Montana Administrative Code

37.55.505 NON-ELIGIBLE SERVICES The cost of the following services and supplies is not eligible for payment from ESRD: attendant or back-up person; drugs not specifically listed in ARM 37.55.502 as eligible medications; transportation for anyone other than a cadaveric transplant …

37.55.701 DOCUMENTATION OF CLAIMS A claim for ESRD reimbursement, in order to be reimbursable, must contain, or be accompanied by, the documentation required by this rule. Each claim for any reimbursable service or supply must contain: the patient's name and address; and the prov…

37.55.702 CONDITIONS OF CLAIM PAYMENT Payment of a claim will be made only when the amount payable by ESRD exceeds $20. Payment will be made, subject to (5) below, directly to the provider for that portion of the cost of eligible services or supplies which does not exceed either …

37.55.705 PRIORITY OF PAYMENT To the extent of the ESRD appropriation for a given fiscal year, bills received by the department during that fiscal year will be paid according to the date ESRD receives them, the first bills received being the first paid. Authorizing statute(s): Se…

37.57.1001 MATERNAL AND CHILD HEALTH BLOCK GRANT: STANDARDS FOR RECEIPT OF FUNDS In order for any county or other local entity to receive federal maternal and child health (MCH) block grant funding from the department, that entity must contractually agree to the following: MCH bl…

37.57.101 PURPOSE OF RULES The purpose of the children's special health services program rules is to provide treatment and enabling services for children and youth with special health care needs. Authorizing statute(s): 50-1-202, MCA Implementing statute(s): 50-1-202, MCA History…

37.57.102 DEFINITIONS Unless otherwise indicated, the following definitions apply throughout this subchapter: "Applicant" means a child or youth with special health care needs (CYSHCN) who has applied or whose parent or guardian has applied on the child's behalf to receive childr…

37.57.105 GENERAL REQUIREMENTS FOR CSHS FINANCIAL ASSISTANCE In order to receive CSHS financial assistance for a particular benefit a CYSHCN must meet the eligibility requirements of ARM 37.57.106. Authorizing statute(s): 50-1-202, MCA Implementing statute(s): 50-1-202, MCA Histo…

37.57.106 ELIGIBILITY FOR CSHS FINANCIAL ASSISTANCE Eligibility criteria for CSHS financial assistance are: an individual under the age of 22 who meets the definition of a child or youth with special health care needs (CYSHCN); a resident of the state of Montana and either a U.S.…

37.57.109 APPLICATION PROCEDURE FOR CSHS FINANCIAL ASSISTANCE A person who desires CSHS financial assistance for a CYSHCN must submit a completed CSHS financial assistance application, along with required supporting documents. This application is available by contacting CSHS at 1…

37.57.110 CONDITIONS AND SERVICES FOR CSHS FINANCIAL ASSISTANCE (REPEALED) Authorizing statute(s): 50-1-202, MCA Implementing statute(s): 50-1-202, MCA History: NEW, 1990 MAR p. 1256, Eff. 6/29/90; AMD, 1992 MAR p. 919, Eff. 5/1/92; AMD, 1994 MAR p. 1836, Eff. 7/8/94; TRANS, from…

37.57.111 PAYMENT LIMITS AND REQUIREMENTS The department will provide financial assistance for a CSHS-eligible CYSHCN with a covered condition: if the benefit is not covered by another payment source, with the exception of the Indian health service (IHS), which is a payer of last…

37.57.112 INFORMAL RECONSIDERATION PROCEDURE A CYSHCN who has been denied eligibility for CSHS, a provider who has been denied reimbursement for services or covered benefits, or anyone who is otherwise adversely affected by denial for CSHS financial assistance may have informal r…

37.57.117 CSHS PROVIDERS RECEIVING CSHS FUNDS: REQUIREMENTS In order to be a CSHS provider for a CSHS client, a provider must meet the following requirements: A physician or surgeon must: be currently licensed by the state of Montana pursuant to Title 37, chapter 3, MCA, or curre…

37.57.118 PROGRAM RECORDS The department will retain specialty clinic participants case files of CSHS services provided for a client for a period of five years after the child reaches the age of 18 as set forth in the Montana Secretary of State records retention schedule, records…

37.57.125 ADVISORY COMMITTEE (REPEALED) Authorizing statute(s): Sec. 50-1-202, MCA Implementing statute(s): Sec. 50-1-202, MCA History: NEW, 1990 MAR p. 1256, Eff. 6/29/90; AMD, 1992 MAR p. 919, Eff. 5/1/92; AMD, 1994 MAR p. 1836, Eff. 7/8/94; TRANS, from DHES, 2001 MAR p. 398; R…

37.57.301 DEFINITIONS As used in this subchapter, the following definitions apply: "Health care facility" means a hospital or other facility licensed by or located in the state of Montana for the purpose of providing health care services, and which provides primary health care se…

37.57.304 NEWBORNS HOSPITALIZED FOR NEONATAL INTENSIVE CARE If a newborn is hospitalized for neonatal intensive care, a specimen of its blood must be taken for testing prior to nonrespiratory treatment and no later than 48 hours of age, unless medically contraindicated, in which …

37.57.305 NEWBORNS OTHER THAN THOSE HOSPITALIZED FOR NEONATAL INTENSIVE CARE For newborns not requiring neonatal intensive care, the required blood specimen must be taken between 24 and 48 hours of age. In the event the newborn is discharged from a health care facility prior to 2…

37.57.306 TRANSFER OF NEWBORN INFANT In the event of transfer of a newborn from one health care facility to another, or from a place of birth that is not a health care facility to a health care facility, a screening blood specimen must be taken and submitted by the receiving heal…

37.57.307 INFANT BORN OUTSIDE HEALTH CARE FACILITY When an infant is born outside of a health care facility and is not subsequently transferred to a health care facility for initial newborn care, it is the responsibility of one of the persons designated in 50-15-221(4)(a), (b), a…

37.57.308 NEWBORN EYE TREATMENT A physician, nurse-midwife, or any other person who assists at the birth of any newborn must, within the time limit stated in (3), instill or have instilled into each conjunctival sac of the newborn, erythromycin (0.5%) ophthalmic ointment or drops…

37.57.315 TRANSFUSION: WHEN BLOOD SPECIMEN TAKEN If a newborn needs a transfusion, blood specimens for the tests required by this subchapter must be taken before the transfusion takes place unless medically contraindicated. If the newborn is transfused prior to collection of the …

37.57.316 REPORTING SCREENING RESULTS If screening results on an infant's blood specimen are within the expected or normal range the department will report the results to the submitter of the specimen and, in addition, to the infant's healthcare provider(s) upon request. If the i…

37.57.320 RESPONSIBILITIES OF REGISTRAR OF BIRTH: ADMINISTRATOR OF HEALTH CARE FACILITY Each person in charge of any health care facility and each person responsible under ARM 37.57.307 for a birth occurring outside a health care facility must: ensure that a blood specimen is tak…

37.57.321 STATE LABORATORY Only those newborn screening blood tests performed by the department laboratory or a laboratory approved by the department meet the requirements of 50-19-201, 50-19-202, 50-19-203, and 50-19-204, MCA. Dried blood specimens remaining after newborn screen…

37.57.401 DEFINITIONS "Health care provider" means a person licensed in the state of Montana to provide health care services to pregnant women and/or newborn infants and who is the primary health care provider in attendance at the birth of a newborn infant born outside of a hospi…

37.57.403 NEWBORN HEARING SCREENING EDUCATION Each licensed hospital and health care facility shall provide education to the parents of any newborn born in the hospital or health care facility or transferred to the hospital or health care facility from the newborn's place of birt…

37.57.406 NEWBORN HEARING SCREENING - REFERRALS FOR NEWBORNS BORN OUTSIDE OF HOSPITALS OR HEALTH CARE FACILITIES Each health care provider who is required to provide newborn hearing screening education shall also provide referral information to the parents of any newborn who was …

37.57.407 NEWBORN HEARING SCREENING PROTOCOLS - HOSPITALS AND HEALTH CARE FACILITIES Each licensed hospital or health care facility that provides obstetric services shall establish a newborn hearing screening program in order to ensure that a hearing screening is provided for eac…

37.57.410 REPORTING NEWBORN HEARING SCREENING RESULTS - PARENTS - PRIMARY CARE PROVIDERS The hospital or health care facility shall document all hearing screening results in the newborn's chart and shall provide the hearing screening results to the parents of the newborn on the n…

37.57.413 REPORTING TO THE DEPARTMENT REGARDING NEWBORN HEARING SCREENING AND EDUCATION Each hospital and health care facility required to provide newborn hearing screenings must make a report to the department each month using the department's designated reporting software regar…

37.57.414 HEALTH CARE PROVIDERS - REPORTING TO THE DEPARTMENT REGARDING EDUCATION AND REFERRAL INFORMATION Each licensed health care provider in attendance at any birth occurring outside a hospital or health care facility shall file a report with the department that documents: th…

37.57.415 AUDIOLOGISTS - REPORTING OF AUDIOLOGICAL ASSESSMENTS TO DEPARTMENT - PARENTAL CONSENT FOR REFERRAL TO THE MONTANA SCHOOL FOR THE DEAF AND BLIND Each licensed audiologist to whom an infant is referred for audiological assessment following a newborn hearing screening shal…

37.59.101 PURPOSE OF RULES The purpose of the rules in subchapters 1 and 2 is to provide a clear procedural framework under which the department administers the federal Special Supplemental Nutrition Program for Women, Infants, and Children (WIC Program), which is sponsored by th…

37.59.102 DEFINITIONS Unless otherwise indicated, the following definitions apply throughout this chapter: "Administrative and program services costs" means those direct and indirect costs, exclusive of food costs, as defined in 7 CFR 246.14(c), which the department determines to…

37.59.105 INCORPORATIONS BY REFERENCE This chapter of ARM Title 37 establishes a state WIC Program which is essentially the equivalent of the federal WIC Program. Where the department has adopted a federal regulation by reference, the following applies: References in the federal …

37.59.109 PROGRAM ADMINISTRATION AND GUIDANCE As the state agency to which the United States Department of Agriculture (USDA) has delegated the administration of the WIC Program, the department is responsible for the effective and efficient administration of the program in accord…

37.59.110 NUTRITION SERVICES STANDARDS Local agency staff will provide participants with nutrition services developed and defined in the state plan, including the following: a complete nutrition assessment including hematological and anthropometric measures as indicated; CPA-iden…

37.59.201 SELECTION OF LOCAL AGENCIES In selecting new local agencies, the department will apply the criteria in 7 CFR 246.5(a) through (f) together with the following criteria: whether the program is located to be accessible to participants; whether the program exhibits sufficie…

37.59.202 AGREEMENTS WITH LOCAL AGENCIES The department adopts and incorporates by reference 7 CFR 246.6, which is a federal agency rule setting forth terms and requirements for agreements between the department and local agencies. Copies of 7 CFR 246.6 may be obtained from the D…

37.59.203 PERIODIC REVIEW AND DISQUALIFICATION OF LOCAL AGENCIES The department will conduct periodic reviews of the qualifications of authorized local agencies under its jurisdiction. In conducting such reviews, the department will consider the program's history of prior program…

37.59.301 REQUIREMENTS FOR STATE AGENCY SELECTION OF RETAILERS AND FARMERS In selecting retailers to participate in the program, the state WIC agency will apply the requirements of 7 CFR 246.12(e) through (v), and the following criteria: whether the place of the retailer's busine…

37.59.302 AGREEMENTS WITH RETAILERS AND FARMERS The department adopts and incorporates by reference 7 CFR 246.12(h) and (v), which is a federal agency rule setting forth terms and requirements for agreements between the department and retailers and farmers. Copies of this documen…

37.59.303 PERIODIC REVIEW AND DISQUALIFICATION OF RETAILERS AND FARMERS The department (or local agency in consultation with the department), before re-authorization, will conduct periodic reviews of the operations of participating retailers and farmers, as described in the state…

37.59.401 APPEALS BY PROGRAM PARTICIPANTS An individual who has been denied participation or been disqualified from the program by the local agency may request a fair hearing by contacting either the local agency or the department no later than 60 days after the local agency's ad…

37.59.402 APPEALS BY LOCAL AGENCIES, RETAILERS, AND FARMERS A local agency, retailer, or farmer which is denied participation or, during the course of a contract or agreement, is disqualified or its participation is otherwise adversely affected may request a fair hearing before t…

37.62.101 AUTHORITY, POLICY AND PURPOSE These guidelines are promulgated under the authority of 40-5-209.htm" target="MCA" style="text-decoration:none">40-5-209 , MCA, for the purpose of establishing a standard to be used by the district courts, child support enforcement agencies…

37.62.102 REBUTTABLE PRESUMPTION The guidelines create a presumption of the adequacy and reasonableness of child support awards. However, every case must be determined on its own merits and circumstances and the presumption may be rebutted by evidence that a child's needs are or …

37.62.103 DEFINITIONS For purposes of this chapter, unless the context requires otherwise, the following definitions apply: "Actual income" is defined in ARM 37.62.105. "CSSD" means the Child Support Services Division of the Department of Public Health and Human Services. "Depart…