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

(2) A home health agency must be:

(a) licensed by the Montana department of public health and human services;

(b) medicare certified; and

(c) an enrolled medicaid provider.

(3) Home health services may be provided by providers located outside of the borders of the state of Montana only if the service meets the requirements of ARM 37.85.207 (3) and the service is prior authorized by the department or the department's designee.

(4) Home health services must be:

(a) ordered by the recipient's attending physician;

(b) part of a written plan of care; and

(c) reviewed and renewed by the recipient's attending physician at a minimum of 60 day intervals.

(5) The provider must maintain documentation that the recipient meets the homebound definition.

(6) Written physician orders, care plans and other recipient records must be current and available upon request of the department or its designated representative.

(7) Home health services, except skilled nursing services, are limited to a combined maximum of 100 visits per recipient per fiscal year. Skilled nursing services are limited to 75 visits per recipient per fiscal year.

(a) The department may, within its discretion, authorize additional visits in excess of this limit. Any services exceeding this limit must be prior authorized by the department or the department's designee.

(8) Home health aide services are subject to the following limitations:

(a) Home health aide services must be prior authorized by the department or the department's designee.

(b) Home health aide services must be provided under the supervision of a registered professional nurse and in accordance with a written plan of treatment established by a physician.

(c) A person receiving personal care attendant services may not receive home health aide services.