- 2025
69th Legislature 2025 SB0072.2
- 1 - Authorized Print Version – SB 72
1 SENATE BILL NO. 72
2 INTRODUCED BY M. YAKAWICH
3 BY REQUEST OF THE CHILDREN, FAMILIES, HEALTH AND HUMAN SERVICES INTERIM COMMITTEE
4
5 A BILL FOR AN ACT ENTITLED: “AN ACT PROVIDING FOR PRESUMPTIVE ELIGIBILITY UNDER THE
6 MONTANA MEDICAID PROGRAM FOR CERTAIN HOME AND COMMUNITY-BASED SERVICES FOR
7 PERSONS WITH PHYSICAL DISABILITIES AND PERSONS WHO ARE ELDERLY; PROVIDING A
8 SCREENING PROCESS FOR PRESUMPTIVE ELIGIBILITY; AND STATING TERMS OF PRESUMPTIVE
9 ELIGIBILITY; AND PROVIDING DIRECTIONS TO THE DEPARTMENT OF PUBLIC HEALTH AND HUMAN
10 SERVICES.”
11
12 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MONTANA:
13
14 NEW SECTION. Section 1.
15 (1) (a) Presumptive eligibility under the Montana medicaid program for certain home and
16 community-based services may be granted to a person who has a physical disability or who is elderly upon
17 completion of the following:
18 (i) the screening process described in this section; and
19 (ii) authorization by the division of the department that administers long-term care services for
20 senior citizens and individuals with physical disabilities.
21 (b) Home and community-based services covered under the presumptive eligibility determination
22 as provided for in this section include the following:
23 (i) personal care services;
24 (ii) meal delivery;
25 (iii) personal emergency response systems;
26 (iv) medical equipment and supplies;
27 (v) assistive or adaptive technology; and
28 (vi)other services necessary to successfully transition a patient from a hospital to the - 2025
69th Legislature 2025 SB0072.2
- 2 - Authorized Print Version – SB 72
1 community or stabilize a patient within the community to prevent hospitalization. HOME AND COMMUNITY-BASED
2 DEPARTMENT'S AND COMMUNITY FIRST CHOICE
3 TO SUCCESSFULLY
4.
5 (2) (a) The screening process may be conducted by staff of:
6 (i) the division of the department that administers long-term care services for senior citizens and
7 individuals with physical disabilities; or
8 (ii) one of the following facilities who have received training and certification from the department
9 to make presumptive eligibility determinations:
10 (A) an area agency on aging or its designated subcontractor;
11 (B) a tribal entity;
12 (C) a hospital or hospital-affiliated facility; or
13 (D) another entity deemed appropriate by the department or the division of the department that
14 administers long-term care services for senior citizens and individuals with physical disabilities.
15 (b) Initial training of staff must be completed before an entity is certified to complete presumptive
16 eligibility determinations, and the certification must be renewed annually.
17 (3) The screening process must include:
18 (a) an application as prescribed by the department;
19 (b) self-attestation that the applicant meets the income, resource, and residency requirements of
20 the Montana medicaid program as prescribed in 53-6-131; and
21 (c) a functional assessment to establish an in-home and community care plan.
22 (4) The applicant or the applicant's representative shall submit an application for ongoing coverage
23 under the Montana medicaid program as provided in 53-6-131 within 10 30calendar days following the
24 applicant's presumptive eligibility determination.
25 (5) The presumptive eligibility period begins on the date the screening is completed and ends on
26 the date a determination of ongoing Montana medicaid program eligibility is made or at the end of the month
27 following the month of the presumptive eligibility determination, whichever is earlier.
28 (6) A person may receive services under a presumptive eligibility determination only once within a - 2025
69th Legislature 2025 SB0072.2
- 3 - Authorized Print Version – SB 72
1 consecutive 12-month period.
2 (7) The applicant does not have a right to an administrative hearing on presumptive eligibility.
3 (8) THE DEPARTMENT MAY PROVIDE TIME EXTENSIONS FOR THE APPLICATION PROCESS AND SERVICE
4(4) AND (5) AND PROVIDE EXCEPTIONS TO THE LIMIT ON AN INDIVIDUAL'S ABILITY TO
5(6) WHEN THE
6
7, INSTITUTIONAL PLACEMENTS, OR HOSPITALIZATIONS.
8 (9) THE DEPARTMENT SHALL SUBMIT TO THE CENTERS FOR MEDICARE AND MEDICAID SERVICES THE
9 SECTION 1115 WAIVER, 1115, 1915() STATE PLAN
10, TO IMPLEMENT THE PRESUMPTIVE ELIGIBILITY PROGRAM DESCRIBED
11.
12
13 NEW SECTION. Section 2. The secretary of state shall send a
14 copy of [this act] to each federally recognized tribal government in Montana.
15
16 NEW SECTION. Section 3. [Section 1] is intended to be codified as an
17 integral part of Title 53, chapter 6, part 4, and the provisions of Title 53, chapter 6, part 4, apply to [section 1].
18 - END -