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Current as of April 27, 2021 | Updated by FindLaw Staff
(1) All individuals enrolled in the program must be provided with a full written explanation of all fee-for-service and managed health care plan options as provided by rule. The department shall provide to enrollees, upon enrollment in the program and at least annually, notice of the process for requesting an appeal under the department's administrative appeal procedures. The department shall maintain a toll-free telephone number for program enrollees' use in reporting problems with managed health care entities.
(2) If an individual becomes eligible for participation in the program while the individual is hospitalized, the department may, but is not required to, enroll the individual in the program prior to the individual's discharge from the hospital. This subsection does not apply to a newborn infant whose mother is enrolled in the program.
(3) The department shall, by rule, establish rates for managed health care entities that:
(a) are in accordance with federal requirements and with the department's current payment system;
(b) take into account any difference of cost to provide health care to different populations based on age and eligibility category. The rates for managed health care entities must be determined on a capitated basis.
(c) are based on treatment settings reasonably available to enrollees.
Cite this article: FindLaw.com - Montana Title 53. Social Services and Institutions § 53-6-706. Requirements relating to enrollees - last updated April 27, 2021 | https://codes.findlaw.com/mt/title-53-social-services-and-institutions/mt-code-ann-sect-53-6-706/
FindLaw Codes may not reflect the most recent version of the law in your jurisdiction. Please verify the status of the code you are researching with the state legislature or via Westlaw before relying on it for your legal needs.
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