1. Program Definition and Services Provided 

Home Health services in Montana are designed to provide medical care and support to individuals in their homes, aiming to prevent or delay institutionalization. These services include skilled nursing, home health aide services, physical therapy, occupational therapy, speech therapy, and medical supplies necessary for care. 

2. Regulations 

Key regulations governing Home Health services include: 

• Mont. Admin. r. 37.40.702: This regulation outlines the requirements for home health agencies, including licensure by the Montana Department of Public Health & Human Services, Medicare certification, and Medicaid enrollment. 

• 42 CFR 440.70: This federal regulation sets forth requirements for home health services, which Montana adopts and incorporates by reference. 

3. Licensing or Certification 

To provide Home Health services, agencies must: 

• Be licensed by the Montana Department of Public Health & Human Services. 

• Be certified by Medicare. 

• Be enrolled as Medicaid providers. 

4. Responsible State Agency 

The Montana Department of Public Health & Human Services (DPHHS) is responsible for licensing and overseeing home health agencies. 

5. Application Process 

The application process involves submitting a license application to DPHHS and obtaining Medicare certification. For Medicaid reimbursement, providers must enroll as Medicaid providers. 

6. Required Documentation 

For licensing: 

• Completed license application 

• Proof of liability insurance 

• Policies and procedures for review and approval 

• Staff qualifications and training records 

For Medicare certification: 

• Compliance with Medicare Conditions of Participation 

• For Medicaid enrollment: 

• Completed Medicaid provider enrollment application 

7. Timeline for Approval 

The timeline for approval can vary, depending on the completeness of the application and compliance with state and federal regulations. 

8. Pre-Application Process 

There is no specific pre-license application process, but providers must ensure they meet all state and federal requirements before applying. 

9. Pre-Application Training 

While not mandated, training in home health care management and compliance with federal regulations can enhance provider expertise. 

10. Additional Notes 

• Home Health services are crucial for supporting individuals in maintaining their independence while receiving necessary medical care. 

• Services are limited to 180 visits within 365 days, with potential for additional visits upon prior authorization.