BEFORE THE DEPARTMENT OF PUBLIC HEALTH
AND HUMAN SERVICES
OF THE STATE OF MONTANA
In the matter of the amendment of ARM 37.86.1402 pertaining to clinic services requirements
NOTICE OF AMENDMENT
TO: All Concerned Persons
1. On January 11, 2019, the Department of Public Health and Human Services published MAR Notice No. 37-872 pertaining to the public hearing on the proposed amendment of the above-stated rule at page 32 of the 2019 Montana Administrative Register, Issue Number 1.
2. The department has amended the following rule as proposed, but with the following changes from the original proposal, new matter underlined, deleted matter interlined:
37.86.1402 CLINIC SERVICES, REQUIREMENTS (1) through (3) remain as proposed.
(4) Conditions for coverage of listed ambulatory surgical center procedures:
(a) Subject to the exclusions in (b), covered surgical procedures are surgical procedures that would not be expected to pose a significant safety risk to a member when performed in an ambulatory surgical center
(ASC) and for which standard medical practice dictates that the member would not typically be expected to require active medical monitoring and care at midnight following the procedure more than 24 hours following an admission. Active medical monitoring includes the monitoring or assessment of respiratory function, cardiovascular function, mental status, pain, temperature, or post-operative hydration at least every 30 minutes.
(b) through (5) remain as proposed.
AUTH: 53-2-201, 53-6-113, MCA
IMP: 53-6-101, 53-6-141, MCA
3. The department has thoroughly considered the comments and testimony received. A summary of the comments received and the department's responses are as follows:
COMMENT #1: The department received 12 comments. All comments expressed concerns about (4)(a) regarding the timeline an ambulatory surgical center is allowed to provide services. Commenters also requested a definition of active medical monitoring.
RESPONSE #1: The department has made two changes to ARM 37.86.1402 based on public comment. Subsection (4)(a) has been updated to state the member would not typically be expected to require active medical monitoring to exceed 24 hours following an admission. A definition of active medical monitoring has been added.
4. These rule amendments are effective upon publication of this notice of amendment.
/s/ Brenda K. Elias /s/ Sheila Hogan
Brenda K. Elias Sheila Hogan, Director
Rule Reviewer Public Health and Human Services
Certified to the Secretary of State March 19, 2019.