BEFORE THE DEPARTMENT OF PUBLIC
HEALTH AND HUMAN SERVICES OF THE
STATE OF MONTANA
In the matter of the adoption of NEW RULE I and the amendment of ARM 37.5.301 pertaining to formal and informal hearing and appeal procedures concerning the Children's Mental Health Bureau
NOTICE OF PUBLIC HEARING ON PROPOSED ADOPTION AND AMENDMENT
TO: All Concerned Persons
1. On July 28, 2016, at 11:00 a.m., the Department of Public Health and Human Services will hold a public hearing in the auditorium of the Department of Public Health and Human Services Building, 111 North Sanders, Helena, Montana, to consider the proposed adoption and amendment of the above-stated rules.
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 July 20, 2016, 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 firstname.lastname@example.org.
3. The rule as proposed to be adopted provides as follows:
NEW RULE I CHILDREN'S MENTAL HEALTH BUREAU (CMHB) MEDICAID SERVICES: APPLICABLE HEARING PROCEDURES (1) Except as otherwise provided in department rule, hearings contesting adverse department actions relating to CMHB Medicaid services are available to the extent provided and according to the procedures specified in ARM 37.5.304, 37.5.305, 37.5.307, 37.5.310, 37.5.311, 37.5.313, 37.5.316, 37.5.318, 37.5.322, 37.5.325, 37.5.328, 37.5.331, 37.5.334, and 37.5.337, and as further provided in the CMHB Medicaid Services Provider Manual, adopted and incorporated by reference in ARM 37.87.903.
AUTH: 50-1-202, 53-2-201, 53-6-113, MCA
IMP: 53-1-601, 53-1-602, 53-1-603, 53-2-201, 53-6-116, 53-21-701, 53-21-702, 53-21-703, MCA
4. The rule as proposed to be amended provides as follows, new matter underlined, deleted matter interlined:
37.5.301 APPLICABILITY (1) This rule and ARM 37.5.304, 37.5.307, 37.5.310, 37.5.313, 37.5.316, 37.5.318, 37.5.322, 37.5.325, 37.5.328, 37.5.331, 37.5.334, and 37.5.337 apply only to hearings in the program areas specified in ARM 37.5.101, 37.5.103, 37.5.105, 37.5.107, 37.5.109, 37.5.113, 37.5.115, 37.5.117, 37.5.119, 37.5.121, 37.5.123, 37.5.125, 37.5.127, 37.5.129, 37.5.131,
and 37.5.301, and [NEW RULE I], and shall must not be construed to grant a right to hearing in any other matter.
(2) The provisions of this rule, ARM 37.5.304, 37.5.305, 37.5.307, 37.5.310, 37.5.311, 37.5.313, 37.5.316, 37.5.318, 37.5.322, 37.5.325, 37.5.328, 37.5.331, 37.5.334, and 37.5.337 are subject to the provisions of ARM 37.5.101, 37.5.103, 37.5.105, 37.5.107, 37.5.109, 37.5.113, 37.5.115, 37.5.117, 37.5.119, 37.5.121, 37.5.123, 37.5.125, 37.5.127, 37.5.129, and 37.5.131.
(3) Where a right to a hearing is granted in ARM 37.5.103, 37.5.105, 37.5.107, 37.5.109, 37.5.113, 37.5.115, 37.5.117, 37.5.119, 37.5.121, 37.5.123, 37.5.125, 37.5.127,
and 37.5.129, and [NEW RULE I], or any other rule of the department, the right to hearing is not absolute but is subject to all applicable provisions of these rules and other applicable law.
AUTH: 50-1-202, 53-2-201, 53-6-113, MCA
IMP: 41-3-1103, 41-3-1142, 42-10-104, 50-1-202, 50-4-612, 50-5-103, 50-6-103, 50-6-402, 50-15-102, 50-15-103, 50-15-121, 50-15-122, 50-31-104, 50-52-102, 50-53-103, 52-1-103, 52-2-111, 52-3-406, 53-2-201, 53-2-904, 53-4-202, 53-4-212, 53-4-606, 53-4-1004, 53-6-111, 53-6-113, 53-6-131, 53-6-402, 53-20-305, 53-24-208, 69-8-412, MCA
5. STATEMENT OF REASONABLE NECESSITY
The Department of Public Health and Human Services (department) proposes to adopt NEW RULE I and amend ARM 37.5.301 to establish fair hearing procedures for claimants and providers who wish to contest adverse department actions by the Children's Mental Health Bureau (CMHB).
The department received feedback from providers and authorized representatives that the process for requesting a fair hearing to contest CMHB adverse actions was not clear. As a result, CMHB conducted a review of its administrative rules pertaining to fair-hearing procedures for CMHB Medicaid services and determined that there were no rules within ARM Title 37, chapter 5 which apply specifically to CMHB Medicaid services. The department determines it necessary to initiate this rulemaking to establish fair-hearing procedures for both medical assistance providers and authorized representatives.
NEW RULE I
The proposed text in New Rule I identifies and includes CHMB's non-Medicaid services with the other named programs to which ARM Title 37, chapter 5, subchapter 1 applies, and generally recognizes that other department rules may have relevance in CMHB Medicaid services contested case proceedings between a person or entity aggrieved by a department action.
The department proposes to amend ARM 37.5.301 to include the citation of proposed NEW RULE I regarding CMHB Medicaid services, which is necessary to officially apply the formal and informal hearing and appeals procedures to these specific CMHB services.
There is no fiscal impact from the proposed adoption of NEW RULE I and the proposed amendment to ARM 37.5.301.
6. 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: Kenneth Mordan, 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 email@example.com, and must be received no later than 5:00 p.m., August 5, 2016.
7. The Office of Legal Affairs, Department of Public Health and Human Services, has been designated to preside over and conduct this hearing.
8. 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 6 above or may be made by completing a request form at any rules hearing held by the department.
9. 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.
10. The bill sponsor contact requirements of 2-4-302, MCA, do not apply.
11. With regard to the requirements of 2-4-111, MCA, the department has determined that the adoption and amendment of the above-referenced rules will not significantly and directly impact small businesses.
12. 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/ Richard H. Opper
Brenda K. Elias, Attorney Richard H. Opper, Director
Rule Reviewer Public Health and Human Services
Certified to the Secretary of State June 27, 2016.