Montana Code Annotated 2023

TITLE 53. SOCIAL SERVICES AND INSTITUTIONS

CHAPTER 6. HEALTH CARE SERVICES

Part 4. Home and Community-Based Long-Term Care Medicaid Services

Fiscal Accountability For Home And Community-Based Services -- Report To Legislature

53-6-406. Fiscal accountability for home and community-based services -- report to legislature. (1) (a) A provider of home and community-based services shall submit cost information to the department each year if personal assistance, community supports, private-duty nursing, or attendant services or supports are funded:

(i) as a state plan service;

(ii) through a medicaid state plan option available to the state under 42 U.S.C. 1396n(k); or

(iii) under a home and community-based services waiver that is operated through a division of the department that administers home and community-based services.

(b) The information provided to the department must reflect costs incurred during the provider's most recent fiscal year.

(2) The department shall develop a standardized format for the information that includes the recognized revenues and expenditures incurred by providers.

(3) The department shall analyze cost information submitted by providers to determine at a minimum:

(a) the reasonable cost of providing the home and community-based services detailed in the report;

(b) the percentage of a provider's cost represented by payment of wages and benefits for direct-care employees; and

(c) the level of profit or loss that each provider incurred in delivering the service. The profit or loss must be determined by comparing the recognized cost of providing the service with the medicaid reimbursement provided for the same service.

(4) The department shall establish protocols to protect provider-specific confidential data from public disclosure.

(5) By September 1 of the year preceding a regular legislative session, the department shall report to the children, families, health, and human services interim committee in accordance with 5-11-210 on all information in this section.

History: En. Sec. 2, Ch. 324, L. 2015; amd. Sec. 1, Ch. 59, L. 2023.