(1) These requirements are in addition to those contained in rule provisions generally applicable to Medicaid providers.

(2) Except as otherwise permitted by federal law, inpatient hospital services must be ordered by a physician or dentist licensed under state law.

(3) Inpatient hospital services include:

(a) bed and board;

(b) nursing services and other related services;

(c) use of hospital facilities;

(d) medical social services;

(e) drugs, biologicals, supplies, appliances, and equipment;

(f) other diagnostic or therapeutic items, or services provided in the hospital and not specifically excluded in ARM 37.85.207; and

(g) medical or surgical services provided by interns or residents-in-training in hospitals with teaching programs approved by the Council on Medical Education of the American Medical Association, the Bureau of Professional Education of the American Osteopathic Association, the Council on Dental Education of the American Dental Association or the Council on Podiatry Education of the American Podiatry Association.

(4) Clinical trials are limited to:

(a) Medicaid coverage of routine costs plus reasonable and necessary items and services used to diagnose and treat complications arising from participation in all qualifying clinical trials;

(b) trials that are directly funded or supported by centers or cooperating groups funded by the National Institutes of Health (NIH), Center for Disease Control (CDC), Agency for Healthcare Research and Quality (AHRQ), Department of Defense (DOD), or the Veterans Administration (VA); and

(c) clinical trial drugs, devices, and procedures are not reimbursable.

(5) Alcohol and drug detoxification services are limited to:

(a) detoxification services up to seven days, except that more than seven days may be covered if concurrently authorized by the department or the department's designated review organization and a hospital setting is required; or

(b) the department or the department's designated review organization determines that the client has a concomitant condition that must be treated in the inpatient hospital setting, and the alcohol and drug treatment is a necessary adjunct to the treatment of the concomitant condition.

(6) Inpatient hospital services provided outside the borders of the United States will not be reimbursed by the Montana Medicaid program.

(7) Inpatient hospital providers must comply with the applicable conditions of participation for hospitals as authorized in 42 CFR 482.

(8) Acute care psychiatric hospitals must comply with 42 CFR 440.160, 42 CFR 441 subpart D, and the applicable conditions of participation for hospitals as authorized in 42 CFR 482.