This chapter establishes billing, reimbursement, and payment rate rules for providers of residential alcohol and drug treatment services for indigent juveniles in Montana. Providers must submit claims within 30 days of the last treatment date, accept the department's set rate ($110/day, up to 40 days) as payment in full, and promptly refund any erroneous payments. Reimbursement is contingent on available appropriated funds, and the department will notify relevant parties when funds are exhausted.
View official source37.25.201 BILLING, REIMBURSEMENT AND PROCESSING The department shall make payments directly to the provider, subject to the following conditions and limitations: (1) Providers shall submit claims for reimbursement on the forms provided by the department. The claim shall be submitted within 30 days of the last day treatment was provided to the juvenile in the facility. (2) Providers shall be reimbursed according to the rates set forth in ARM 37.25.210 . The provider will accept payment in accordance with ARM 37.25.210 as payment in full. (3) The department will not reimburse the provider for any services other than alcohol and drug treatment. Authorizing statute(s): Sec. 41-3-1103 , MCA Implementing statute(s): Sec. 41-3-1103 , MCA History: NEW, 1985 MAR p. 1251, Eff. 8/30/85; TRANS, from Dept. of SRS, 1987 MAR p. 1492, Eff. 7/1/87; TRANS, from DFS, 1997 MAR p. 2295. 37.25.205 ERRONEOUS OR IMPROPER PAYMENTS (1) The department is entitled to promptly recover all payments erroneously or improperly made to a provider. (2) The provider shall notify the department of any erroneous or improper payment and shall promptly refund the entire amount of any erroneous or improper payment. Authorizing statute(s): Sec. 41-3-1103 and 53-2-108 , MCA Implementing statute(s): Sec. 41-3-1103 , MCA History: NEW, 1985 MAR p. 1251, Eff. 8/30/85; TRANS, from Dept. of SRS, 1987 MAR p. 1492, Eff. 7/1/87; TRANS, from DFS, 1997 MAR p. 2295. 37.25.210 RATES (1) The department will pay providers the usual and customary charges or the rates set forth in this rule, whichever is lower. (2) The rate for residential alcohol and drug treatment for indigent juveniles shall be $110.00 per day for each day of care actually provided, not to exceed 40 days of care. The department shall pay for the day the juvenile enters the treatment facility, but not the day the juvenile leaves the facility. Authorizing statute(s): Sec. 41-3-1103 , MCA Implementing statute(s): Sec. 41-3-1103 , MCA History: NEW, 1985 MAR p. 1251, Eff. 8/30/85; TRANS, from Dept. of SRS, 1987 MAR p. 1492, Eff. 7/1/87; TRANS, from DFS, 1997 MAR p. 2295. 37.25.215 UNAVAILABILITY OF FUNDS (1) Payments for residential alcohol and drug treatment for indigent juveniles are subject to the availability of funds appropriated for that purpose. (2) When the entire amount of the appropriation has been accrued in any fiscal year, the department will no longer accept applications for residential alcohol and drug treatment for indigent juveniles. (3) The department shall send written notice to the youth courts, probation officers, department of corrections and the residential alcohol and drug treatment facilities when the entire amount of the appropriation has been accrued for the fiscal year. (4) All providers who are providing residential alcohol and drug treatment to eligible indigent juveniles at the time of receiving the notice that the appropriated funds have been exhausted will be reimbursed for the treatment of those juveniles who have been determined eligible for benefits by the department and are receiving treatment at the time of notice. The provider shall be reimbursed according to the terms and conditions set forth in ARM 37.25.210 . Authorizing statute(s): Sec. 41-3-1103 , MCA Implementing statute(s): Sec. 41-3-1103 , MCA History: NEW, 1985 MAR p. 1251, Eff. 8/30/85; TRANS, from Dept. of SRS, 1987 MAR p. 1492, Eff. 7/1/87; TRANS, from DFS, 1997 MAR p. 2295.