Quality Assurance Division

"Improving the Lives of Others"

Mission: Promote and protect the health, safety, and well being of people in Montana by providing responsive, independent assessment and monitoring of human services, through respectful relationships.

Services:

• Certifying health care services
• Licensing health care and residential services
• Licensing child care
• Detecting and investigating abuse and fraud committed by recipients of Supplemental Nutrition Assistance Program (SNAP), Temporary Assistance to Needy Families (TANF), Medicaid and  Low Income Energy Assistance Program (LIEAP)
• Recovering recipient overpayment claims for TANF, Medicaid and SNAP
• Performing federally mandated quality-control reviews of the Medicaid and SNAP
• Reducing Medicaid costs by identifying others responsible for paying a beneficiary's medical expenses
• Paying for beneficiary’s private health insurance when it is cost effective
• Conducting retrospective reviews of Medicaid provider claims
• Determining medical necessity for prior authorization of medical services and requests for durable medical equipment
• Maintaining a certified nurse aide registry
• Approving and monitoring nurse aide training programs
• Managing the marijuana program registry
• Certificate of Need program