Montana Code Annotated 2023



Part 1. Medical Assistance -- Medicaid


53-6-165. Definitions. As used in this part, unless expressly provided otherwise, the following definitions apply:

(1) "Department" means the department of public health and human services provided for in 2-15-2201.

(2) "Financial institution" means any organization in the business of moving, investing, or lending money, dealing in financial instruments, or providing financial services, including but not limited to federally chartered and state-chartered banks, savings and loan associations, and credit unions.

(3) "Recipient" means an individual who has been determined by a medicaid agency to be eligible for medicaid benefits, whether or not the individual has actually received a benefit, or an individual who has received benefits, whether or not that person has been determined to be eligible.

(4) (a) "Recoverable medical assistance" means a payment pursuant to this part, including but not limited to a payment made for items or services provided to and insurance premiums, deductibles, and coinsurance paid on behalf of a recipient who:

(i) during the recipient's lifetime, was an inpatient in a nursing facility, intermediate care facility for the developmentally disabled, or institution for mental disease and, with respect to that institutionalization, the department determined under 53-6-171 that the person was not reasonably expected to be discharged and return home; or

(ii) was at least 55 years of age or younger if allowed by 42 U.S.C. 1396p, as may be amended, when the item or service was provided or when the insurance premium, deductible, or coinsurance was paid.

(b) The term does not include medical assistance for medicare cost sharing or for benefits described in 42 U.S.C. 1396a(a)(10)(E).

(5) "Recovery" means legal action brought for the payment or repayment of recoverable medical assistance or amounts of money paid for other purposes.

History: En. Sec. 1, Ch. 492, L. 1995; amd. Sec. 2, Ch. 403, L. 2003; amd. Sec. 2, Ch. 153, L. 2009.