Montana Medicaid Expansion (HELP Program) Waiver Submission – August 2019

Public Comments Due by August 23, 2019

The Montana Department of Public Health and Human Services (DPHHS) is providing public notice of its intent to: (1) submit to the Centers of Medicare and Medicaid Services (CMS), on or before August 30, 2019, a written 1115 Demonstration application to amend and extend the Health and Economic Livelihood Partnership (HELP) Demonstration Program and test new program features including work/community engagement requirements and a premium increase structure based on coverage duration; and (2) hold public hearings to receive comments on the 1115 Demonstration amendment and extension application.

In November 2015, CMS approved Montana’s Section 1115 Demonstration Waiver, “Montana Health Economic Livelihood Partnership (HELP) Demonstration,” that: expanded Medicaid coverage to newly eligible adults effective January 1, 2016; authorized 12 month continuous eligibility for all new adults; applied enrollee premiums equal to two percent of aggregate household income; and, instituted maximum co-payments allowable under federal law. The approved waiver also authorized the administration of Medicaid through a Third Party Administrator (TPA) for enrollees subject to premiums.

In December 2017, CMS approved an amendment to Montana’s Section 1115 Demonstration Waiver that maintained Medicaid expansion, 12 month continuous eligibility and premiums, but removed the authorization of the TPA and the premium credit that applied to some HELP enrollees’ cost-sharing obligations. The amended Demonstration is approved for the period from January 1, 2016 through December 31, 2020.

House Bill 658, the Medicaid Reform and Integrity Act, directs the Department of Public Health and Human Services (DPHHS or the Department) to request federal Demonstration approval to continue the state’s Medicaid expansion and to implement new Medicaid expansion program features. The Department is seeking to amend its Medicaid Section 1115 Waiver, Montana Health and Economic Livelihood Partnership (HELP) Demonstration Program, to: (1) condition Medicaid coverage on compliance with work/community engagement requirements; and (2) apply a premium structure that gradually increases enrollee premiums based on coverage duration. Read the full public notice.

Two public meetings will be held regarding the waiver. Members of the public may attend these meetings in person or via webinar.

  1. July 31, 2019 from 11:30 am to 1:30 pm at Billings Clinic, Conference Center, 2800 10th Ave North, Billings, Montana.

    Register to attend July 31 via webinar
  2. August 1, 2019 from 11:00 am to 1:00 pm at the Sanders Auditorium, 111 North Sanders, Helena, Montana.

    Register to attend August 1 via webinar

Please Note: If you registered for the July 15 or July 18, 2019 Public Hearing, you will need to re-register to attend the July 31, 2019 or August 1, 2019 Public Hearing.

You will receive instructions for joining the meeting upon registration. If special accommodations are needed, contact (406) 444-2584.

Public comments may be submitted until midnight on August 23, 2019. Questions or comments may be addressed care of Medicaid Expansion Extension, Director’s Office, PO Box 4210, Helena, MT 59604-4210, or by telephone to (406) 444-2584, or by electronic mail to dphhscomments@mt.gov. You will also have opportunity to officially comment during the federal public comment period after CMS finds the application and public notice requirements met.

A hard copy of the draft application and the public notice documents are available at the DPHHS Director’s Office, 111 North Sanders Street, Room 301, Helena, Montana.

CMS Waiver Approval Process