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37.40.1407    HOME AND COMMUNITY-BASED SERVICES FOR ELDERLY AND PHYSICALLY DISABLED PERSONS: GENERAL REQUIREMENTS

(1) Services of the program may only be provided by a provider that is enrolled with the department as a Medicaid provider or, in rare instances, through a provider with whom the department is contracting for home and community-based case management services.

(2) A facility providing services to a recipient must meet all licensing requirements including fire and safety standards as well as other service-specific requirements set forth by the department in this chapter.

(3) A provider of service must meet the requirements necessary for the receipt of reimbursement with Medicaid monies.

(4) Immediate family members and legally responsible individuals may be paid for the provision of certain services under the following conditions:

(a) the service is identified in the federally approved waiver;

(b) the service is specified in the individual's service plan;

(c) the family member or legally responsible individual meets the provider qualifications and training standards for that service as specified in the federally approved waiver;

(d) the services do not supplant tasks that are customarily performed by legally responsible individuals; and

(e) the family member or legally responsible individual may not provide more than 40 hours of service in a seven-day period.

(5) Immediate family members include:

(a) a spouse; and

(b) a natural or adoptive parent of a minor child.

(6) A provider may also provide support to other family members in the recipient's household during hours of program reimbursed service if approved by the case management team or FM.

History: 53-2-201, 53-6-101, 53-6-113, 53-6-402, MCA; IMP, 53-2-201, 53-6-101, 53-6-402, MCA; NEW, 1983 MAR p. 863, Eff. 7/15/83; AMD, 1986 MAR p. 2094, Eff. 1/1/87; AMD, 1988 MAR p. 1268, Eff. 7/1/88; AMD, 1991 MAR p. 470, Eff. 12/14/90; TRANS & AMD, from SRS, 2000 MAR p. 2023, Eff. 7/28/00; AMD, 2011 MAR p. 1722, Eff. 8/26/11.

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