Rule 37.55.502 - ELIGIBLE SERVICES AND SUPPLIES(1) ESRD will pay for the cost of each of the following services and supplies which remains after all available third-party benefits have been utilized to pay for them: (a) For home or center dialysis: (i) insertion and maintenance of access site;(ii) physician and hospital service for maintenance of home dialysis;(iii) the following medications, not exceeding a 30-day supply: (D) hyperphosphatemia (phosphate binder) drugs;(F) vitamins, iron, and/or folic acid;(G) vitamin D preparations;(J) antibiotics for peritonitis associated with peritoneal dialysis.(b) For home dialysis patients only: (i) training the patient to implement and maintain home dialysis (excluding room, board, and travel expenses) ;(ii) modification of existing plumbing and wiring, at the cost represented by the lowest of three bids submitted to the department, or, if three bidding sources are not reasonably available to the patient, the lowest of those bids available;(iii) for those patients choosing to let a facility provide and maintain dialysis supplies and equipment (medicare method I), the charge per run by that facility;(iv) for those patients choosing to obtain and maintain their own home dialysis supplies and equipment (medicare method II) : (A) rental and/or purchase of dialysis machine and supplies;(B) repairs to dialysis equipment.(c) For a renal transplant patient: (i) preliminary medical work-up for donor/donee match for a dialysis patient who is otherwise program-eligible;(ii) in the case of a cadaveric transplant, if ESRD is notified within 72 hours after the patient is admitted to a hospital for the transplant, transportation of the patient to and from the site where the transplant takes place, at the least expensive commercial rate available for the trip on the day of transplant; the above notification must be by the physician or social worker at either the transplant center or the dialysis facility;(iii) physician and hospital care related to transplant surgery;(iv) the following medications not exceeding a 30-day supply: (v) medical follow-up services which are directly related to maintenance or monitoring of the transplanted kidney.Mont. Admin. r. 37.55.502
NEW, 1984 MAR p. 41, Eff. 1/13/84; AMD, 1987 MAR p. 1790, Eff. 10/16/87; TRANS & AMD, from DHES, 2000 MAR p. 1660, Eff. 6/30/00.Sec. 50-44-102 and 53-6-202, MCA; IMP, Sec. 50-44-102 and 53-6-202, MCA;