BEFORE THE DEPARTMENT OF PUBLIC

HEALTH AND HUMAN SERVICES OF THE

STATE OF MONTANA

In the matter of the amendment of ARM 37.86.2402 pertaining to preferred hospital transportation reimbursement

) ) ) ) )

NOTICE OF PROPOSED AMENDMENT   NO PUBLIC HEARING CONTEMPLATED

TO: All Interested Persons

1. On August 16, 2008, the Department of Public Health and Human Services proposes to amend the above-stated rule.

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 who need an alternative accessible format of this notice. If you need an accommodation, contact the department no later than 5:00 p.m. on July 30, 2008. Please contact Rhonda Lesofski, Office of Legal Affairs, Department of Public Health and Human Services, P.O. Box 4210, Helena MT 59604-4210; telephone (406)444-5622; fax (406)444-1970; e-mail dphhslegal@mt.gov.

3. The rule as proposed to be amended provides as follows. New matter is underlined. Matter to be deleted is interlined.

37.86.2402 TRANSPORTATION AND PER DIEM, REQUIREMENTS

(1) and (2) remain the same.

(3) Coverage for transportation and per diem is only available for transportation and per diem to the site of medical services at the provider closest to the locality of the recipient or to a preferred out-of-state hospital Center of Excellence, as defined in ARM 37.86.2901, if prior authorization requirements have been met.

(a) through (15)(h) remain the same.

AUTH: 53-6-113, MCA

IMP: 53-6-101, 53-6-141, MCA

4. The Department of Public Health and Human Services (the department) is proposing an amendment to ARM 37.86.2402, pertaining to Medicaid transportation and per diem, requirements. The proposed rule change is necessary to bring Medicaid transportation and per diem provisions into conformity with the proposed designation of certain out-of-state health care providers as "Centers of Excellence" to be effective October 1, 2008. For information about the proposed rate methodology, please see MAR Notice No. 37-435.

The alternative to the proposed amendment would be to make no changes to the existing rule. Leaving ARM 37.86.2402 unchanged would adversely result in transportation and per diem charges the department would be unable to pay. In order to fairly implement the proposed "Centers of Excellence" rules, the department has rejected the no change option.

The proposed amendments have no effect on Medicaid benefits or expenditures that have not been considered in MAR Notice No. 37-435.

There are approximately 100 Medicaid recipients who could be affected by the proposed amendments annually.

5. This rule amendment is proposed to be effective October 1, 2008.

6. Interested persons may submit comments concerning the proposed action in writing to Rhonda Lesofski, Office of Legal Affairs, Department of Public Health and Human Services, P.O. Box 4210, Helena 59604-4210; by fax (406)444-1970; or by e-mail to dphhslegal@mt.gov. no later than 5:00 p.m. on August 14, 2008. Comments may also be faxed to (406)444-1970 or e-mailed to dphhslegal@mt.gov. The department maintains lists of persons interested in receiving notice of administrative rule changes. These lists are compiled according to subjects or programs of interest. To be included on such a list, please notify this same person.

7. If persons who are directly affected by the proposed action wish to comment orally or in writing at a public hearing, they must make a written request for a public hearing and submit such request with any written comments to Rhonda Lesofski, Office of Legal Affairs, Department of Public Health and Human Services, P.O. Box 4210, Helena MT 59604-4210; by fax (406)444-1970; or by e-mail to dphhslegal@mt.gov no later than 5:00 p.m. on August 14, 2008.

8. If the Department of Public Health and Human Services receives requests for a public hearing on the proposed action from either 10% or 25, whichever is less, of those who are directly affected by the proposed action; from the administrative rule review committee of the Legislature; from a governmental subdivision or agency; or from an association having not less than 25 members who will be directly affected, a hearing will be held at a later date. Notice of the hearing will be published in the Montana Administrative Register. Ten percent of those directly affected has been determined to be ten based on the 100 Medicaid recipients who could be affected by the proposed amendments annually.

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 this 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. The web site may be unavailable at times, due to system maintenance or technical problems.

10. The bill sponsor notice requirements of 2-4-302, MCA, do not apply.  

/s/ John Koch________________               /s/ Joan Miles_________________

Rule Reviewer                                                  Director, Public Health and Human Services

Certified to the Secretary of State July 7, 2008.