Montana Administrative Register Notice 37-841 No. 8   04/27/2018    
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In the matter of the amendment of ARM 37.79.326 pertaining to Healthy Montana Kids (HMK) Dental Benefits






TO: All Concerned Persons


            1. On May 17, 2018, at 11:00 a.m., the Department of Public Health and Human Services will hold a public hearing in Room 107 of the DPHHS Building, 111 N. Sanders, at Helena, Montana, to consider the proposed amendment of 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 need an alternative accessible format of this notice. If you require an accommodation, contact the Department of Public Health and Human Services no later than 5:00 p.m. on May 7, 2018, to advise us of the nature of the accommodation that you need. Please contact Gwen Knight, Department of Public Health and Human Services, Office of Legal Affairs, P.O. Box 4210, Helena, Montana, 59604-4210; telephone (406) 444-4094; fax (406) 444-9744; or e-mail dphhslegal@mt.gov.


3. The rule as proposed to be amended provides as follows, new matter underlined, deleted matter interlined:


37.79.326 DENTAL BENEFITS (1) remains the same.

            (2) Providers must bill for services using the procedure codes and modifiers set forth, and according to the definitions contained in the American Dental Association Manual of Current Dental Terminology (CDT 2017) (CDT 2018).

            (3) Effective July 1, 2017 2018, only the dental procedures listed at http://dphhs.mt.gov/hmk.aspx are benefits of the HMK coverage group Dental Program.

            (4) through (6) remain the same.


AUTH:  53-4-1004, 53-4-1005, 53-4-1009, 53-4-1105, MCA

IMP: 53-4-1003, 53-4-1004, 53-4-1005, 53-4-1009, 53-4-1104, 53-4-1105, MCA




Healthy Montana Kids (HMK) CHIP continues to follow the State of Montana Employee Dental Benefits as a benchmark for the Healthy Montana Kids dental benefit as stated in the Centers for Medicare and Medicaid Services (CMS) approved CHIP State Plan. The department proposes to update dental procedure codes, as needed, annually, as the state employee benchmark plan changes. This will reflect any new procedure code updates, code additions and deletions, or changes to existing code descriptions. Also included is an update to the Current Dental Terminology (CDT) code book reference from 2017 to 2018.


The proposed rule amendment would be effective July 1, 2018. All other rules regarding the HMK Dental Plan will remain the same.


CMS has approved the State Plan citing the State of Montana Employee Dental Benefits as a benchmark. The proposed changes will comply with the benchmark plan and 2018 CDT Dental Procedure Codes.


The State Employee Dental Benefit Plan (Delta Dental) issues a revised list of covered procedure codes each January 1. When Delta Dental releases the code file with deletions, additions, and changes to descriptions with a January effective date, the department reviews this file and applies any of the changes to the program. The department also reviews the new codes if they replace deleted ones or are an addition to existing codes currently covered. The department examines and makes appropriate changes to any descriptions of codes that may have resulted with the release of the file.




The proposed changes to this rule amendment should have no fiscal impact at this time. The proposed rule changes could affect an estimated 507 dental providers and 32,597 HMK members.


All dental providers would meet the criteria of a small business with less than 50 full-time employees as defined in Senate Bill 139. The amendment of this rule should have no impact on these small businesses.


The proposed rule amendments are necessary for the department to administer and maintain compliance with federal funding requirements.


            5. Concerned persons may submit their data, views, or arguments either orally or in writing at the hearing. Written data, views, or arguments may also be submitted to:  Gwen Knight, Department of Public Health and Human Services, Office of Legal Affairs, P.O. Box 4210, Helena, Montana, 59604-4210; fax (406) 444-9744; or e-mail dphhslegal@mt.gov, and must be received no later than 5:00 p.m., May 25, 2018.


6. The Office of Legal Affairs, Department of Public Health and Human Services, has been designated to preside over and conduct this hearing.


7. The department maintains a list of interested persons who wish to receive notices of rulemaking actions proposed by this agency.  Persons who wish to have their name added to the list shall make a written request that includes the name, e-mail, and mailing address of the person to receive notices and specifies for which program the person wishes to receive notices. Notices will be sent by e-mail unless a mailing preference is noted in the request. Such written request may be mailed or delivered to the contact person in 5 above or may be made by completing a request form at any rules hearing held by the department.


8. The bill sponsor contact requirements of 2-4-302, MCA, do not apply.


9. With regard to the requirements of 2-4-111, MCA, the department has determined that the proposed amendment of the above-referenced rule will not significantly and directly impact small businesses.


10. The department has determined that the proposed amendment is not appropriate for the performance-based measurement requirements of 53-6-196, MCA.



/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 April 17, 2018.


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