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(1) "Home health agency" means an entity licensed by the Montana Department of Public Health and Human Services, certified by Medicare, and enrolled as a Medicaid provider.

(2) "Home health aide services" means services of a certified home health aide to assist with routine care not requiring specialized nursing skills and supervised by a licensed registered nurse.

(3) "Home health services" means services provided by a home health agency to a member, on a part-time or intermittent basis for the purposes of postponing or preventing institutionalization.

(a) Home health services include:

(i) skilled nursing services;

(ii) home health aide services;

(iii) physical therapy services;

(iv) occupational therapy services;

(v) speech therapy services;

(vi) disposable medical supplies for the purposes of the visit; and

(vii) medical supplies, equipment, and appliances suitable for use in any setting in which normal life activities take place and as provided in ARM 37.86.1801.

(b) Home health services do not include:

(i) personal care services as provided at ARM Title 37, chapter 40, subchapter 11;

(ii) Community First Choice services provided in ARM Title 37, chapter 40, subchapter 10;

(iii) visits made by a registered nurse for evaluating the home health needs of a member or to review the provision of home health services by a home health aide or a licensed practical nurse; and

(iv) maintenance therapy as provided at ARM Title 37, chapter 86, subchapter 6.

(4) "Home health services visit" means a personal contact with the member in a place of service for the purpose of providing a covered home health service.

(5) "Place of service" means the setting in which normal life activities take place.

(a) Place of service does not include a hospital, a nursing facility, or an intermediate care facility for individuals with intellectual disabilities.

(6) "Skilled nursing services" means professional nursing services, as defined in the Montana Nurse Practice Act, that are medically necessary to treat health care problems, provided health teaching, and/or provide health counseling.


History: 53-6-113, MCA; IMP, 53-6-101, 53-6-131, MCA; NEW, 1980 MAR p. 1761, Eff. 6/27/80; AMD, 1981 MAR p. 690, Eff. 7/17/81; AMD, 1983 MAR p. 863, Eff. 7/15/83; AMD, 1986 MAR p. 2017, Eff. 1/1/87; AMD, 1989 MAR p. 1285, Eff. 9/1/89; AMD, 1995 MAR p. 1182, Eff. 7/1/95; AMD, 1997 MAR p. 1042, Eff. 6/24/97; TRANS, from SRS, 2000 MAR p. 489; AMD, 2019 MAR p. 141, Eff. 1/26/19.

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