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Home & Community Based Services Policy Manual

Home and Community Based Services Program Policy Manual

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 SDMI-HCBS 001 - TABLE OF CONTENTS

Section/Subsection

Title/Content

Issued/Revised

  001 Indexes - Contents Index 02/2016
  002 Introduction - Recovery 11/2014
  003 Prefix - Definitions 02/05/2014
  004 Appendix - Abbreviations/Acronyms/Initials 02/06/2014

100

Introduction

 
  101 Manual Program 02/06/2014
  103 Program Goals 02/06/2014
  104 Eligibility Requirements for SDMI and Legal Requirements 05/06/2014

200 - 300

Medicaid Program Description, General Program Administration

 

  201 Organizational Responsibilities 02/06/2014
  202 Medicaid Overview 02/06/2014
  203 Medicaid Services 02/06/2014
  204 Relationship of Medicaid and Medicare 02/06/2014
  205 Fair Hearings 02/28/2014
  206 Third Party Liability (TPL) 02/28/2014
  207 Fraud and Abuse 02/28/2014
  208 Surveillance and Utilization Review 02/28/2014
  209 Medicaid Management Information System (MMIS) 02/28/2014
  210 Medicaid Eligibility Requirements 02/28/2014
  211 Beneficiary Identification 02/28/2014
  212 Team Care 02/28/2014
  213 Co-payments 02/28/2014
  214 Freedom of Choice 02/28/2014
  301 Civil Rights 02/28/2014
  302 Release of Information/Confidentiality/HIPAA 02/28/2014
  304 Notification of Suspected Abuse or Neglect 02/28/2014
  305 Serious Occurrence Report 03/04/2010
  305a SOR Form 09/01/2010
  306 Principles of Charting 10/01/2008
  308 Program Description Quality Assurance Process 06/2014
  309 Request for Case Review 06/2014
  309a Request for Case Review form 09/01/2010

400

Eligibility for Services

 
  401 Home and Community Based Services Eligibility Requirements 07/19/2016
  402 Referral Procedures 02/21/2014
  403 Prior Authorization by the Mental Health Services Bureau 02/21/2014
  404 Termination of Services / Adverse Actions 12/2014
  405 Referrals for Service 02/21/2014
  406 Waiting List Criteria 02/27/2014
  410 Retainer Payments 08/2015
  410a Retainer Payments - Attachment A 07/01/2012

599-1

Screening

 
  599-1 Screening Determination (Word) 12/2014

600

Administrative Requirements

 
  601 Provider Eligibility 10/2014
  602 Provider Responsibilities 10/2014
  603 Provider Enrollment 10/2014
  604 Payment Requirements 02/21/2014
  604-1 Payment Made to Legally Responsible Individuals 10/2014
  605 Payment Processing 10/2014
  606 Reimbursement Methodology 10/2014
  607 Licensure Requirements 10/2014
  608 Quality Assurance Process 06/2014
  608 form Provider Prepared Standards - Full Review Form 04/2013
  699-1 General Medicaid Services - Administrative Rule 01/2007
  699-1 General Medicaid Services 12/2007
  699-2 Health Insurance Claim Form 12/2007
  699-3 File Transfer 10/2014
  699-4 Referral for Services (699-4) 10/2014
  699-5 Referral for Services (699-5) 10/11/2010

700

Services

 
  701 Covered Services 08/2016
  702 Service Limitations and Exclusions 05/15/2014
  703 Adult Day Health 05/15/2014
  704 Residential Habilitation 12/2014
  705 Personal Emergency Response System 12/01/2014
  706 Community Transition 05/15/2014
  707 Substance Use Related Disorders Counseling 05/15/2014
  710 Participant Direction of Services 05/15/2014
  712 Habilitation Services 03/2016
  713 Environmental Accessibility Adaptations 03/2016
  714 Health and Wellness 07/01/2015
  715 Homemaker 07/2017
  718 Nonmedical Transportation 12/2014
  719 CompanioServices 07/01/2015
  720 Nutrition 07/01/2015
  721 Pain and Symptom Management 05/15/2014
  722 Overnight Supports 12/2014
  725 Respite Care 12/2014
  727 Personal Assistance Services 12/01/2014
  728 Specialized Medical Equipment 04/05/2016
  729 Specially Trained Attendant 01/2016
  730 Peer Support 01/2016
  731 Life Coach 02/2016
  732 Supported Living 06/2014
  734 Wellness Recovery Action Plan 05/2014
  735 Private Duty Nursing 10/2017
  799-1 HCBS Administrative Rules of Montana 01/2012

800 - 900

Case Management System

 
  802 Case Management Team Requirements 01/2011
  804 Records Requirements 07/2016
  809-1 Person-Centered Recovery Plan: Development 08/2015
  809-2 Person-Centered Recovery Plan: Components 07/2016
  809-3 Person-Centered Recovery Plan: Requirements 02/27/2014
  809-4 Person-Centered Recovery Plan: Costs 02/27/2014
  809-5 Case Management Responsibilities 02/2017
  811 Year-End Money 02/28/2014
  812 Monthly Utilization Report - 812 02/28/2014
  813 Monthly Utilization Report - 813 02/28/2014
  814 Medication Monitoring Process and Requirements 10/2017
  814a Wellness and Monitoring Form 02/28/2014
  899-02 Chart Audit Form 02/27/2014
  899-02a Monthly Utilization Report 12/2008
  899-06 Entrance / Discharge Form 02/27/2014
  899-07 Request for Level of Care 02/27/2014
  899-08 Level of Care Determination (DPHHS-AMDD-86) Instructions 02/28/2014
  899-08a Level of Care Determination Form 02/28/2014
  899-11 Person-Centered Recovery Plan Short Form (DPHHS-AMDD-135B) Instructions -11 02/27/2014
  899-11a Person-Centered Recovery Plan Short Form (DPHHS-AMDD-135B) Instructions - 11a 02/24/2014
  899-11b Plan of Care Short Form 02/28/2014
  899-12 Intake Sheet 02/28/2014
  899-13 Discharge Sheet 02/28/2014
  899-14 Authorized Services for Incurment (DPHHS-AMDD-131) 02/28/2014
  899-14a Authorized Services for Incurment 02/28/2014
  899-15 Reevaluation Form 02/28/2014
  899-17 Psychosocial Summary (DPHHS-AMDD-143) Instructions 02/28/2014
  899-18 Letter of Notification 02/28/2014
  899-19 Level I Screen (DPHHS-AMDD-145) Instructions 02/28/2014
  899-19a Level I Screen 02/28/2014
  899-20 Waiting List Criteria Tool (DPHHS-AMDD-146) Instructions 5/2009
  899-20a Waiting List Criteria Tool 02/28/2014
  899-22 Request for Prior Authorization (DPHHS-AMDD-149) Instructions 02/28/2014
  899-22a Request for Prior Authorization 02/28/2014
  913 Screening for Abuse and Risk 08/2015
  914 Initial Screening Assessment 03/2015
  914a Risk Assessment Screening Tool 03/2015
  915 Risk Prevention and Management Plan 08/2015
  915a Risk Prevention and Management Form 09/2016
  916 Risk Negotiation Agreement Procedure and Form 04/2015