing data reporting burdens.


RESPONSE NO. 1: The department appreciates the support and acknowledgment of its efforts to work in a collaborative way with the stakeholder council and other interested parties.


COMMENT NO. 2: The department received comments from members of its staff indicating some minor edits that were needed to clarify the intent of the proposed language and to eliminate outdated instructions. 


RESPONSE NO. 2:  A clarification was made to indicate that the "4 out of 5" measures requirement would continue in the years following 2017.  A similar change was made for pediatric clinics. Outdated instructions for 2015 were removed in (6). 


/s/ Nick Mazanec                                   /s/ Christina L. Goe                    

Nick Mazanec                                       Christina L. Goe

Rule Reviewer                                       General Counsel


Certified to the Secretary of State December 14, 2015.


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