53-6-1304: Montana HELP Act program -- eligibility for coverage of health care services -- exceptions.

(1) An individual is eligible for coverage of health care services provided pursuant to this part if the individual meets the requirements of 42 U.S.C. 1396a(a)(10)(A)(i)(VIII).

(2) The department may serve individuals who are eligible for medicaid-funded services pursuant to this part through the medical assistance program established in Title 53, chapter 6, part 1, if the individuals would be served more appropriately because the individuals:

(a) have exceptional health care needs, including but not limited to medical, mental health, or developmental conditions;

(b) live in a geographical area, including an Indian reservation, that would not be effectively or efficiently served through this part;

(c) need continuity of care that would not be available or cost-effective through this part;

(d) are exempt under the waiver implementing this part as of July 1, 2019; or

(e) are otherwise exempt under federal law.