Mont. Admin. r. 37.86.3405

Current through Register Vol. 23, December 6, 2024

Rule 37.86.3405 - TARGETED CASE MANAGEMENT SERVICES FOR HIGH RISK PREGNANT WOMEN, COVERAGE

(1) Reimbursable targeted case management services for high risk pregnant women are:

(a) comprehensive assessment and periodic reassessment;

(b) care plan development;

(c) care coordination and referral for other services; and

(d) monitoring and follow up.

(2) Face-to-face comprehensive assessments must occur at least monthly during the pregnancy.

(3) Two post-partum reassessments must occur after the end of pregnancy and prior to the last day of the month in which the 12-month postpartum period occurs.

(4) Monitoring must include at least one annual monitoring to determine if the following conditions are met:

(a) services are being furnished in accordance with the member's care plan;

(b) services in the care plan are adequate; and

(c) changes in the needs or status of the member are reflected in the care plan.

Mont. Admin. r. 37.86.3405

NEW, 1991 MAR p. 1295, Eff. 7/26/91; TRANS, from SRS, 2000 MAR p. 481; AMD, 2017 MAR p. 1906, Eff. 10/14/2017; AMD, 2024 MAR p. 2021, Eff. 8/10/2024

AUTH: 53-6-113, MCA; IMP: 53-6-101, MCA